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Snus: Stealth Health Risk

Snus smokeless tobacco: Less harmful than cigarettes, but not safe.

Snus: Harm Reduction or Multiplication? continued...

It's a huge public health experiment -- and the results already are plain to see, says Terry Pechacek, PhD, associate director for science at the CDC's Office on Smoking and Health.

Pechacek notes that more than a fourth of white, male high school students report having used smokeless tobacco products in the last month. Overall, nearly 7% of all U.S. high school students already use smokeless tobacco.

And they are not using snus instead of cigarettes.

"The overwhelming pattern is to smoke cigarettes along with smokeless tobacco -- and two-thirds of this is among young adults," Pechacek tells WebMD. "Over half of teens using smokeless tobacco are also using cigarettes. … It is of great public health concern."

This isn't an accident, says Michael Steinberg, MD, MPH, director of the tobacco dependence program at the University of Medicine and Dentistry of New Jersey.

Steinberg notes that in 2006, major U.S. cigarette companies bought the major smokeless tobacco brands. And the two major brands of snus? They're from leading cigarette makers Altria/Philip Morris (Marlboro Snus) and RJ Reynolds (Camel Snus).

"Snus is being co-marketed with cigarettes," Steinberg tells WebMD. "The companies are not shy in saying, 'When you can't smoke, use snus.' But when you can smoke, it is clear they want you to smoke cigarettes. They make more money from cigarettes sales than anything else on the planet."

Steinberg also notes that U.S. snus deliver less nicotine than do cigarettes.

"So if people try to get nicotine from snus, they will not get what they are used to. They will go through nicotine withdrawal and so will not use snus alone," Steinberg says. "My conclusion is that companies do not want to replace cigarettes with snus."

Snus: An Aid to Quitting Cigarettes?

Data from Sweden show that snus users don't always progress to cigarette use, and that it's possible to use snus to reduce dependence on cigarettes.

One Swedish study, for example, found that there were more ex-smokers using snus that there were ex-snus users using cigarettes.

However, Steinberg notes that this study fails to account for significant anti-smoking efforts taking place in Sweden at the same time, such as indoor health programs and government assistance to smoking cessation programs.

"Other countries, such as Norway, have not seen the same outcomes in terms of health benefits of snus as in Sweden," he says.

Steinberg points to studies showing that snus isn't any more helpful than nicotine replacement products such as nicotine gum and nicotine nasal spray.

"The real question is who do you buy your nicotine from?" GSU's Erickson says. "Do you buy it from a tobacco company that can put anything on the market with no testing … or do you buy it from pharmaceutical companies that have to demonstrate the safety and effectiveness of their products as a drug and demonstrate they actually work?"

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