Background: It is well known that Swedish men have lower tobacco-related mortality than men in other European countries, but there are questions that need further investigation to what extent this is related to the specific patterns of tobacco use in Sweden, where use of snus, the Swedish low-nitrosamine oral tobacco, dominates over smoking in men but not in women. The recent WHO Global Report: Mortality Attributable to Tobacco provides a unique set of estimates of the health burden of tobacco in all countries of the world in the year 2004, and these data can help elucidating the above-mentioned questions.
Methods: For Sweden and all other European Union Member States mortality data for a number of tobacco-related causes of death were extracted from the WHO Report. The size of the mortality advantage for selected causes of death in different age groups of Swedish men compared to men of the same age in Europe as a whole was calculated in terms of ratios of death rates attributable to tobacco. Differences between age groups with respect to tobacco-related mortality were analyzed with respect to differences in terms of development and status of smoking and snus use. The analyses also paid attention to differences between countries regarding tobacco control regulations.
Findings: Among men in the European Union Member States the lowest level of mortality attributable to tobacco was consistently found in Sweden, while Swedish women showed levels similar to European average. A strong co-variation was found between the mortality advantage and the degree of dominance of snus use in the different age groups of Swedish men. Among Swedish women there are no age groups with dominant use of snus, and similar observations were therefore not possible for women.
Conclusions: The above findings support the assumption that the widespread use of snus instead of cigarettes among Swedish men may be a major part of the explanation behind their position with Europe’s lowest mortality attributable to tobacco.
REFERENCES(14)
1.
Zatoński W, Przewoźniak K, Sulkowska U, West R, Wojtyła A: Tobacco smoking in countries of the European Union. Ann Agric Environ Med. 2012, 19 (2): 181-192.
World Health Organization: WHO Global Report: Mortality Attributable to Tobacco. 2012, Geneva, Available from: http://www.who.int/tobacco/pub... accessed on 07/08/14.
Statistics Sweden: Use of alcohol and tobacco. Report no 114, Living Conditions. 2007, Stockholm, Available from: http://www.scb.se/statistik/_p... accessed on 07/08/14.
Joossens L, Raw M: The Tobacco Control Scale 2010 in Europe. 2011, Brussels: Association of European Cancer Leagues, Available from: http://www.europeancancerleagu....
Foulds J, Ramström L, Burke M, Fagerström K: Effect of smokeless tobacco (snus) on smoking and public health in Sweden. Tob Control. 2003, 12: 349-359. 10.1136/tc.12.4.349.
Engholm G, Ferlay J, Christensen N, Johannesen TB, Khan S, Køtlum JE, Milter MC, Olafsdóttir E, Pukkala E, Storm HH: NORDCAN: Cancer Incidence, Mortality, Prevalence and Survival in the Nordic Countries, Version 6.1 (25.04.2014). Association of the Nordic Cancer Registries. Danish Cancer Society, Available from: http://www.ancr.nu accessed on 07/08/14.
Levy DT, Mumford EA, Cummings KM, Gilpin EA, Giovino G, Hyland A, Sweanor D, Warner KE: The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts. Cancer Epidemiol Biomarkers Prev. 2004, 13: 2035-2042.
Gartner CE, Hall WH, Vos TH, Bertram MY, Wallace AL, Lim SS: Assessment of Swedish snus for tobacco harm reduction: an epidemiological modelling study. Lancet. 2007, 369: 2010-2014. 10.1016/S0140-6736(07)60677-1.
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA): Harm reduction: evidence, impacts and challenges. EMCDDA scientific monograph No.10. 2010, Lisbon: EMCDDA.
Galanti MR, Rosendahl I, Wickholm S: The development of tobacco use in adolescence among “snus starters” and “cigarette starters”: An analysis of the Swedish “BROMS” cohort. Nicotine Tob Res. 2008, 10: 315-323. 10.1080/14622200701825858.
Stenbeck M, Hagquist C, Rosén M: The association of snus and smoking behaviour: a cohort analysis of Swedish males in the 1990s. Addiction. 2009, 104: 1579-1585. 10.1111/j.1360-0443.2009.02661.x.
