The scientific committee (SCENIHR, Standing Committee on Emerging and Newly Identified Health Risks) has been assigned by the European Commission to evaluate the health effects of smokeless tobacco products including Swedish snus. The committee has now presented the final version of its findings to the Commission.
- The committee confirms the significant health benefits of Swedish snus relative to cigarettes. The report therefore constitutes a reevaluation of Swedish snus within the European Union where the product is currently banned, except in Sweden, says Lars E Rutqvist, MD, Ph D, Vice President for Scientific Affairs, Swedish Match AB, Stockholm, Sweden, previously Professor of Oncology at the Karolinska Institute in Stockholm.
- The scientific debate about snus within the EU has come to an end, and the politicians must now decide on whether it is reasonable to continue to deny European smokers access to a dramatically less hazardous alternative to cigarettes, Rutqvist concludes.
The SCENIHR report implies that there is no longer a scientific basis for a continued ban of snus within the European Union because the committee unanimously says that (page references to the report within parentheses):
- Swedish snus has dramatically less adverse health effects than cigarettes (p. 113-114)
- A smoker who switches to snus substantially reduces his or her risk for tobacco-related disease (p. 115-117)
- The availability of snus as a substitute for cigarettes has had positive effects on Swedish public health (p. 116-117)
- Swedish data contradict the hypothesis that snus is a gateway to smoking (p. 108, 116, 121)
It is, however, regrettable that these conclusions from an unanimous committee are not mentioned in the summary of the report which instead concludes that smokeless tobacco products contain nicotine which make them potentially addictive in the same way as cigarettes, that the nitrosamines in tobacco can be carcinogenic, and that the lack of controlled clinical trials of smokeless tobacco as a smoking cessation aid precludes firm conclusions, although it is noted that Swedish snus has been effective among Swedish male smokers (p. 110).
The committee finds it difficult to extrapolate the positive effects of snus on Swedish public health to other European countries. The potential net effect depends on the balance between the number of smokers who are able to quit with the aid of snus, and the number of non-tobacco users who take up snus unnecessarily (that is, smokers who would have quit anyway, or those who would not have used tobacco in any form). Although it is likely that the positive effects of snus on public health probably would be far more prominent (p. 117), the Committee feels that a lifting of the snus ban requires a more strict regulation of the whole tobacco area within the Union.
- It is not unexpected that the report mentions a number of potential negative aspects of smokeless tobacco products, says Rutqvist. Nobody has ever claimed that tobacco in any form is a health product. But what is striking is that the Committee so definitively and unanimously concludes that Swedish snus is dramatically less hazardous to health than cigarettes. This means that the scientific part of the debate about snus in the European Union now has come to an end. The next step is for the politicians decide whether it is reasonable to continue to deny European cigarette smokers access to an alternative that the Union’s own scientific expertise has concluded is much less hazardous. It is absurd that the most dangerous form of tobacco - cigarettes - continues to be freely sold all over the Union whereas the product with the least health effects - Swedish snus - is banned.
- This is probably only the first step in a long political process, says Rutqvist. There are strong forces within the European public health establishment that - irrespective of what the science says about Swedish snus - do not want to change their 30 year old message to the public about smokeless tobacco. But this final report includes so much scientific data about the relative benefits of snus which cannot be ignored in the debate about tobacco and public health. I remain optimistic that many decision-makers will take note of the Committee’s conclusions. Current tobacco policies within Europe are clearly inadequate as more than 700,000 EU citizens die prematurely every year as a result of cigarette smoking, Rutqvist concludes.
For more information:
Lars Erik Rutqvist, medical advisor, Swedish Match AB, Professor, formerly Head of the Department of Oncology, Karolinska University Hospital/Huddinge
Mobile: +46 (0)768 - 788 498, e-mail: firstname.lastname@example.org
Link to the report: