Comparison Between Different Pathways of Tobacco Use in Sweden – Implications for the Prevention of Tobacco Induced Diseases

Oral presentation by Lars Ramström at the 6th Annual Conference of ISPTID, Little Rock, Arkansas, 2-4 November, 2007

Health & Medicine

Comparison Between Different Pathways of Tobacco Use in Sweden – Implications for the Prevention of Tobacco Induced Diseases Lars M. Ramström Institute for Tobacco Studies Stockholm, Sweden 6th Annual Conference of ISPTID, Little Rock, Arkansas, 2-4 November, 2007

SNUS (moist oral snuff) in portion packages or loose

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Ever-Daily-Smokers who have tried to quit smoking. Percentage having used different cessation aids at latest quit attempt. Source: FSI/ITS surveys 2003-2006 61% 57% No particular aid 2% 2% Other combination 4% 2% Gum and patch 2% 1% Bupropion only 4% 3% Other single aid 1% 1% Snus and gum 5% 21% Snus only 8% 5% Nicotine patch only 12% 7% Nicotine gum only WOMEN (n=5388) MEN (n=4528) Category of aid

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The document discusses the role of harm reduction in tobacco control. It argues that for current tobacco users who cannot quit, switching to a nicotine product that is markedly less harmful than cigarettes, such as nicotine replacement therapy or low-nitrosamine smokeless tobacco, can significantly reduce health risks compared to continuing smoking. While prevention and smoking cessation efforts are important, harm reduction strategies are also needed to help smokers unable or unwilling to quit nicotine use altogether. Regulating alternative nicotine products to ensure they are much safer than cigarettes can achieve public health benefits as part of a comprehensive approach to tobacco control.

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The document discusses tobacco harm reduction through the use of low-toxicity smokeless tobacco products like Swedish snus. It summarizes evidence from Swedish population studies that finds little risk of snus leading to smoking, strengthening nicotine addiction, or weakening smokers' efforts to quit. The evidence suggests that snus use can substantially reduce tobacco-related disease risk and that some smokers who switch to snus do subsequently quit nicotine altogether. There is little scientific evidence to support arguments against tobacco harm reduction and good evidence to reject such arguments.

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