How much snus is in a can

Plus, snus advocates say, it helps people stop smoking. They point to the public health benefits of snus use in Sweden. Specifically, the smoking rate dropped dramatically in Sweden as more men switched to snus use. According to a review in the BMJ journal Tobacco Control, 40 percent of males smoked daily in , compared with 15 percent in At the same time, the researchers found that there have been reductions in lung cancer, cardiovascular disease, and deaths from other causes in Sweden.

Whether snus causes cancer is a complex question to sort out scientifically. Study results are bewilderingly diverse. Some studies find a specific cancer risk connected to snus use, and other studies find the opposite. Some research studies lump all smokeless tobacco products together.

Others are limited to snus use in Swedish populations. Smoking is known to be a high risk factor for pancreatic cancer. A meta-analysis of 82 different studies found that the increased risk of pancreatic cancer for current smokers was 74 percent. The increased risk for former smokers was 20 percent. Does the risk remain the same with smokeless tobacco? Two studies that included snus specifically found a moderate risk increase. Two other studies found no association.

The study concluded that use of Swedish snus should considered a possible risk factor for pancreatic cancer. The most recent and largest study , reported in , involved a large sample of , males in Sweden.

This included nonusers and users of snus. The study authors noted that their findings may be related to the lower nitrosamine levels in Swedish snus than in tobacco smoke. They also suggested that the increased risk of pancreatic cancer in tobacco smokers is related to the carcinogens involved with combustion. Tobacco smoking is one of the strongest risk factors for oral cancers. Evidence for snus leading to oral cancers is mixed. A study , which included snus products from different countries, made a stronger conclusion: that there is a strong link between smokeless tobacco use and cancers of the cheek and gums.

The study noted that the previous data on smokeless tobacco and oral cancers was sparse. A study of , Swedish construction workers who used snus but were previously nonsmokers concluded that there was no increased risk of oral cancers in snus users. Note that this is the same study that found an increased risk of pancreatic cancer in the same population. Another Swedish study differed. The validity of self-reported tobacco use has been demonstrated among adolescents and adults [ 44 , 45 ].

However, we found some inconsistence in reported tobacco use between baseline and follow-up, which may indicate over reporting of occasional tobacco use among the adolescents at baseline. Those with the lowest levels of occasional use may have been more likely to forget about it. In an additional analysis where the inconsistent records were removed, we found an increase in the effect size for tobacco use transitions, indicating low levels of tobacco use among those with inconsistent answers.

The low participation rate in HUNT3 among our cohort participants from Young-HUNT1 was possibly affected by the setting of large population studies and the inclusion of both eligible and not eligible moved out of the county for education etc. However, to improve the response rate, non-responders in HUNT3 received a short version of the questionnaire by mail including core questions on health and lifestyle [ 15 ].

Other strategies to recruit participants to HUNT3 included information to the entire population in different news channels. One main incentive of participating in HUNT3 may have been the benefit of a health check [ 16 ], obviously a bigger gain for older age groups than for the young men in our cohort.

Participants lost to follow-up had higher prevalence of family members smoking and parental divorce than those in the study population, which may be indicators of lower socioeconomic status among non-participants [ 20 ]. A higher prevalence of smoking was found among those not attending follow-up, especially among the older age smokers.

Corresponding differences were small for snus users and dual users. Thus, a selection of too few, and perhaps less vulnerable smokers in our study population may have taken place. One implication of this is possibly an underestimation of the transitions to smoking and dual use in adulthood, rather than the opposite.

In other aspects, we have no reason to believe that these data would differ much from national data. For some purposes it is a limitation with cohort-data back to —97 and — Nevertheless, even when collected a decade back in time, our data have the benefits of following the adolescents into young adulthood in a time where smoking was still prevalent and snus use started to rise Additional file 5.

Norway was among the first countries to introduce new nicotine products with reduced harm potential [ 11 ]. Hence, this experience may be useful as a parallel to the recent introduction of e-cigarettes in many countries. A small glance at the mainly smoking women in the same cohort showed nearly no increase in the prevalence of smoking from adolescence to adulthood, combined with a modest increase of snus use and dual use at low levels Additional file 1.

The men in our study population had similar smoking prevalence as the women in adulthood, dual use included. The adolescent snus users and dual users conferred a high risk of being tobacco users in young adulthood. The extensive use of snus among the young boys in our study is followed by persistent dual use and smoking into adulthood. The desired effect of snus in reducing smoking is not apparent, as tobacco use was escalating in men while fairly stable in women.

This experience from a Norwegian population study reveals possible disadvantages of the access to new nicotine products. Risk and protective factors of adolescent exclusive snus users compared to non-users of tobacco, exclusive smokers and dual users of snus and cigarettes.

Addict Behav. Statistics Norway: Smoking habits. Google Scholar. Norwegian Institute of Public Health. In: Report. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for causes of death, a systematic analysis for the global burden of disease study Article Google Scholar. New and traditional smokeless tobacco: comparison of toxicant and carcinogen levels.

Nicotine Tob Res. Benowitz NL. Emerging nicotine delivery products. Implications for public health. Ann Am Thorac Soc. Effect of smokeless tobacco snus on smoking and public health in Sweden. Tob Control. Discontinuation of smokeless tobacco and mortality risk after myocardial infarction. Smokeless tobacco snus is associated with an increased risk of type 2 diabetes: results from five pooled cohorts. J Intern Med.

Influence of snuff and smoking habits in early pregnancy on risks for stillbirth and early neonatal mortality. Lund I, Lund KE. How has the availability of snus influenced cigarette smoking in Norway?

