Snus og risiko for hjertesykdom

[25årstrening]

Er bruk av snus farlig i den forstand at det gir økt risiko for kreft og kardiovaskulær sykdom? Dette er selvsagt ett hett tema ifm økningen i bruk av røkfrie tobakksprodukter. Forskning på sammenhengen mellom snusbruk og hjerte-karsykdom synes ikke å gi helt entydige svar:

Epidemiology. 2005 Jan;16(1):12-6. Related Articles, Links 
 
Swedish moist snuff and myocardial infarction among men.
Hergens MP, Ahlbom A, Andersson T, Pershagen G.


BACKGROUND: Previous studies have provided inconsistent results on possible increased risk of cardiovascular disease with the use of smokeless tobacco. The aim of this study was to assess whether long-term use of Swedish moist snuff (widely used among Swedish men) increases the risk of acute myocardial infarction. METHODS: This case-control study was conducted in 2 Swedish counties. We identified 1760 men, age 45-70 years, who had a myocardial infarction in 1992-1994. We randomly selected male controls from the study base after stratification for age and hospital catchment area. Information about snuff consumption, smoking history, hypertension, and other factors was obtained by mailed questionnaire and medical examination. The participation rate was 77% among cases and 78% among controls, with tobacco use data available for 1432 cases and 1810 controls. RESULTS: After adjustment for age, hospital catchment area, and smoking, the relative risk of first acute myocardial infarction was 1.1 (95% confidence interval=0.8-1.5) for former snuff users and 1.0 (0.8-1.3) for current snuff users. Analyses limited to either nonfatal or fatal cases did not change the results. Among the controls, the consumption of smokeless tobacco was strongly associated with certain risk factors for myocardial infarction such as hypertension and high body mass index. CONCLUSION: The hypothesis that smokeless tobacco increases the risk for myocardial infarction is not supported in the present study.
PMID: 15613940 [PubMed - indexed for MEDLINE]

Kommentar; dette er sikkert et tema som vil bli studert mer framover. Det er grunn til å spørre seg om det er hensiktsmessig av myndighetene å advare så sterkt mot overgang fra røyking til bruk av snus, når risikoen for alvorlig sykdom ikke er mer entydig dokumentert. MEN: merk altså sammenhengen mellom snusbruk og økt blodtrykk/høy kroppsmasse.

[25årstrening]

Og flere stiller samme spørsmål-

BMC Public Health. 2005 Apr 5;5(1):31.

  You might as well smoke; the misleading and harmful public message about smokeless tobacco.
Phillips CV, Wang C, Guenzel B.

University of Texas Medical School, Center for Clinical Research and Evidence Based Medicine, Houston, USA. carl.v.phillips@cphps.org

BACKGROUND: Compared to smoking cigarettes, use of Western smokeless tobacco (ST) products is associated with a very small risk of life-threatening disease (with estimates in the range of a few percent of the risk from smoking, or even less). This means that smokers can realize substantial health benefits by switching to ST, an obvious substitute. But consumers and policy makers have little chance of learning that ST is much less dangerous than smoking because popular information provided by experts and advocates overstates the health risks from ST relative to cigarettes. METHODS: To examine the extent of this overstatement in one medium, we conducted a systematic review of websites containing information about ST and health risks. We examined the content of 316 relevant websites identified by a Google search. RESULTS: We found that when any substantive information about the risk from ST is given, the risk is almost universally conflated with the risk from cigarettes. Accurate comparative risk information was quite rare, provided by only a handful of websites, all appearing low in our search results (i.e., of low popularity and thus unlikely to be found by someone searching for information). About 1/3 of the websites, including various authoritative entities, explicitly claimed that ST is as bad as or worse than cigarettes. Most of the other sites made statements that imply the risks are comparable. CONCLUSION: Through these websites, and presumably other information provided by the same government, advocacy, and educational organizations, ST users are told, in effect, that they might as well switch to smoking if they like it a bit more. Smokers and policy makers are told there is no potential for harm reduction. These messages are clearly false and likely harmful, representing violations of ethical standards.

PMID: 15811179 [PubMed - in process]

[25årstrening]

La meg tippe: enkelte her hjemme liker nok ikke denne informasjonen-

Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):2035-42.

