Some Scientific Data on Snus

Smokers who switch to snus get almost as good health gains as those who succeed in giving up tobacco completely

Three weeks ago I published an open letter to all anti-snus lobbyists, asking them what scientific studies on snus they have based their opposition to snus on. So far, not a single anti-snus lobbyist has responded, neither the Smoke Free Partnership (who are otherwise very active on the subject), nor any other organization.

I find this rather odd, considering how keen lobbyists in general usually are when it comes to arranging meetings with members of the European Parliament. Since I am genuinely interested in learning why they (and DG SANCO at the European Commission) are opposed to this traditional Swedish smoke free product, I have sent another mail to the Smoke Free Partnership and some other anti-snus lobbyists today, inviting them to meet me in Brussels.

Time will show if they respond, or if they feel that they are not in a position to answer my question.

In the meanwhile, I would like to share a link to a very thorough article arguing in favour of snus as a help for smokers who want to quit, but find it difficult to do so cold turkey.

The article is written by Clive Bates, who is a former Director of the UK public health charity Action on Smoking and Health. Although he now works in an unrelated field, he has written the article expressing his own views out of concern is for smokers who would like to quit but find it hard.

I will cite the beginning of the article here:

Death by regulation: the EU ban on low-risk oral tobacco

Is it right to ban certain types of smokeless tobacco from sale in the European Union?  The short and unequivocal answer is  ’no’.But surely banning any type of tobacco can only reduce the size of the overall tobacco market and therefore be good for health?  No, not at all, it just isn’t that simple…  

This post gives my personal take on this important public health issue.

The reason for allowing it on the market is that smokeless tobacco is an effective substitute for smoking, but far less hazardous to health than cigarettes.  The chart to the left puts it quite well. It models the effect on life expectancy of switching from smoking to a type of smokeless tobacco (‘snus’ or Swedish oral snuff) at a given age. These are dramatic findings.  Given the addictiveness of nicotine and how difficult some smokers find quitting even if they really want to, banning this option amounts to death by regulation.   What has gone wrong?

Switching provides a substantial health benefit to smokers who switch, in fact switching is not that much different to quitting smoking altogether. Furthermore, the risks of the product itself (the bottom red line) are quite low (Gartner et al 2007 - see SCENIHR p117).   However, these products are banned in law the EU (other than in Sweden), and smokers have been denied the option to switch to this much lower risk way of taking nicotine.

A group of us concerned about public health policy set out the arguments for this in 2003 (Bates et al 2003) and the arguments haven’t changed since.  They have only strengthened as more evidence has become available. As Gartner et al conclude:

Current smokers who switch to using snus rather than continuing to smoke can realise substantial health gains. Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers. Relaxing current restrictions on the sale of snus is more likely to produce a net benefit than harm, with the size of the benefit dependent on how many inveterate smokers switch to snus.

Despite this, these products are banned in the European Union under Tobacco directive 2001/37/EC article 8 (other than in Sweden).   Worse still, and in the face of abundant evidence that supports the lifting of this ban, the EU appears ready to maintain or extend it in a new tobacco directive (see consultation [PDF see p4-6]) and comments from the Commission (here and here).

This is wrong at many different levels. In the sections that follow, I’ll address three major policy failings under the following headings:

Public health science ignored and abused
Ethics and consumer rights violated
EU legal principles disregarded

Read more at Clive Bates blog

As I have said, I would be very interested to hear how both DG SANCO (the General Directorate within the European Commission responsible for the Tobacco Products Directive) and any anti-snus lobbyists would respond to the arguments that Clive Bates presents in his article.