Snuff – how dangerous is it? The controversy continues

Asplund, Kjell

doi:10.1046/j.1365-2796.2001.00918.x

Cited by 21 publications

(24 citation statements)

References 50 publications

(60 reference statements)

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“…In Sweden, smokeless tobacco is now prepared without traditional smoke drying, whereas in the United State snuff is produced by fermentation, resulting in differences in the content of tobacco-specific nitrosamines. 1 In countries in which snuff is homemade or various additives are used, snuff may contain exceedingly high concentrations of tobacco-specific nitrosamines. 1…”

Section: Smoking Versus Snuffing: Possible Mechanismsmentioning

confidence: 99%

“…In contrast, use of smokeless tobacco is endemic, largely restricted to certain geographical areas such as North America, the Scandinavian countries, India, Bangladesh, southeast Asia, and parts of Africa. 1 Of the commercially available forms of smokeless tobacco, snuff is probably the most widespread. It constitutes pulverized tobacco that is most often moist and taken orally, either in a loose form or in tea bag-like small packages (sachets) placed between the gum and the chin or under the upper lip.…”

mentioning

confidence: 99%

“…1 Three studies performed in Sweden have consistently demonstrated a much lower risk of myocardial infarction and sudden death among snuff users than among cigarette smokers. [2][3][4] Whereas no excess risk at all for myocardial infarction was observed in snuff users in 2 of the studies, 2,4 the third study showed a 40% higher risk of cardiovascular death in snuff dippers compared with nonusers of tobacco.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Smokeless Tobacco as a Possible Risk Factor for Stroke in Men

Asplund

Nasic

Janlert

et al. 2003

Stroke

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Background and Purpose-Snuff and other forms of smokeless tobacco are widely used in some populations. Whereas the detrimental cardiovascular effects of smoking are well documented, possible health hazards associated with the use of smokeless tobacco remain controversial. The purpose of this study was to explore whether the use of snuff, a smokeless tobacco product, increases the risk of stroke in men. Methods-In a nested case-control study (1 case and 2 matched controls without cardiovascular disease), information on tobacco habits was collected through population risk factor surveys. During follow-up, first-ever fatal and nonfatal strokes occurring among 25-to 74-year-old participants were identified in a population-based stroke register. The study was restricted to men (276 cases, 551 controls). Results-The unadjusted odds ratio for stroke in regular cigarette smokers compared with men who never used tobacco was 2.21 (95% CI, 1.29 to 3.79). When never-smoking regular snuff dippers (excluding ex-smokers) were compared with men who never used tobacco, the unadjusted odds ratio was 1.05 (95% CI, 0.37 to 2.94). The odds ratio for never-snuffing smokers versus never-smoking snuff users was 2.90 (95% CI, 0.92 to 9.1). After adjustment for multiple cardiovascular risk factors, the odds ratio for having a stroke was 1.

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Section: Smoking Versus Snuffing: Possible Mechanismsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Smokeless Tobacco as a Possible Risk Factor for Stroke in Men

Asplund

Nasic

Janlert

et al. 2003

Stroke

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“…Schwedischer Mundtabak wird heutzutage z. B. nicht wie der amerikanische Mundtabak einem Fermentationsprozess unterzogen, sondern durch Hitzebehandlung ohne Rauchtrocknung hergestellt.Es resultiert ein semisteriles Produkt mit einem geringeren Gehalt an polyzyklischen aromatischen Kohlenwasserstoffen und tabakspezifischen Nitrosaminen [5]. Schwedische Studien fanden kein [28] oder nur ein gering erhöhtes Risiko [20] für orale Karzinome bei Konsumenten von schwedischem Mundtabak (Tabelle 1).…”

Section: Erhöhtunclassified

“…der Nasennebenhöhlen nachgewiesen werden. Unabhän-gig von einer möglichen krebsrisikosteigernden Wirkung führt der Konsum von rauchlosen Tabakprodukten zu einer Nikotinaufnahme, die vergleichbar der eines Rauchers ist und ähnliche Risiken im Hinblick auf Herz-und Kreislauferkrankungen mit sich bringt [5]. Abschließend muss man feststellen, dass der Konsum rauchloser Tabakprodukte höchstwahrscheinlich nicht nur das Krebsrisiko erhöht, sondern darüber hinaus zu einer Abhängkeit füh-ren und v. a. bei Jugendlichen eine Rolle als "Einstiegsdroge" für eine spätere Raucherkarriere spielen kann [5].…”

Section: Risiken Bei Regelmäßigem Schnupftabakkonsumunclassified

Krebs durch Schnupftabak?

