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Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden Lars Ramström

Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden Lars Ramström Institute for Tobacco Studies Stockholm, Sweden Presentation at The 13th World Conference on Tobacco OR Health Session: Swedish Snus: Panacea or Pandora's Box? Saturday, 15 July 2006: 10:30 AM-12:00 PM.

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Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden Lars Ramström

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  1. Is Snus a Model for Harm Reduction: The Scientific Evidence from Sweden Lars Ramström Institute for Tobacco Studies Stockholm, Sweden Presentation at The 13th World Conference on Tobacco OR Health Session: Swedish Snus: Panacea or Pandora's Box? Saturday, 15 July 2006: 10:30 AM-12:00 PM

  2. Does primary snus use make young people more likely to start smoking???

  3. Does snus use favour smoking cessation???

  4. QUIT RATE(Proportion of ”Ever daily smokers” having quit completely) • All men 59%All women 49% • Men WITHOUT a history of daily snus use 51%Women WITHOUT a history of daily snus use 48% • Men WITH a history of daily snus use 72%Women WITH a history of daily snus use 71% • All WITHOUT a history of daily snus use 49%All WITH a history of daily snus use 72%

  5. How hazardous is snus to health???

  6. Possible scenario without snus • According to Peto et al (2006)* there were 4678 deaths attributed to smoking among men in Sweden in the year 2000. *http://www.ctsu.ox.ac.uk/~tobacco/index.htm • Adopting the calculation that, in the absence of snus use, the prevalence of daily smoking would have been 1.28 times as high as now… • and assuming that the number of smoking-attributed deaths would then also have been 1.28 times as high, i.e. 5988… • it may be suggested that male snus use in Sweden has been preventing more than one thousand deaths annually around the year 2000.

  7. Summaryof evidence from Sweden • Primary snus users are less likely so start smoking. • Increasing primary snus use has been associated with even larger decrease of onset of daily smoking. • Secondary snus use is associated with attempts to quit smoking. • Both in men and women are quit-smoking-rates higher in those with than in those without a history of daily snus use. • Snus is a commonly used smoking cessation aid in men. • Both in men and women is snus more efficient as smoking cessation aid than nicotine gum or patch. • The use of snus appears to have decreased the number of deaths attributed to tobacco use.

  8. What is snus? A panacea?No. A Pandora’s box?No. A useful toolbox for Yes. In Sweden it has contributed Harm Reduction? to health beneifts in spite of wide- spread misbeliefs exaggerating its toxicity. Further efforts are needed for regulation and education to make sure that only the best possible products are available, through responsible channels, to a well informed public.

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