Smokeless tobacco products equally harmful

Washington: Smokers often misunderstand health risks that come with consuming smokeless tobacco product, a recent study suggests. While smokeless tobacco products are addictive, contain cancer-causing chemicals and are linked with cardiovascular and certain cancer risks, products such as snus, a kind of smokeless tobacco, have comparatively fewer health risks than smoking when used exclusively.

This product can also serve as harm reduction alternatives for smokers unable or unwilling to completely quit tobacco. Published in the Journal of Addictive Behaviours, the study provides new research on what smokers think about snus.

Snus, a Swedish word for "snuff", is a moist powder tobacco that can be sold in a loose form or in small pre-packed pouches that users place under the top lip for about 30 minutes. It is typically spit free. The product is popular in Scandinavia, but newer to the United States. In Sweden, snus use has been linked to a decrease in tobacco smoking and smoking related diseases.

The researchers reviewed how 256 smokers responded to questions about their perceived risk of developing lung cancer, heart disease and oral cancer from using snus versus cigarettes, and whether there were sub-groups of smokers with similar patterns of beliefs. More than 75 per cent of the participants smoked daily and about 20 per cent had tried smokeless tobacco.

The researchers found that smokers fell into three subgroups based on their beliefs.

- About 45 per cent perceived snus to be as harmful as smoking overall and for all three risks: lung cancer, heart disease and oral cancer.

- About 38 per cent perceived that snus poses less risk for lung cancer and heart disease than cigarettes but had the same oral cancer risk as cigarettes.

- Another 17 per cent accurately perceived snus to have lower risks for lung cancer but perceived risks for oral cancer and heart disease to be about the same as that from smoking.

- Almost 40 per cent incorrectly perceived the risk of oral cancer to be higher from snus use than smoking.

"These findings continue to suggest that the public does not understand that combustion escalates the health risks in tobacco products that are smoked, making them more harmful than non-combusted smokeless tobacco on a continuum of risk," said lead researcher Olivia Wackowski.

“They are also significant given that use of Scandinavian snus has not been clearly associated with oral cancer, unlike smoking, which poses a significant risk for oral cancer," Wackowski added.

Quitting all tobacco is the best course of action. However, smokers who have not been successful in quitting or who do not want to quit tobacco entirely may be able to reduce their risks by learning about and switching to a product like snus, Wackowski said.

However, this information can be challenging to communicate and is a key area for research work. It's important for smokers to know that the reduced risks may come from completely switching over from smoking to snus use, and not using both products, she said. It's also important that such messaging does not unintentionally encourage product initiation among non-users, especially youth.