Is moist snuff use associated with excess risk of IHD or stroke? A longitudinal follow-up of snuff users in Sweden

Scand J Public Health. 2007;35(6):618-22. doi: 10.1080/14034940701436949.


Background: The potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results.

Aims: The aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use.

Methods: The 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.

Results: Among 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).

Conclusions: This 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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myocardial Ischemia / etiology*
  • Risk Factors
  • Socioeconomic Factors
  • Stroke / etiology*
  • Tobacco, Smokeless / adverse effects*