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Lee PN. Epidemiological evidence relating snus to health--an updated review based on recent publications. Harm Reduct J 2013; 10:36. [PMID: 24314326 PMCID: PMC4029226 DOI: 10.1186/1477-7517-10-36] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/02/2013] [Indexed: 02/06/2023] Open
Abstract
An earlier review summarized evidence relating use of snus (Swedish-type moist snuff) to health and to initiation and cessation of smoking. This update considers the effect recent publications on snus use and health have on the overall evidence. The additional evidence extends the list of neoplastic conditions unassociated with snus use (oropharynx, oesophagus, stomach, lung) to include colorectal cancer and acoustic neuroma, and further undermines the weakly-based argument that snus use increases the risk of pancreatic cancer, although there is a report of poorer cancer survival in users. It remains undemonstrated that “snuff-dipper’s lesion” increases risk of oral cancer, and recent publications add to the evidence that snus use has no effect on periodontitis or dental caries. Although onset of acute myocardial infarction is not adversely associated with snus use, there is some evidence of an association with reduced survival. Whether this is a direct effect of snus use or a result of confounding by socioeconomic status or other factors requires further investigation, as does a report of an increased risk of heart failure in snus users. Even if some adverse health effects of snus use do exist, it remains clear that they are far less than those of smoking.
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Affiliation(s)
- Peter N Lee
- P N Lee Statistics and Computing Ltd, Sutton, Surrey SM2 5DA, United Kingdom.
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Bertuccio P, La Vecchia C, Silverman DT, Petersen GM, Bracci PM, Negri E, Li D, Risch HA, Olson SH, Gallinger S, Miller AB, Bueno-de-Mesquita HB, Talamini R, Polesel J, Ghadirian P, Baghurst PA, Zatonski W, Fontham E, Bamlet WR, Holly EA, Lucenteforte E, Hassan M, Yu H, Kurtz RC, Cotterchio M, Su J, Maisonneuve P, Duell EJ, Bosetti C, Boffetta P. Reply to Are cohort data on smokeless tobacco use and pancreatic cancer confounded by alcohol use? Ann Oncol 2011; 22:1931-1932. [PMID: 32629618 DOI: 10.1093/annonc/mdr305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Bertuccio
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
| | | | | | - P M Bracci
- University of California-San Francisco, San Francisco
| | - E Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - D Li
- The University of Texas M.D Anderson Cancer Center, Houston
| | - H A Risch
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven
| | - S H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Talamini
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (PN), Italy
| | - J Polesel
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (PN), Italy
| | - P Ghadirian
- Epidemiology Research Unit, Research Centre (CRCHUM), Montréal, Canada
| | - P A Baghurst
- Public Health, Women's and Children's Hospital, Adelaide SA, Australia
| | - W Zatonski
- Cancer Center and Institute of Oncology, Warsaw, Poland
| | - E Fontham
- Louisiana State University, New Orleans
| | | | - E A Holly
- University of California-San Francisco, San Francisco
| | - E Lucenteforte
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
| | - M Hassan
- The University of Texas M.D Anderson Cancer Center, Houston
| | - H Yu
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven
| | - R C Kurtz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - M Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Cancer Care Ontario, Toronto, Canada
| | - J Su
- National Cancer Institute, Bethesda
| | | | - E J Duell
- Catalan Institute of Oncology, Barcelona, Spain
| | - C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - P Boffetta
- International Prevention Research Institute, Lyon, France; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA.
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