• Bengt Haglund, Mats Eliasson, Magnus Stenbeck, and Måns Rosén.
• Centre for Epidemiology, Swedish National Board of Health and Welfare, Stockholm, Sweden. Bengt.Haglund@socialstyrelsen.se
• Scand J Public Health. 2007 Jan 1; 35 (6): 618-22.

BackgroundThe potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results.AimsThe aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use.MethodsThe Swedish Survey of Living Conditions from 1988-89 was record-linked to the Swedish Cause of Death Register and the Swedish Hospital Discharge Register to investigate excess mortality and hospitalization from IHD and stroke. A Poisson regression model was used and incidence rate ratios (IRRs) for snuff and smoking were calculated controlling for age, physical activity, self-reported health, number of longstanding illnesses, residential area, and socioeconomic position.ResultsAmong snuff users there were no excess risks of mortality or hospitalization from IHD (IRR 0.8; 0.5-1.2,) or stroke (IRR 1.1; 0.7-1.8), but, as expected, clear excess risks were found for smokers (IRR 1.7; 1.4-2.1 for IHD, and IRR 1.4; 1.0-1.9 for stroke).ConclusionsThis study has not shown any excess risk among users of snuff for IHD or stroke. If there is a risk associated with snuff it is evidently much lower than those associated with smoking.

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