Perceived Health Risks of Snus and Medicinal Nicotine Products Dorothy K. Hatsukami, R. I. Vogel, Herb H. Severson, Joni A. Jensen, Richard J. O’Connor Nicotine & Tobacco Research
The Case for Requiring Graphic Warning Labels on Smokeless Tobacco Product Packages Smita Pakhale, Jonathan Samet, Patricia Folan, Frank Leone, Alexander White Annals of the American Thoracic Society
Interventions to reduce harm from continued tobacco use Nicola Lindson-Hawley, Jamie Hartmann-Boyce, Thomas R Fanshawe, Rachna Begh, Amanda Farley, Tim Lancaster Cochrane Database of Systematic Reviews
Patterns of Smoking and Snus Use in Sweden: Implications for Public Health Lars Ramström, Ron Borland, Tom Wikmans International Journal of Environmental Research and Public Health
Carbonyl Emissions in E-cigarette Aerosol: A Systematic Review and Methodological Considerations Konstantinos E. Farsalinos, Gene Gillman Frontiers in Physiology
Randomised clinical trial of snus versus medicinal nicotine among smokers interested in product switching Dorothy K Hatsukami, Herbert Severson, Amanda Anderson, Rachael Isaksson Vogel, Joni Jensen, Berry Broadbent, Sharon E Murphy, Steven Carmella, Stephen S Hecht Tobacco Control
E-cigarettes: Comparing the Possible Risks of Increasing Smoking Initiation with the Potential Benefits of Increasing Smoking Cessation Kenneth E Warner, David Mendez Nicotine & Tobacco Research
Differential Taxes for Differential Risks — Toward Reduced Harm from Nicotine-Yielding Products Frank J. Chaloupka, David Sweanor, Kenneth E. Warner New England Journal of Medicine
Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis José Manuel Aburto, Maarten Wensink, Alyson van Raalte, Rune Lindahl-Jacobsen BMC Public Health
Determination of thermal degradants in e-cigarette fluid via direct sample introduction (DSI) gas chromatography-tandem mass spectrometry Kevin J. Bisceglia, Sahar Caravan, Keegan Rogers, Ling Huang Analytical Methods
Physical and mental health burden in cases of bipolar disorder classified as current, former, or non-tobacco smokers R. Icick, S. Gard, M. Barde, M. Carminati, A. Desage, S. Guillaume, J. Scott, F. Bellivier Journal of Affective Disorders
Nicotine vaping products as a harm reduction tool among smokers: Review of evidence and implications for pharmacy practice Daniel Erku, Coral Gartner, Kylie Morphett, Centaine Snoswell, Kathryn Steadman Research in Social and Administrative Pharmacy
Dependence on nicotine in US high school students in the context of changing patterns of tobacco product use Sarah Jackson, Jamie Brown, Martin Jarvis Addiction
Regulatory Approaches and Implementation of Minimally Addictive Combusted Products Dorothy Hatsukami, Dongqun Xu, Wayne Ferris Nicotine & Tobacco Research
Introducing a Novel Biorelevant In Vitro Dissolution Method for the Assessment of Nicotine Release from Oral Tobacco-Derived Nicotine (OTDN) and Snus Products Matthias Knopp, Nikolai Kiil-Nielsen, Anna Masser, Mikael Staaf Separations
Estimated Public Health Gains From Smokers in Germany Switching to Reduced-Risk Alternatives: Results From Population Health Impact Modelling by Socioeconomic Group Romana Rytsar, Smilja Djurdjevic, Alexander Nussbaum, Ashok Kaul, Emanuel Bennewitz, Peter Lee, John Fry Contributions to Tobacco & Nicotine Research
Estimating the public health impact had tobacco-free nicotine pouches been introduced into the US in 2000 Peter Lee, John Fry, Tryggve Ljung BMC Public Health
Estimated Public Health Gains From German Smokers Switching to Reduced-Risk Alternatives: Results From Population Health Impact Modelling Romana Rytsar, Smilja Djurdjevic, Alexander Nussbaum, Ashok Kaul, Emanuel Bennewitz, Peter Lee, John Fry Contributions to Tobacco & Nicotine Research
Trends in Tobacco Use among 9th Graders in Sweden, 1991–2020 Jonas Raninen, Isabella Gripe, Martina Zetterqvist, Mats Ramstedt International Journal of Environmental Research and Public Health
Chemical Characterization of Indian Smokeless tobacco products by spectroscopy, chromatography, and allied techniques: Interproduct Variation Nilesh Jain, Reena Jhamtani, Shilpa Gupta, SV Varman
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.