 
The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts.
Levy DT, Mumford EA, Cummings KM, Gilpin EA, Giovino G, Hyland A, Sweanor D, Warner KE.

Department of Economics, University of Baltimore, 11710 Beltsville Drive, Suite 300, Calverton, MD 20878, USA. Levy@pire.org

A nine-membered panel of experts was asked to determine expert opinions of mortality risks associated with use of low-nitrosamine smokeless tobacco (LN-SLT) marketed for oral use. A modified Delphi approach was employed. For total mortality, the estimated median relative risks for individual users of LN-SLT were 9% and 5% of the risk associated with smoking for those ages 35 to 49 and > or =50 years, respectively. Median mortality risks relative to smoking were estimated to be 2% to 3% for lung cancer, 10% for heart disease, and 15% to 30% for oral cancer. Although individual estimates often varied between 0% and 50%, most panel members were confident or very confident of their estimates by the last round of consultation. In comparison with smoking, experts perceive at least a 90% reduction in the relative risk of LN-SLT use. The risks of using LN-SLT products therefore should not be portrayed as comparable with those of smoking cigarettes as has been the practice of some governmental and public health authorities in the past. Importantly, the overall public health impact of LN-SLT will reflect use patterns, its marketing, and governmental regulation of tobacco products.
PMID: 15598758 [PubMed - indexed for MEDLINE]

[25årstrening]

Ikke min mening å oppfordre til bruk av snus, men dagens produkter ser heller ikke ut til å gi noen dramatisk økning i kreft i munnhule/svelg, men dette kan selvsagt være doseavhengig.

Crit Rev Oral Biol Med. 2004 Sep 1;15(5):252-63.

 
Smokeless tobacco and oral cancer: a review of the risks and determinants.
Rodu B, Jansson C.

Department of Pathology, School of Medicine, LHRB 156, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA. rodu@uab.edu <rodu@uab.edu>

Smokeless tobacco has been associated with oral cancer for many decades. The purpose of this article is to review research relevant to this association, including epidemiologic studies, studies of putative carcinogens such as tobacco-specific nitrosamines (TSNAs) and other contaminants, and possible cancer inhibitors. Epidemiologic studies addressing this issue primarily consist of case-control studies. They show that the use of chewing tobacco and moist snuff is associated with very low risks for cancers of the oral cavity and related structures (relative risks [RR] from 0.6 to 1.7). The use of dry snuff is associated with higher RRs, ranging from 4 to 13, while the RRs from smokeless tobacco, unspecified as to type, are intermediate (RR = 1.5 to 2.8). With regard to TSNAs, historical levels in American moist snuff products were higher than those in their Swedish counterparts, but levels in contemporary products are uniformly low. TSNA levels in chewing tobacco have always been low, but levels in dry snuff have been higher, including some very high levels in current products. In general, smokeless tobacco users are not exposed to significant levels of cadmium, lead, benzo(a)pyrene, polonium-210, and formaldehyde, when compared with concentrations of these compounds in foods. Finally, low oral cancer risk from smokeless tobacco use may be influenced by the presence of cancer inhibitors, mainly anti-oxidants, in smokeless tobacco products.

Publication Types:

PMID: 15470264 [PubMed - indexed for MEDLINE

[LurePer]

Jeg synes det er morsomt hvordan advarselene på snusboksen er formulert: "...kan være skadelig". Forøvrig kunne jo en kraftig prisreduksjon på snus redusere antall røykere, det må jo være noe for alle på venstresiden med sans for statlig oppdragelse.

[SilverFox]

Er bruk av snus farlig i den forstand at det gir økt risiko for kreft og kardiovaskulær sykdom? Dette er selvsagt ett hett tema ifm økningen i bruk av røkfrie tobakksprodukter. Forskning på sammenhengen mellom snusbruk og hjerte-karsykdom synes ikke å gi helt entydige svar:

Epidemiology. 2005 Jan;16(1):12-6. Related Articles, Links
 
Swedish moist snuff and myocardial infarction among men.
Hergens MP, Ahlbom A, Andersson T, Pershagen G.


