Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden

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Oral presentation by Lars Ramström at the 13th World Conference on Tobacco OR Health Washington, DC, USA, July 12-15, 2006

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Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden

  1. 1. Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden Lars Ramström Institute for Tobacco Studies Stockholm, Sweden Presentation at The 13th World Conference on Tobacco OR Health Session: Swedish Snus: Panacea or Pandora's Box? Saturday, 15 July 2006: 10:30 AM-12:00 PM
  2. 6. Does primary snus use make young people more likely to start smoking???
  3. 9. Does snus use favour smoking cessation???
  4. 11. QUIT RATE (Proportion of ”Ever daily smokers” having quit completely) <ul><li>All men 59% All women 49% </li></ul><ul><li>Men WITHOUT a history of daily snus use 51% Women WITHOUT a history of daily snus use 48% </li></ul><ul><li>Men WITH a history of daily snus use 72% Women WITH a history of daily snus use 71% </li></ul><ul><li>All WITHOUT a history of daily snus use 49% All WITH a history of daily snus use 72% </li></ul>
  5. 13. How hazardous is snus to health???
  6. 16. Possible scenario without snus <ul><li>According to Peto et al (2006)* there were 4678 deaths attributed to smoking among men in Sweden in the year 2000. * http://www.ctsu.ox.ac.uk/~tobacco/index.htm </li></ul><ul><li>Adopting the calculation that, in the absence of snus use, the prevalence of daily smoking would have been 1.28 times as high as now… </li></ul><ul><li>and assuming that the number of smoking-attributed deaths would then also have been 1.28 times as high, i.e. 5988 … </li></ul><ul><li>it may be suggested that male snus use in Sweden has been preventing more than one thousand deaths annually around the year 2000. </li></ul>
  7. 17. Summary of evidence from Sweden <ul><li>Primary snus users are less likely so start smoking. </li></ul><ul><li>Increasing primary snus use has been associated with even larger decrease of onset of daily smoking. </li></ul><ul><li>Secondary snus use is associated with attempts to quit smoking. </li></ul><ul><li>Both in men and women are quit-smoking-rates higher in those with than in those without a history of daily snus use. </li></ul><ul><li>Snus is a commonly used smoking cessation aid in men. </li></ul><ul><li>Both in men and women is snus more efficient as smoking cessation aid than nicotine gum or patch. </li></ul><ul><li>The use of snus appears to have decreased the number of deaths attributed to tobacco use. </li></ul>
  8. 18. What is snus? <ul><li>A panacea? No. </li></ul><ul><li>A Pandora’s box? No. </li></ul><ul><li>A useful toolbox for Yes . In Sweden it has contributed Harm Reduction? to health beneifts in spite of wide- spread misbeliefs exaggerating its toxicity. Further efforts are needed for regulation and education to make sure that only the best possible products are available, through responsible channels, to a well informed public. </li></ul>

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