US Smokers Mistakenly Equate Harms of Snus With Those of Cigarettes

March 7, 2019

Most American smokers continue to believe that snus, a moist tobacco product placed under the lip that originates from Sweden, is as harmful as combustible tobacco—even though it is not.

A new study out of Rutgers University asked 256 smokers about how they perceive the risks for developing lung cancer, heart disease and oral cancer when using snus versus cigarettes. A high rate of respondents (45 percent) incorrectly perceived that snus was equally or more harmful for all three disease-risks. A smaller proportion (38 percent) incorrectly believed that snus carried increased risks for oral cancer only. Only about 17 percent accurately identified that snus has lower risks for lung cancer.

Lead researcher Olivia Wackowski, assistant professor of Health Behavior, Society and Policy at Rutgers and a member of the Rutgers Center for Tobacco Studies and Rutgers Cancer Institute of New Jersey, noted: “These findings continue to suggest that the public does not understand that combustion escalates the health risks in tobacco products that are smoked, making them more harmful than non-combusted smokeless tobacco on a continuum of risk.”

The results “are also significant given that use of Scandinavian snus has not been clearly associated with oral cancer, unlike smoking, which poses a significant risk for oral cancer,” said Wackowski.

To be clear, snus does pose harms: Some of its chemicals are carcinogenic, and also connected with risks for cardiovascular diseases. People often experience nicotine as addictive. But for people who switch from smoking, snus is a key harm reduction tool.

In Sweden, large-scale switching from cigarettes to snus, particularly among men, has seen lung cancer mortality rates fall to dramatically lower levels than in other European Union countries. Other research has suggested that overall, a snus user who has never smoked cuts their life expectancy by between 0.2-0.5 years, compared with a life-expectancy reduction of between 1.9-5 years for cigarette smokers.

The new study’s press release emphasizes that quitting all tobacco use is the best step to protect health—but that people who cannot or do not want to quit can significantly reduce their risks by moving towards products like snus. The study concluded: “If smokers are to consider snus for harm-reduction, efforts may be needed to better inform smokers about their lower relative risks.”

Around 7 percent of men in the United States currently use some form of smokeless tobacco, according to the Centers for Disease Control and Prevention, but this number is growing.


Photo via Andreas Hagerman on Flickr

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