News; May 9, 2007 10:00 AM CET

Lancet: Snus positive for public health

Bans on snus or overstated propaganda against the product are not a sound public-health policy, since cigarette smoking is the overshadowing health problem. This is the conclusion reached in today's issue of the respected medical journal The Lancet.

Today, The Lancet published two scientific studies on the public-health effects of Swedish moist snuff ("snus"). The studies are examined in a leading article by two of the US's most respected tobacco researchers.

Same health gain for smoking cessation with moist snuff

In the Australian study (Gartner et al, 2007) the authors conclude that access to snus would bring substantial public-health gains in countries where the product is not used today. They find, for example, that smoking cessation, whether it is achieved with the aid of snus or by some other means, brings about roughly the same health gains. The authors conclude that this motivates a more positive attitude to snus as an aid to smoking cessation.

Smoking causes major cancer risk, but not snus

The second article contains an analysis of the risk of contracting three smoking-related forms of cancer among participants in the Swedish Construction Worker Survey: lung cancer, oral cavity cancer and cancer of the pancreas (Luo et al, 2007). There was no increase in the incidence of either lung cancer of oral cavity cancer among users of snus. On the other hand, the authors found that there was a doubling of the risk of cancer of the pancreas among non-smoking construction workers who stated that they used snus, compared with those who neither used snus nor smoked cigarettes. However, the risk increase was less for snus than for cigarettes.

Dramatic differences in health risk

The American tobacco researchers Jonathan Foulds and Lynn Kozlowski comment on the Lancet articles in an Editorial. They take the view that the results support the use of snus in countries where smoking is common. They also believe that public-health representatives should give the general public correct information about the dramatic difference in health risks between smoking and snus. The background is that a large percentage of the population in most countries, including Sweden, labor under the misapprehension that the use of smokeless tobacco products, such as snus, involves approximately the same health risks as smoking. They conclude their Editorial by stating that bans on snus or overstated propaganda against it are not sound public-health policy, since cigarette smoking is the overriding health problem.

Significant step for combating smoking

"This is a significant step forward for research on how to combat the harmful effects of smoking," says Lars Erik Rutqvist, medical spokesman for Swedish Match AB, oncologist and former Professor of Oncology at the Karolinska Institute in Stockholm.

"This provides grounds for a more responsible and evidence-based attitude to tobacco-related issues, particularly in Sweden, where the availability of snus has proved to be an effective tool for limiting the harmful effects of smoking, despite vociferous resistance from a small group of aggressive snus opponents," says Rutqvist.

Cancer of the pancreas halved - despite increased use of snus

"It is unlikely that the results regarding cancer of the pancreas from the Swedish Construction Worker Survey are an accurate reflection of the effects of snus," says Freddi Lewin, also a medical spokesman for Swedish Match and oncologist.

"The risk of being affected by this form of cancer has been cut in half in Sweden since the mid-1980s, simultaneously as the use of snus has increased substantially. This suggests that snus, unlike smoking, is not a significant risk factor. There are sources of error in all epidemiological studies, including this one. Swedish results in this area point in different directions, but we naturally welcome all additional knowledge that can help to clarify the issue," concludes Lewin.


Foulds J., Kozlowski L. "Snus - what should the public health response be? The Lancet, online publication, May 10, 2007.

Gartner C. E., Hall W. D., Vos T., et al. "Assessment of Swedish snus for tobacco harm reduction: an epidemiological modeling study. The Lancet, online publication, May 10, 2007.

Luo J., Ye W., Zendehdel K., et al. Oral use of Swedish moist snuff (snus) and risk of cancer of the mouth, lung and pancreas in male construction workers: a retrospective cohort study. The Lancet, online publication, May 10, 2007.

For more information, contact:

Lars Erik Rutqvist, specialist in cancer-related illnesses and former Professor of Oncology, Karolinska Institute, Stockholm Medical spokesman for Swedish Match AB Tel.
+46 8-658 02 43, mobile +46 76-878 84 98, e-mail