Is Swedish snus associated with smoking initiation or smoking cessation? Cigarettes and oral snuff use in Sweden: prevalence and transitions. Pedersen W, von Soest T. Tobacco use among Norwegian adolescents: from cigarettes to snus. Int J Epidemiol. Tobakksmarkedets sammensetning og endring.

Social differences in smoking and snuff use among Norwegian adolescents: a population based survey. BMC Public Health. The social epidemiology of substance use. Epidemiol Rev. Socioeconomic status and smoking: a review.

Ann N Y Acad Sci. Educational differences in smoking: international comparison. Lund KE, Lund M. Smoking and social inequality in Norway Tidsskr Nor Laegeforen.

PubMed Google Scholar. Behav Genet. Personality and smoking: individual-participant meta-analysis of nine cohort studies. Tambs K. A study of sexual abuse of children. Oslo: Norwegian Institute of Public Health; Patterns of snus and cigarette use: a study of Norwegian men followed from age 16 to Associations between initial water pipe tobacco smoking and snus use and subsequent cigarette smoking: results from a longitudinal study of US adolescents and young adults.

Only A total of Cigarettes were the major co-used tobacco product, with 9. A slightly higher incidence of cigarette smoking was reported among pouched snus users Frequency of cigarette use among daily snus users was also investigated; all daily snus users who also smoked reported doing so at least once per week, and Few differences in tobacco product use behaviors were observed across genders or snus type, although no female respondents reported concurrent use of snus with cigars, pipe, or chewing tobacco.

Several styles of pouch are available on the Swedish market. Mini pouches tend to contain tobacco with lower moisture content than the larger pouches. The survey respondents had a general preference for the Large Normal pouches; this preference was different for female respondents, who showed greater use of Mini pouches There are also different pouch color types, the main styles being brown and white, which can result from different processing practices during the manufacture of the products.

The brown pouch products tend to have higher moisture content than the white ones due to the spraying of water during pouching. This extra process step for brown pouch products turns the pouch material from the standard white color to a brown color, which is due to staining from the tobacco. Pouch products with different pouch material colors—for example, black—are also available.

Supplementary Table 3 shows that The majority of pouched snus users in the survey However, the remainder The percentage of males and females using one to four portions concurrently is reported in Supplementary Table 4. There was no observed trend between the pouch size and the number of pouches used concurrently, when taking into account the variation in the survey population numbers across the different pouch sizes data not shown. The calculation for quantity of snus used per day described in the Methods section relied upon the frequent use by respondents of their main brand.

In support of this, the majority The consumption results from the calculations are summarized in Table 2. Full statistical analyses are provided in Supplementary Tables 5 — Supplementary Data.

The consumption data were not normally distributed but appeared to be composed of a complex series of different distributions. Nevertheless, the consumption estimates obtained by the two different calculations were in very good agreement. By comparison, significantly higher levels of loose snus consumption were observed because the portion weights were in the order of three times greater than for pouched snus; the mean consumption of loose snus was This difference was primarily due to the larger portion size of loose snus, as the numbers of packages or portions per day were very similar for loose and pouched snus.

The data for male and female loose snus users were very similar, albeit with a very small number of female respondents in this group Table 2. Exposure time may be an important parameter influencing intake of constituents from snus.

In the first stage of the survey, the respondents were asked how long, on average, they kept their portion in their mouth. Responses were limited to seven time categories ranging from less than 5 min to more than 35 min. However, it was found that the majority of respondents used the products for more than 35 min and, due to the limited scope of this question, the actual usage times of over 35 min were not specified.

Therefore, the survey was repeated with subsets of the original pouched and loose snus user survey population second and third stages of the survey, respectively, Supplementary Table 1.

These later stages examined usage time by querying the shortest, average, and longest times that portions and pouches were normally kept in the mouth during use. In each case, the respondents were asked to state the exact time in minutes. There were insufficient completed questionnaires from female loose snus users in the third stage of the survey to provide robust data for this group. Values reported by the survey respondents were found to be nonuniformly distributed, clustering around certain time intervals—for example, 30, 45, 60, 90 min.

Table 3 shows that, on average, the normal time that respondents kept either a loose portion or a pouch in their mouths was slightly in excess of 1 hr. Full statistical analyses are provided in Supplementary Table 8. The shortest normal time of use was just over 20 min for female respondents and just over 30 min for male respondents. Examination of the data for the longest time normally kept in mouth shows some extreme values, with male pouched snus users reporting times in mouth of up to 15 hr, and 7 hr for female pouched snus users.

All respondents, third stage of the survey recontacted users of loose snus. The third-stage, loose snus survey investigated the total fraction of the day during which the product is used Table 4.

These data are open to some degree of interpretation as to whether the respondents provided an answer which was a percentage of the day that they were awake or the total 24 hr day.

To examine this more closely, the total length of daily use time was estimated from the average normal use time per portion and the reported number of portions per day. These estimates also indicated that snus use occurs for a significant proportion of the day, with a mean value of 12— These estimates were consistent with the survey respondents reporting their total usage time as a percentage of the time they are awake; for a to hr time period, this would represent a period of 10— Due to the lack of precision in the survey question and the difficulty in obtaining realistic estimates for some survey respondents, the values for total usage time reported from this survey should be regarded as indicative estimates only.

Although most snus users maintained the portion at the site of application, a significant number, In the past the nicotine content was also stated as a percentage on our snus cans, because we consider the nicotine content to be relevant consumer information. In May the EU Tobacco Products Directive was implemented in Swedish law, and Swedish snus producers have not been allowed to state nicotine content on snus cans since then.

We think that this is unfortunate and that it makes things worse for consumers, but we have no choice but to comply with applicable regulations. Nicotine content and nicotine absorption The nicotine content of snus is not the same as the nicotine absorption, which can vary from person to person.