Stroke
Summery
Stroke (brain infarction and cerebral haemorrhage) is another form of vascular disease. The relationship between the risk of stroke and snus use has been explored in two epidemiologic studies, one cohort study and one case-control study.
Important research results on Swedish snus:
- Whereas regular smoking doubles the risk of stroke in men, snuff use is not associated with any apparent excess risk.
In a cohort study comprising Swedish construction workers the relationship between snus use and a number of different cardiovascular diseases including stroke was investigated (Bolinder et al., 1994). The results showed that snus use did not increase the risk of stroke in men in either of the age groups 35-45 years or 55-65 years. In a recently published case-control study Asplund et al. (2003) used prospective data from two cohort studies. This study comprised 276 men aged 25-74 years, who had had their first stroke and 551 matched controls, who did not suffer from any cardiovascular disease. There was no excess risk of stoke among snus users, who were never smokers. By contrast, smokers had higher risk than non-tobacco users. One conclusion was that snus use is associated with considerably lower risk of cardiovascular disease than smoking. The increased risk among cigarette smokers can be explained by exposure to the combustion products generated on smoking.
REFERENCES Bolinder, G., Alfredsson, L., Englund, A., and de Faire, U. 1994. Smokeless tobacco use and increased cardiovascular mortality among Swedish construcion workers. Am. J. Public Health 84:399-404. Asplund, K., Nasic, S., Janlert, U., and Segmayr, B. 2003. Smokeless tobacco as a possible risk factor for stroke in men. A nested case-control study. Stroke 34: 1-6.