Pfaue

Tisch

Maier

2003

HNO

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Der deutsche Schnupftabak wurde zusammen mit den verschiedenen Mundund Kautabaksorten unter der Rubrik "Tabakerzeugnisse ohne Verbrennung" geführt und musste ab 1998 zusätzlich zu dem allgemeinen Hinweis "Die EUGesundheitsminister: Tabak gefährdet die Gesundheit" mit dem Warnhinweis "Verursacht Krebs" versehen werden., Inwieweit sind rauchlose Tabakprodukte krebserregend, und können sie hinsichtlich ihres gesundheitsschädigen-den Potenzials, v. a. im Hinblick auf das Krebsrisiko, miteinander verglichen werden? Was sind rauchlose Tabakprodukte?Unter dem Begriff "rauchlose Tabakprodukte" werden Tabakarten zusammengefasst, die sowohl oral als auch nasal konsumiert und dabei nicht verbrannt werden, wie Schnupftabak oder Mundund Kautabak. Die englische Überset-zung für Schnupftabak ist "snuff".Im angloamerikanischen Sprachraum versteht man allerdings unter dem Begriff "snuff" heute in erster Linie Mundtabak; der orale Konsum wird als "snuff dipping" bezeichnet. Unter "sniffing" versteht man dagegen die fast ausschließlich in Deutschland gebräuchliche nasale Verwendung in Form von Schnupftabak.Beim Schnupfen einer Prise werden 0,1-0,2 g Schnupftabak in die Nase eingebracht und nach einer Verweildauer von 3-5 min wieder ausgeschnäuzt. Der durchschnittliche Verbrauch pro Tag wird auf 2-10 g geschätzt. Bei einem Konsum von 2 g deutschen Schnupftabak werden etwa 14 mg Nikotin aufgenommen. Vergleichbare Werte werden beim Rauchen von 20 Filterzigaretten erreicht [25].

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Use of snus and acute myocardial infarction: pooled analysis of eight prospective observational studies

et al. 2012

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The use of snus (also referred to as Scandinavian or Swedish moist smokeless tobacco), which is common in Sweden and increasing elsewhere, is receiving increasing attention since considered a tobacco smoke "potential reduction exposure product". Snus delivers a high dose of nicotine with possible hemodynamic effects, but its impact on cardiovascular morbidity and mortality is uncertain. The aim of this study was to investigate whether snus use is associated with risk of and survival after acute myocardial infarction (AMI). Data from eight prospective cohort studies set in Sweden was pooled and reanalysed. The relative risk of first time AMI and 28-day case-fatality was calculated for 130,361 men who never smoked. During 2,262,333 person-years of follow-up, 3,390 incident events of AMI were identified. Current snus use was not associated with risk of AMI (pooled multivariable hazard ratio 1.04, 95 % confidence interval 0.93 to 1.17). The short-term case fatality rate appeared increased in snus users (odds ratio 1.28, 95 % confidence interval 0.99 to 1.68). This study does not support any association between use of snus and development of AMI. Hence, toxic components other than nicotine appear implicated in the pathophysiology of smoking related ischemic heart disease. Case fatality after AMI is seemingly increased among snus users, but this relationship may be due to confounding by socioeconomic or life style factors.

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Snuff – how dangerous is it? The controversy continues

Cited by 21 publications

References 50 publications

Smokeless Tobacco as a Possible Risk Factor for Stroke in Men

Smokeless Tobacco as a Possible Risk Factor for Stroke in Men

Krebs durch Schnupftabak?

Use of snus and acute myocardial infarction: pooled analysis of eight prospective observational studies

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