The relationship of snus use to diabetes and allied conditions

Abstract

A recent meta-analysis reported smoking to be associated with a 37% higher risk of type 2 diabetes in current smokers, rising to a 57% increase in heavy smokers, which declines on quitting. If the increase results from nicotine exposure, it is possible that using Swedish moist snuff ("snus"), which provides at least equivalent nicotine doses, might also increase diabetes risk. Following a recent publication reporting pooled results from five cohorts, we present a detailed meta-analysis of data from 18 studies. Based on covariate-adjusted estimates, no significant increased risk was seen in never smokers with RRs (95% CIs) of 1.08 (0.86-1.34), 0.93 (0.79-1.11) and 1.05 (0.94-1.18) for current, former and ever snus users. Significant increases were also not seen in the whole population, the corresponding RR estimates being 1.18 (0.94-1.48), 0.69 (0.49-0.96) and 0.95 (0.81-1.11). Nor was there an association of snus use with related endpoints, such as impaired glucose tolerance. However, dose-response analyses showed a relationship, with the highest levels of snus exposure associated with a diabetes RR of 1.65 (1.25-2.18) in never smokers. The evidence relating snus to type 2 diabetes is somewhat limited, requiring further studies to confirm any possible relationship.

Effect of Tobacco Chewing on Metabolic Risk Factors in North Indian Adult Males

“…These current results are consistent with previously published research that showed chewing tobacco increases insulin sensitivity and hyperinsulinemia, which raises the chance of developing diabetes mellitus (14,15,17,18). A few research, however, reported the opposite results (19,20).…”

Smokeless Tobacco Use and Its Association with Type 2 Diabetes: A Case Control Study

“…It is similar to another Swedish study that discovered excessive snus intake was independently associated with metabolic syndrome even after adjusting for smoking (Norberg et al, 2006). However, the contrary findings were found in the study conducted by Lee and Thornton (2017); Eliasson et al, (2004); Rasouli et al, (2017) and Rooban et al, (2010) where they reported that use of smokeless tobacco does not increase risk of T2DM.…”

Smokeless tobacco consumption and its association with risk factors of chronic kidney disease in rural and peri-urban Bangladesh

“…Hypertension and CKD are closely intertwined pathophysiological states; sustained hypertension can lead to the development and progression of end-stage CKD, and conversely, a decline in renal function can lead to the development of hypertension. The association of SLT consumption with type 2 diabetes mellitus has been explored in several studies, and no significant association with a higher risk of diabetes has been reported 32 , although the pathophysiology of this disorder in relation to SLT consumption is yet to be described.…”