Smoking cessation

  • There is a growing body of evidence that using Swedish snus can help some people quit smoking.
  • Most cigarette smokers want to quit smoking, but few are able to do so. Many smokers say they need help to be able to succeed in quitting.
  • Smoking rates among Swedish men have declined significantly over time as snus use has increased, suggesting that snus might be responsible for this decline.
  • Epidemiology studies have shown that snus can serve as an effective smoking cessation aid, particularly among Swedish men.
  • There are many benefits associated with using snus to quit smoking. There are also some public health implications, and some people have raised concerns that there could be unintended consequences.

Why would anyone consider using snus to quit smoking?

The vast majority of cigarette smokers want to quit smoking, and most who want to quit say they need help to do so, but only about 2% manage to quit each year (USDHHS 2000). Most believe they need support to be successful in quitting (Bolinder 2003). There is obviously a need for any method, especially an informal one, by which an addicted cigarette smoker could quit smoking.

What evidence is there that the use of snus can lead to quitting smoking?

The pattern of smoking seen in Sweden over time is very different from that of other countries. During the past 20 years, smoking declined markedly while use of snus became more popular, especially among men. This striking inverse relationship suggested that Swedish men may have been using snus to quit smoking. An epidemiology study that specifically examined this hypothesis found that snus use was associated with smoking cessation (Furberg et al. 2005).

There is also evidence that the general public in Sweden recognizes that the use of snus as a simple and uncomplicated way to quit smoking. Surveys show that many smokers stopped smoking when they started using snus (TEMO 2004). In addition, there is evidence that people who use snus are more likely to be successful in quitting smoking than those who use other aids, such as nicotine gum or the nicotine patch (Ramström and Foulds 2006). Ultimately, additional data from the most rigorous studies (called controlled clinical trials) is needed to demonstrate that snus is an effective aid in quitting smoking.

What are the benefits of using snus to quit smoking?

There are several important benefits: snus is available without prescription, may be less expensive than traditional nicotine replacement therapies, and is associated with an immediate reduction in the health risks attributed to smoking. A quantitative analysis recently confirmed that the health risks associated with snus use are significantly lower than those associated with smoking (Roth et al. 2005).

Are there any risks to using snus to quit smoking?

There is some debate in the public health community about advocating using snus to quit smoking. Critics fear that there could be unintended consequences and argue that the only risk-free solution is to quit all tobacco products.

However, given the significant health hazards of long-term smoking, and the need for effective smoking cessation tools, many people believe that it is important to continue to investigate the potential use of snus as a smoking cessation aid. 

 

REFERENCES
Bolinder, G. 2003. Swedish snuff: A hazardous experiment when interpreting scientific data into public health ethics. Addiction 98:1201-1204.
Furberg, H., Bulik, C.M., Lerman, C., Lichtenstein, P., Pedersen, N.L., and Sullivan, P.F. 2005. Is Swedish snus associated with smoking initiation or smoking cessation? Tobacco Control 14:422-424.
Ramström, L.M. and Foulds, J. 2006. Role of snus in initiation and cessation of tobacco smoking in Sweden. Tobacco Control 15:210-214.
Roth, H.D., Roth, A.B., and Liu, X. 2005. Health risks of smoking compared to Swedish snus. Inhal. Toxicol. 17:741-748.
TEMO 2004. A word to the consumer. Basic tobacco consumption data. Study commissioned by Swedish Match.
U.S. Department of Health and Human Services. 2000. Reducing tobacco use: A report of the Surgeon General 2000. At a glance.