News; Aug 15, 2007 CET

Further step toward new view of snus

That snus is a significantly less harmful alternative to cigarettes is a viewpoint that is gaining a stronger foothold in the scientific community. One example is the scientific committee that recently evaluated the health effects of smokeless tobacco on behalf of the EU. In the May issue of the respected magazine, The Lancet, two scientists demanded that snus should be allowed where it is prohibited today.

It was the scientific committee, Standing Committee on Emerging and Newly Identified Health Risks (SCENIHR), that received the assignment from the EU Commission to investigate the health risks of smokeless tobacco products, including Swedish snus. The committee presented a preliminary report at the beginning of July, which is also based on a review of a large number of scientific studies and reports, and particular attention was paid to Swedish experience of snus.

The committee states that, while smokeless tobacco contains nicotine, which is addictive, and other health risks cannot be excluded, the committee nevertheless subscribes to the Harm Reduction perspective, meaning that Swedish snus holds a unique position among smokeless tobacco products. It is significantly less harmful than cigarettes and there are major health gains for smokers exchanging cigarettes for snus.

"Hopefully, this can be the first step toward a reassessment of Swedish snus within the EU," says Lars-Erik Rutqvist, Vice President, Scientific Affairs within the Swedish Match Group.

This is also recommended by two reputable American tobacco researchers, Jonathan Foulds and Lynn Kozlowski. In an editorial in the May issue of the respected medical magazine, The Lancet, they wrote: "It is a perverse public-health policy that makes an addictive drug (tobacco) widely available in its most harmful form (cigarettes), yet bans or fails to properly inform consumers of the availability of that drug in a much less harmful form (snus)."

Lars-Erik Rutqvist, who is a cancer specialist and professor of oncology, welcomes the acknowledgement published in The Lancet. "It is a historic event. A medical magazine, least of all such a respected magazine as The Lancet, has never before expressed in an editorial that a tobacco product could be good for public health. It is completely unique and a clear political standpoint."

Current regulations are unreasonable

Lars-Erik Rutqvist believes that SCENIHR's report and The Lancet's position should have consequences in quite a number of areas. In particular, political decision makers should be influenced and the EU's ban on snus should be lifted and replaced by factual, scientifically based demands on the content of smokeless products, according to Rutqvist.

"This would lead to a ban on some other smokeless products that are sold within the EU today, but not on Swedish snus, which is presently prohibited. This proves that the regulations currently applicable are completely unreasonable."

At the same time, he is well aware that the road to lifting the ban on snus will be long and politically complicated. In large parts of the EU's public health establishment, there is a strong reluctance to change policies that have been in effect for the past 30 years. He believes that this also applies to the Swedish National Institute of Public Health.

"The National Institute of Public Health should be pragmatic and regard snus as an important feature in public health work instead of ideologically concentrating on the fact that snus is addictive. It is also strange that all energy is focused on snus, when there are still more Swedes that smoke than use snus."

He believes that the consequence is that Swedes in general are misinformed by the authorities. "There seems to be an element of fear of changing society's tobacco policies, at the risk of `losing credibility´. I believe the opposite; credibility is at risk when more and more data contradicts government information. Sooner or later people will begin to realize that they are being misinformed."

Clear picture

In recent years, new scientific reports on snus have been published on a regular basis. "This will probably continue," emphasizes Rutqvist. "But all this new research will not change the big picture: everyone is now aware that the risk associated with snus is dramatically lower than that related to cigarettes. My colleague Freddi Lewin and I have had this opinion for more than ten years and it was considered extremely politically incorrect by some. It is very gratifying that The Lancet is now saying the same thing."