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 Based on questionnaires answered by more than 16,000 never-smokers
in Sweden, researchers found that snus users were over 50 percent
more likely than non-users to have asthma. In addition, snus users
were 37 to 59 percent more likely to snore and have trouble falling
asleep, the study found.
Snus, which was developed in Sweden, usually comes in a small pouch
and users tuck a pinch of it between the gums and upper lip.
“Snus is used by a large proportion of especially young and
middle-aged men in Sweden,” said senior study author Dr. Christer
Janson of the University of Uppsala.
“There are some studies showing association between the use of snus
and heart disease but to my knowledge no studies on the possible
effects of snus on the respiratory system,” Janson said by email.
Janson said someone on his staff told him her husband’s asthma had
improved when he stopped using snus. “Then a young Icelandic doctor,
Arna Yr Gudnadottir, contacted me and wanted to do some research
here in Uppsala,” he said.
Gudnadottir, Janson, and their colleagues examined data taken from a
questionnaire that was mailed to 45,000 randomly selected Swedish
residents as part of the Global Allergy and Asthma European Network
survey in 2008.
Nearly 27,000 people, ranging in age from 16 to 75, responded. They
lived in one of four Swedish cities: Uppsala, Stockholm, Ume or
Gothenburg.
Of this entire study group, 16,082 people were never-smokers and
roughly 18 percent of men and 5 percent of women used snus. Overall,
younger people were more likely to be dual users of snus and smoked
tobacco, while older people were more likely to smoke than to use
snus, according to the report in BMJ Open.
All in all, participants who reported having any respiratory
symptoms were more likely to be smokers and dual users of cigarettes
and snus. However, snus users were more likely to suffer from
wheezing and night-time chest tightness, chronic bronchitis, and
chronic nose and sinus problems, when compared with participants who
were completely tobacco-free.
The study team also found that people who reported having asthma
were more likely to be current snus users and the same link wasn’t
seen among past snus users, dual users or people who only smoked.
“My guess is that the finding between a higher risk of asthma in
snus users is related to inflammation in the upper part of the
airways. This inflammation can then expand to the lower parts of the
airways and thereby cause asthma,” Janson said.
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The theory is supported by the fact that rhinitis, or inflammation
in the nose, increases the risk of developing asthma, Janson said.
The researchers acknowledge that these associations don’t prove that
snus cause asthma.
“We will start a follow-up study of this population next year. We
can then get more precise information on what happens to
participants that start or quit using snus,” Janson said.
The study reports some novel findings, and the sample is quite
impressive, said Lucy Popova, of the Georgia State University School
of Public Health in Atlanta who was not involved in the research.
However, she added, “As the authors themselves acknowledge, it could
be that snus causes asthma and other problems, or it could be that
people with asthma are more likely to use snus than smoke (or to not
use snus).”
Popova noted that less than 1 percent of U.S. adults use snus every
day or some days and that Swedish snus is less harmful than the
traditional smokeless tobacco (moist snuff, also called chew or dip)
sold in the U.S.
“Swedish snus has a lower concentration of cancer-causing chemicals
called ‘tobacco-specific nitrosamines’ or TSNAs that naturally occur
in tobacco plants and increase during the fermentation of tobacco
leaves, Popova said by email.
“While snus is not risk-free, if used exclusively, snus is safer
than smoking,” she said.
SOURCE: http://bit.ly/2rUl2Ul BMJ Open, online May 29, 2017.
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