Snus does not save lives: quitting smoking does!

Le, Holm; J, Fisker; Bi, Larsen; Puska, Pekka; Halldórsson, Matthías

doi:10.1136/tc.2009.030221

Cited by 14 publications

(15 citation statements)

References 7 publications

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“…They also failed to identify randomised trials in addition to those included in the current systematic review. Due to the scarcity of experimental data on snus as a smoking cessation aid together with the cited need for such information (Holm et al, 2009; Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), 2008 (Accessed Oct 2010)), the risk of publication bias is probably low for controlled clinical studies addressing this issue. Also, our search criteria were relatively wide so it seems highly likely that we did not miss any relevant randomised clinical trial.…”

Section: Figurementioning

confidence: 98%

“…Although the lack of such data was noted by an EU-commissioned report in 2008 (Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), 2008 (Accessed Oct 2010)), and reiterated by several Nordic public health officials in 2009 (Holm et al, 2009), we conducted literature searches to confirm this. This report may be regarded, therefore, as a systematic review of all the available data.…”

Section: Introductionmentioning

confidence: 93%

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Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

Rutqvist¹,

Fry

Lee

2013

J. Smok Cessat

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Introduction: The ability of Swedish snus to serve as a smoking cessation aid has been documented in several observational, population surveys from Scandinavia, but randomised clinical trials provide more reliable information on efficacy. Aims: To perform a systematic review and meta-analysis of randomised clinical trials of Swedish snus as an aid to smoking cessation. Methods: Literature searches were conducted in MedLine, Cochrane Library, and Embase to identify relevant clinical trials. The primary outcome was defined as biologically confirmed smoking cessation during around six months. Meta-analyses based on primary subject data tested for effect of allocated treatment as well as selected baseline characteristics. Results: There were two relevant clinical trials, one conducted at five sites in the US (n = 250), the other at two sites in Serbia (n = 319). Based on the primary outcome, success was higher in the treated group in both Serbia (5.7% vs 1.9%) and the US (4.0% vs 1.6%). Meta-analysis estimated the relative success rate at 2.83 (95% CI 1.03–7.75), which was of borderline significance (exact p = 0.06, chi-squared p = 0.03). For smoking cessation in the last 4 weeks of each study, rates were 12.4% for snus and 6.6% for placebo (RR 1.86, 95% CI 1.09-3.18). Efficacy of snus was not clearly related to any baseline characteristic. Conclusions: Swedish snus increased quit rates similarly in US and Serbia. These results confirm and extend previous information based on observational population surveys.

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Section: Figurementioning

confidence: 98%

Section: Introductionmentioning

confidence: 93%

Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

Rutqvist¹,

Fry

Lee

2013

J. Smok Cessat

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“…Many in public health attribute the high male snus consumption for the reductions in Swedish male smoking, proposing that this proof of concept could be replicated elsewhere in the EU and achieve net health gains [20],[124],[125]. Others [112],[126],[127], many from Scandinavia, have criticized this interpretation of Swedish data, countering that strong Swedish tobacco control measures instead played a significant role in reducing male smoking prevalence, highlighting that Swedish data show that only 5% of Swedish males smokers quit smoking using snus, that four out of 10 male snus users started their tobacco use with snus, and that almost as many continue to smoke and are dual users. Furthermore, they argue that smoking prevalence amongst Swedish women also significantly declined in the last 20 years (from 29% to 14%), albeit with no significant uptake in snus, thus indicating that snus is not associated with this decline.…”

Section: Introductionmentioning

confidence: 99%

Transnational Tobacco Company Interests in Smokeless Tobacco in Europe: Analysis of Internal Industry Documents and Contemporary Industry Materials

Peeters

Gilmore

2013

PLoS Med

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“…Substituting cigarettes with NRT or snus facilitates risk reduction by allowing smokers to become smoke-free without abstaining from nicotine or tobacco respectively, but complete abstinence is still achievable [5,7,17]. There is a great deal of political controversy connected to the issue of harm reduction, also in Scandinavia, where the health authorities have stated that they do not want to recommend smokers to switch to snus or use snus as a method for smoking cessation [18]. …”

Section: Introductionmentioning

confidence: 99%

Contrasting snus and NRT as methods to quit smoking. an observational study

Scheffels¹,

Lund²,

McNeill

2012

Harm Reduction Journal

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BackgroundSnus is considerably less hazardous to health than cigarettes. Recent data from Scandinavia have indicated that many smokers use snus as a method for quitting smoking.MethodsData from five repeated cross-sectional surveys of Norwegian men and women aged 16-74 were pooled (N = 6 262). Respondents were asked about current and former smoking and snus use. Former daily smokers (N = 1219) and current daily smokers who had tried to quit at least once (N = 1118) were asked about the method they had used at their latest quit attempt and how many quit attempts they had made. Former smokers were also requested to report what year they had made their final quit attempt.ResultsSnus was the most common method used for quitting smoking among men, while NRT was most often used among women. Stratifying the data according to year of quitting smoking (1945-2007) indicated a significant increase in use of the methods for quitting asked about over time. Among men, this was largely due to an increase in the use of snus. Among male quitters under the age of 45 years, 45.8% of those who had used snus on their last attempt to quit were current non-smokers (OR = 1.61, CI 1.04-2.29), while 26,3% of those who had used NRT were current non-smokers. 59.6% of successful quitters and 19.5% of unsuccessful quitters who had used snus as a method for quitting smoking had continued to use snus on a daily basis after quitting.ConclusionNorwegian men frequently use snus as a method for quitting smoking whereas women are more likely to use NRT. The findings indicate that switching to snus can be an effective method for quitting smoking.

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Snus does not save lives: quitting smoking does!

Cited by 14 publications

References 7 publications

Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

Transnational Tobacco Company Interests in Smokeless Tobacco in Europe: Analysis of Internal Industry Documents and Contemporary Industry Materials

Contrasting snus and NRT as methods to quit smoking. an observational study

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