Making the European case for snus
Imagine this news story: “As Sweden celebrates the fifty-third anniversary of the seat belt as a standard accessory in Volvos, the European Commission health directorate reiterated its seat belt ban for all other EU countries. ‘All automobiles are dangerous; seat belts have not been proven to make cars safer and may promote riskier driving,’ said the EU health commissioner. Opposition in Sweden is led by the Karolinska Institute, which has documented rare fatalities among those wearing the devices…”
Today, this story is unimaginable. Seat belts are a proven harm reduction measure, preventing deaths and injuries from auto accidents. Why does the EC embrace seat belts and still ban another proven Swedish harm reduction measure, snus?
Snus is a 200-year old tobacco product. When placed in the mouth, it delivers nicotine and tobacco satisfaction, like cigarettes, but without the smoke. Nicotine is not the major cause of any disease; it is no more harmful than caffeine, which is addictive but safely consumed in coffee, tea and cola drinks.
Smoke kills. In contrast, studies from Sweden show that snus has minuscule health risks that are barely measurable with modern epidemiologic tools. This applies even to mouth cancer, for which snus poses virtually no risk. The EU removed the cancer warning on snus packages in 2001.
For 50 years, men in Sweden have smoked less and used more smokeless tobacco than in any other developed country, resulting in the lowest rates of lung cancer — indeed, of all smoking-related deaths. The Swedish snus experience is not only about men; increasing numbers of Swedish women are using spit-free, socially acceptable snus products.
The EU ban on vastly safer snus is contributing to smokers’ deaths. In a published study, I found that if EU men smoked at the Swedish rate, 274,000 smoking-attributable deaths would be avoided every year.
The EU ban is largely based on health risks identified in Karolinska Institute (KI) studies, which have also had a profound impact on tobacco regulation around the globe. These studies have obvious technical problems and contradictions that I have documented in medical journals. The KI refused to respond to or resolve them. Three years ago, I asked the researchers for access to their data so that their findings could be validated. My request was refused, despite the fact that KI had shared research data with other investigators. Scientific results must be open to challenge to determine their accuracy and integrity.
It is a tragedy that the EU ban on snus is based on exaggerated, fictitious or outlier health risks that mask the true harm reduction value of this product.
EU tobacco experts wrote in 2003: “Through the [snus] ban, the EU is actively preventing smokers having access to a product at least 90% less dangerous than cigarettes, but that is clearly an effective substitute for at least some people (and for many people in Sweden). It is important to consider where the EU draws its moral (and legal) authority to make such ‘life-or-death’ choices on behalf of its citizens—especially as, on the basis of Swedish evidence, it appears to be making the wrong choices.”
Almost ten years later, EU smokers are still facing avoidable premature deaths. It is inhumane for the EC to continue to deny them the tobacco equivalent of seat belts.