• 5/28/2007
  • web-based article
  • David Holmes
  • Nature Reviews Cancer 7, 406 (June 2007)

An oral smokeless tobacco known as snus is continuing to stir up controversy, after two new articles published in the Lancet found that although snus users did not experience an increased risk of lung or mouth cancer compared with people who had never smoked, they were twice as likely to develop pancreatic cancer.

The first study, led by Coral Gartner of the University of Queensland in Australia, modelled the potential effect of snus if it were to be introduced in Australia, and found that there would be little difference in health-adjusted life expectancy between smokers who gave up all tobacco and those who switched to snus, concluding that, “Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers” (http://www.medicalnewstoday.com, 10 May 2007).

The second study, led by Olaf Nyrén of the Karolinska Institutet in Sweden, was more cautionary. Snus is widely used in Sweden, so the authors surveyed around 280,000 Swedish construction workers on their tobacco consumption from 1978 to 1992, and then followed them until 2004. They found that although snus use did not increase the risk of lung or mouth cancer, those who used snus had double the risk of developing pancreatic cancer.

Whether or not the net effect of snus is positive or negative has been a contentious issue for some time. Nyrén stresses that, “We don’t only need reliable and accurate measures of the risks of both smoking and taking snus, we also need to know the effects of other, alternative methods to cut smoking. We also have to be certain that an increase in snus marketing will not cause addictions in young people who otherwise wouldn’t have started to smoke” (http://www.sciencedaily.com, 11 May 2007).