BACKGROUND: Previous studies have provided inconsistent results on possible increased risk of cardiovascular disease with the use of smokeless tobacco. The aim of this study was to assess whether long-term use of Swedish moist snuff (widely used among Swedish men) increases the risk of acute myocardial infarction. METHODS: This case-control study was conducted in 2 Swedish counties. We identified 1760 men, age 45-70 years, who had a myocardial infarction in 1992-1994. We randomly selected male controls from the study base after stratification for age and hospital catchment area. Information about snuff consumption, smoking history, hypertension, and other factors was obtained by mailed questionnaire and medical examination. The participation rate was 77% among cases and 78% among controls, with tobacco use data available for 1432 cases and 1810 controls. RESULTS: After adjustment for age, hospital catchment area, and smoking, the relative risk of first acute myocardial infarction was 1.1 (95% confidence interval=0.8-1.5) for former snuff users and 1.0 (0.8-1.3) for current snuff users. Analyses limited to either nonfatal or fatal cases did not change the results. Among the controls, the consumption of smokeless tobacco was strongly associated with certain risk factors for myocardial infarction such as hypertension and high body mass index. CONCLUSION: The hypothesis that smokeless tobacco increases the risk for myocardial infarction is not supported in the present study.
PMID: 15613940 [PubMed - indexed for MEDLINE]

Kommentar; dette er sikkert et tema som vil bli studert mer framover. Det er grunn til å spørre seg om det er hensiktsmessig av myndighetene å advare så sterkt mot overgang fra røyking til bruk av snus, når risikoen for alvorlig sykdom ikke er mer entydig dokumentert. MEN: merk altså sammenhengen mellom snusbruk og økt blodtrykk/høy kroppsmasse.

Phu - godt å vite for en som ett årevis med fravær, her for en tid tilbake pluselig fant seg selv med kjeften full av hamsterbleier .........

Mye dumt en skal gjøre, men det er jo en god følelse dah.....

[J-King]

Snusing eller noen form for tobakk er bra.

Men snusing er bedre enn røyk hvertfall..Røyk skader myye mer..Så bedre å snuse enn røyk..Men jeg oppfordrer IKKE til snus..

[neven]

FÅ ting er bedre enn å slenge innpå en pris å sette seg i badstua etter en hardt treningsøkt!:D:D

[VargThor]

Snusing eller noen form for tobakk er bra.

Men snusing er bedre enn røyk hvertfall..Røyk skader myye mer..Så bedre å snuse enn røyk..Men jeg oppfordrer IKKE til snus..

Huh?

[Wacko]

FÅ ting er bedre enn å slenge innpå en pris å sette seg i badstua etter en hardt treningsøkt!:D:D

Badstue uten pris er vel så deilig spør du meg.....

[J-King]

Sitat fra: J-King på 23. november 2005, 22:59
Snusing eller noen form for tobakk er bra

Jeg glemte å skrive -ikke-

Haha..

[Hammer]

Har drevet å lest en del forskningsartikler i løpet av det siste halve året. Jeg sitter igjen med det intrykket at det er sinnsykt mye rart ute å går. Personlig synes jeg et abstract gir litt for lite informasjon til å kunne gjøre seg opp en mening. Når man studerer metoden som er brukt i mange studier oppdager man fort at mye av det er dårlig.

Har for eksempel en problemstilling i forhold til den første abstrakten. Snus gir økt risiko for hjerte- kar sykdommer. Blandt annet har snusere høyere BMI enn befolkningen generelt. Ut i fra det som kan leses her vet vi ikke hvor grundig det er undersøkt hvorvidt det er andre livsstilsfaktorer, enn snus, som har skyld i høy  BMI. I utgangspunktet vet vi jo at snus er med på å øke forbrenningen. Dette tatt i betraktning virker det jo ikke urimelig at det kan være andre faktorer som også spiller inn. Det kan jo hende at en gjennomsnittlig snuser har en annen livsstil enn gjennomsnittet av de som ikke snuser. BMIen kan tyde på det.

I bunn og grunn har jeg ikke peiling på dette, men dette var ihvertfall en liten og rotete refleksjon fra min side.

mvh Hammer