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What is snus?

Snus, pronounced snoos, is a smokeless form of tobacco which is produced and used essentially only in Norway and Sweden. Snus is typically placed under the upper lip, either as loose tobacco, lössnus or in prepackaged small bags, portionsnus. It is kept in place for an average of 20 minutes delivering a steady stream of nicotine. Unlike the form of chewing tobacco used in North America, snus does not require spitting. It also differs from regular tobacco in that it is steam cured rather than flue cured. This results in lowers levels of carcinogens such as nitrosamines. On the other hand, snus contains higher levels of nicotine.

Snus made the news lately when it was announced that Imperial Tobacco, Canada's largest tobacco manufacturer, is test marketing the product for possible introduction in the country. Given the increased restriction on smoking in public places snus would offer the company a new avenue for its product. But does snus represent less of a health risk than smoking? It is true that in Sweden where 25% of men use snus regularly , and less than 15% smoke, the lung cancer rate in men is among the lowest in the world. Among Swedish women, where snus is not as widely used, the lung cancer rate is significantly higher.

To answer the health question, the New Zealand health agency reviewed systematically all the literature on the known effects of snus. The findings published in February 2007 (NZHTA Report 10) offer a mixed bag. When compared to smoking, the use of snus appears to be associated with a lower overall cancer risk. Also, there does not seem to be an increased risk for lung or mouth cancer when compared to non-tobacco users. However snus users are twice are likely to develop pancreatic cancer when compared to non-tobacco users. However, snus users are less likely to contract pancreatic cancer than tobacco smokers. The investigators also reported that a large study of Swedish construction workers found a 40% increased risk of death from cardiovascular disease and strokes among snus users when compared to non-tobacco users. This can be explained by the high levels of nicotine found in snus which among other effects, decreases oxygen to the heart and increases heart rate and blood pressure.

Snus use could be justified if it were to lead to eventual tobacco cessation. However the Swedish experience suggests that this is not the case. Snus users just replace one form of nicotine addiction by another. 

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