Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large-scale population survey

J Intern Med. 1992 Oct;232(4):327-34. doi: 10.1111/j.1365-2796.1992.tb00593.x.


Health hazards associated with the use of smokeless tobacco were evaluated in a cross-sectional study of 97,586 Swedish construction workers undergoing health examinations in 1971-74. All users of smokeless tobacco only (5014 subjects) and all exclusive smokers of > or = 15 cigarettes daily (8823 subjects) were compared with all non-users of any tobacco (23,885). Both smokeless tobacco users and smokers showed higher prevalences of circulatory and respiratory disorders. Hypertension was most common in smokeless tobacco users. In the 45- to 56-years age group, the odds ratio for a diastolic blood pressure of > 90 mmHg was 1.8 (95% CI, 1.5-2.1), and for a systolic blood pressure > 160 mmHg, 1.7 (95% CI, 1.3-2.1). Smokers showed the lowest prevalence of hypertension. Disability pensions due to cardiovascular disease were nearly 50% more frequent in both smokeless tobacco users and smokers. These findings indicate that an increased cardiovascular risk is also associated with the use of smokeless tobacco.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Pressure / drug effects*
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cross-Sectional Studies
  • Disabled Persons
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology
  • Health Status*
  • Heart Rate / drug effects
  • Humans
  • Middle Aged
  • Nicotine / adverse effects*
  • Pensions
  • Plants, Toxic*
  • Sweden / epidemiology
  • Tobacco, Smokeless / adverse effects*


  • Nicotine