Effects of smokeless tobacco
Effects of smokeless tobacco
The Swedish Experience with smokeless tobacco
The prevalence of male tobacco use in Sweden is similar to that of many other European countries. However, the risk for men of dying from a tobacco-related disease is less in Sweden than in any other European country. In the scientific community this paradox has been referred to as "the Swedish Experience" and can probably be explained by the unique pattern of tobacco use in Swedish males. Swedish men smoke much less than in other countries but instead use Swedish smokeless tobacco to a large extent. In fact, smokeless tobacco use is as common as smoking.
However, the risk for Swedish females of dying from a tobacco-related disease is in level with the risk for women in the rest of Europe. The tobacco consumption pattern of Swedish females is in line with the pattern in other parts of Europe as Swedish females never used smokeless tobacco to any large extent. This comparison between males and females speaks for the fact that smokeless tobacco is one of the major factors involved in the staggering harm-reduction statistics for Swedish men.
Facts:
- In 1998, 17.1% of adult Swedish males smoked compared with an average of 32% for Denmark and 33.7% for Norway .
- In 1997, Swedish smokeless tobacco was used by 19% of the adult male population. Swedish males are the only Europeans to extensively use Swedish smokeless tobacco.
- The per capita consumption of tobacco products, grams per person, 15 years +, in 1998 was: Sweden - 1400, Denmark - 1612 and Norway - 1304 .
- More users progress from smoking to Swedish smokeless tobacco than from Swedish smokeless tobacco to smoking
- Sweden became the first and only country in the world to lower adult smoking prevalence below the WHO target level of 20% before the end of year 2000
- In 1990, 11% of all male deaths in Sweden were smoking-related compared with an average of 25% in Europe
- In 1990, the risk of a 35 year-old male dying from smoking-related illness before the age of 70 was 4% in Sweden compared with 10% in Denmark and 6% in Norway in 1990. Sweden has an average incidence of smoking-related death amongst women in Europe (
This evident difference in tobacco related health effects in Swedish males in relation to males in the rest of Europe implies that the health risks associated with Swedish smokeless tobacco differ from those known to be associated with smoking. This difference has also been confirmed in recent scientific studies. Even if the studies do not clear Swedish smokeless tobacco completely from potential negative health effects the reports show a very different picture of smokeless tobacco related effects than those associated with smoking.
Facts:
- The incidence of lung cancer amongst Swedish males has dropped in the past 20 years. Females have shown an increasing trend on lung cancer .
- Two epidemiological studies recently performed in Sweden did not show any association between the use of Swedish smokeless tobacco and oral cancer
- Recent epidemiological studies on gastric cancer and esophageal cancer did not find any association between Swedish smokeless tobacco and an increased risk of any type of those cancers
- Cancer deaths are not raised amongst Swedish smokeless tobacco (smokeless tobacco) users compared to non-tobacco users
- The risk of myocardial infarction is not increased in smokeless tobacco users
- No significant elevation of diastolic blood pressure, hemoglobin concentrations, white cell count, serum cholesterol or triglyceride levels has been found in smokeless tobacco users. This is in contrast with findings for cigarette smokers
- Both smokeless tobacco users and smokers face a higher risk of dying from cardiovascular disease than non-users. The risk for smokeless tobacco users is lower than for smokers
- The health risks associated with smokeless tobacco are, with a high probability, less than the risks associated with smoking