Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies

Araghi, Marzieh; Galanti, Maria Rosaria; Lundberg, Mari; Lager, Anton; Engström, Gunnar; Alfredsson, Lars; Knutsson, Anders; Norberg, Margareta; Sund, Malin; Wennberg, Patrik; Lagerros, Ylva Trolle; Bellocco, Rino; Pedersen, Nancy L.; Östergren, Per Olof; Magnusson, Cecilia

doi:10.1002/ijc.30773

Cited by 26 publications

(25 citation statements)

References 46 publications

(160 reference statements)

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“…Although medical consensus is that snus use is approximately 90% less harmful to health than smoking, studies have provided empirical support for an association between snus use and increased mortality risk in cardiovascular patients, and a modest increase in the risk for heart failure [10]. On the European level, an association has been demonstrated between the use of smokeless tobacco and risk of pancreatic cancer, but among Swedish male snus users, pooled analysis of nine prospective studies found no such association [11].…”

Section: Introductionmentioning

confidence: 99%

The relative impact of smoking, alcohol use and drug use on general sickness absence among Norwegian employees

2019

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Background It is well documented that tobacco, alcohol and drug use can be detrimental to health. However, little is known about the relative impact of these factors on sickness absence, and whether the association between use of these substances and sickness absence is different for women and men. The aim of this study was to examine the association between tobacco-, alcohol- and drug use, as well as polydrug use, and sickness absence among Norwegian employees. Methods During 2011–2014, 1911 employees in Norway completed a questionnaire about their tobacco, alcohol and drug use habits, their total number of sickness absences during the last 12 months, and the length (no. of days) of their last sick leave. Samples of oral fluid were analysed for illegal and medicinal drugs. Results Daily smoking and current use of medical drugs were significantly associated with sickness absence. Employees who were daily smokers also had an increased likelihood of having long and frequent sickness absence. Use of snus (Swedish moist snuff), binge drinking, current use of illegal drugs and polydrug use were not significantly associated with sickness absence. Women and young participants were more likely to report having had sickness absence the past 12 months. However, the associations between daily smoking and medical drug use and sickness absence, respectively, were only statistically significant for men. Conclusion According to this study, daily smoking and use of medical drugs are the substance use habits most closely associated with sickness absence. Implications for future research are discussed.

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Section: Introductionmentioning

confidence: 99%

The relative impact of smoking, alcohol use and drug use on general sickness absence among Norwegian employees

2019

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“…To date, the largest study [64] investigating a potential link between snus use and pancreatic cancer used pooled data from the Swedish Collaboration on Health Effects of Snus Use. A total of 424,152 males were followed up for risk of pancreatic cancer through linkage to health registers with a reported total of 9,276,054 person-years of observation.…”

Section: Other Cardiovascular Risk Factorsmentioning

confidence: 99%

Snus: a compelling harm reduction alternative to cigarettes

Clarke

Thompson²,

Weaver

et al. 2019

Harm Reduct J

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Snus is an oral smokeless tobacco product which is usually placed behind the upper lip, either in a loose form or in portioned sachets, and is primarily used in Sweden and Norway. The purpose of this review is to examine the reported effects of snus use in relation to specified health effects, namely lung cancer, cardiovascular disease, pancreatic cancer, diabetes, oral cancer and non-neoplastic oral disease. The review also examines the harm reduction potential of snus as an alternative to cigarettes by comparing the prevalence of snus use and cigarette smoking, and the reported incidence of tobacco-related diseases across European Union countries. The scientific literature generally indicates that the use of snus is not a significant risk factor for developing lung cancer, cardiovascular disease, pancreatic cancer or oral cancer. Studies investigating snus use and diabetes have reported that high consumption of snus (estimated as being four or more cans per week) may be associated with a higher risk of developing diabetes or components of metabolic syndrome; however, overall results are not conclusive. Snus use is associated with the presence of non-neoplastic oral mucosal lesions which are reported to heal rapidly once use has stopped. The most recent Eurobarometer data from 2017 reported that Sweden had the lowest prevalence of daily cigarette use in the European Union at 5% whilst daily “oral tobacco” use was reported to be 20%. European data published by the World Health Organisation in 2018 indicated that Sweden had the lowest rate of tobacco-related mortality and the lowest incidence of male lung cancer. Overall, prevalence statistics and epidemiological data indicate that the use of snus confers a significant harm reduction benefit which is reflected in the comparatively low levels of tobacco-related disease in Sweden when compared with the rest of Europe. The available scientific data, including long-term population studies conducted by independent bodies, demonstrates that the health risks associated with snus are considerably lower than those associated with cigarette smoking.

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“…While there was no significant association seen with smokeless tobacco, studies have been inconclusive [29,30]. Studies have shown that the use of snus (moist powdered tobacco) in the Swedish population is not associated with pancreatic cancer risk [31].…”

Section: Smokingmentioning

confidence: 99%

Pancreatic cancer trends in Europe: epidemiology and risk factors

Hawksworth¹,

Hales²,

Martínez³

et al. 2019

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Pancreatic cancer is the 12 th most common cancer worldwide and the seventh leading cause of cancer-related deaths worldwide. However, it is the seventh most common cancer in Europe. The estimated number of cases of pancreatic cancer worldwide in 2018 was 458,918 with a male to female ratio of 1:1.13. Among those 458,918 patients, 132,559 cases were found in Europe. Rates of pancreatic cancer are 3-4 times higher in the developed world. With incidence and mortality rates being very close, pancreatic cancer is considered one of the deadliest of all cancers. Lifestyle in developed nations, including the rise in physical inactivity and obesity, tobacco smoking, consumption of alcohol, dietary factors, and occupational exposures, may be responsible for the increased incidence of pancreatic cancer. Updated statistics on the epidemiology of pancreatic cancer along with a better understanding of the risk factors are essential for the primary prevention of this disease. Streszczenie Rak trzustki jest dwunastym najczęściej występującym nowotworem i siódmą główną przyczyną zgonów związanych z rakiem na świecie. Jest to także siódmy najczęściej występujący nowotwór w Europie. Liczba przypadków raka trzustki na świecie w 2018 roku wynosiła 458 918, przy stosunku mężczyzn do kobiet 1 : 1,13. W Europie stwierdzono 132 559 przypadków. Występowanie raka trzustki jest 3-4 razy częstsze w krajach rozwiniętych. Ponieważ częstość występowania i śmiertelność są bardzo zbliżone, rak trzustki jest uważany za jeden z najbardziej śmiertelnych nowotworów. Styl życia w krajach rozwiniętych, w tym brak aktywności fizycznej i otyłość, palenie tytoniu, spożywanie alkoholu, czynniki dietetyczne i narażenie zawodowe, może odpowiadać za zwiększoną częstość występowania raka trzustki. Zaktualizowanie statystyki dotyczącej raka trzustki oraz lepsze zrozumienie czynników ryzyka są niezbędne do zapobiegania tej chorobie.

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Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies

Cited by 26 publications

References 46 publications

The relative impact of smoking, alcohol use and drug use on general sickness absence among Norwegian employees

The relative impact of smoking, alcohol use and drug use on general sickness absence among Norwegian employees

Snus: a compelling harm reduction alternative to cigarettes

Pancreatic cancer trends in Europe: epidemiology and risk factors

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