Sweden is known for giving the world products such as IKEA, volvo, smorgasbords and even meatballs, and if their next health experiment pulls off, they might also be the ones to provide us with an effective therapy to stop smoking.

Their answer to the smoking problem is “Snus” (rhymes with goose). Snus or smokeless tobacco is being endorsed by the Swedish public health system as a better option to smoking. It is a form of chewed tobacco (also known as “snuff” or “spit tobacco”), but unlike chewing tobacco, snus does not require spitting - thus adding to its popularity. Like NRPs, it removes the risk of inhaled smoke while providing the same nicotine injection. However, these products still cause dental and heart problems and possibly mouth cancer. As such, the benefit of switching to snus is still being debated, with Sweden taking center stage.

Early reports coming out of Sweden seem to indicate that their effots might be working. Smoking rates among men dropped by 25% and women by 14% (Foulds 2003). Their rates of lung cancer and heart attacks have also decreased significantly since introducing snus, and this drop has not been mirrored by first world countries adopting other cessation strategies.

Preliminary analysis of these reports have prompted tobacco labels like Marlboro and Camel to start test-marketing snus as a “healthier” substitute to cigarettes. However it will be years before snus overtakes cigarettes in the tobacco market, as it has already met resistance with policy makers.

The European Union banned snus in 1992 after a report by the IARC (WHO’s Cancer Research Institute) linked cancer with snus. This report was based not on snus itself, but on other chewing tobacco that resembled snus. Sweden’s open embracement of this controversial product almost affected its bid to join the EU in 1994. Later studies failed to link snus to cancer, and this led to an investigation by the SCENIHR (Standing Committee on Emerging and Newly Identified Health Risks) in Feb 2008. The conclusions were:

• Using snus is significantly less harmful than smoking (p. 113-114)
• A smoker who switches to snus will significantly reduce his/her risk of contracting tobacco-related illnesses (p. 115-117)
• Access to snus has had positive effects on Swedish public health (p. 116-117)
• Swedish data opposes the notion that snus is a gateway to smoking (p. 108, 116, 121)
• Read the PDF here

“Swedish snus is best in its class with regard to risk reduction among known smokefree products,” says Lars Erik Rutqvist, Vice President Scientific Affairs at Swedish Match (snus supplier).

The world will simply have to wait for the conclusion of the Swedish experiment. Only time will tell us if snus will become a cigarette replacement. The bottom line is that not every snus user has given up smoking. In Sweden, only an estimated 5% of men have completely swapped cigarettes for snus.