SmokeLess New Zealand

www.smokeless.org.nz  info@smokeless.org.nz

                                                                                 Printable version: www.smokeless.org.nz/oralsnuff.pdf

Oral snuff

A less harmful alternative to smoking cigarettes

Snuff is finely ground tobacco, containing nicotine. As long as it is not burnt to create smoke, it will not be inhaled into the lungs. Thus it will not cause lung cancer or emphysema.

It should be regulated to contain less than 5 parts per million of TSNA (tobacco specific nitrosamines, as in Sweden where a million Swedes daily use snus, and where the rate of mouth cancer in males is the lowest in the western world.

 

 

Cigarettes the most dangerous tobacco product

In New Zealand, 99% of tobacco sold in New Zealand is in the most dangerous category – cigarettes (including hand rolled).1 Contrast Sweden:  48% cigarettes, 46% snus, 6% cigars, pipes and hand rolled.2

·         Cigars and pipe tobacco make up less than 1 percent of tobacco sold in New Zealand.1

·         Sale of (less dangerous) snuff is banned; only import for personal use is permitted.

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1. Laugesen M. Analysis of Manufacturers’ returns to Ministry of Health. Wellington. www.ndp.govt.nz .

2. Fagerstrom K. The Nicotine market: an attempt to estimate the nicotine intake from various sources and the total nicotine consumption in some countries. Nic Tob Res. 2005; 7: 343-50.

Risks higher for inhalers (Figure 1)

  • Heavy cigarette smoking triples the risk of a never smoker of dying early.
  • Moderate or light smoking doubles the risk of a never smoker of dying early.
  • Very light smoking still increases the risk of dying early by half.
  • Cigarette smokers mostly inhale, incurring increased risks compared with cigars and pipes.
  • Cigar smoke when inhaled – increases the risk as for light cigarette smoking.
  •  Inhaled second hand smoke is next most dangerous – as from living with a smoker.

 

 

Risks lower for non-inhalers (Fig. 1)

  • Swedish moist snuff (snus) raises total death risk by 5% over than of a never-smoker.
  • Cigar smoke, if not inhaled, raise total death risk by 4% over that of a never-smoker.
  • Never smokers who live in a home where no-one smokes have the least risk.

 Anyone combining cigarettes with other products will have an intermediate level of risk.

 

 

·          

The continuum of death risk across tobacco products

Cigarette smoking risks far exceed any other type of tobacco. Never using it and avoiding breathing second hand smoke is the safest way. In between are products of varying grades of risk. (Figure 1)

 Figure 1. Relative mortality risk from smoking, inhaling, snuffing, or abstaining from tobacco

Sources:

Cigarette smoking risks:Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day

Tobacco Control 2005; 14: 315-20, based on followup of 43,000 Norwegians from 1970s to 2002.

Cigar smoking risks: Cigars, health effects and trends. Monograph 9, National Cancer Institute USA,  1998, based on follow-up of  1 million US subjects for 12 years, including 22,000 cigar smokers, in Cancer Prevention Study I, 1959-72, normalized to the Bjartveit estimates for cigarette smoking risks, using the cigar to cigarette smoking risk ratios  in CPI I.

 

Second hand smoke risk: Hill S, Blakely T, Kawachi I, Woodward A. BMJ 2004 988-89 (24 April). Based on fate of  never smokers whether living with a smoker or not in 1996 NZ census.

Risks of snus Levy DT et al. Cancer Epidemiology, Biomarkers and Prevention 2004; 13: 2035-42.

Risks of nicotine gum. Murray RP, et al. Safety of nicotine polacrilex gum used by 3094 participants in the Lung Health Study. Chest 1996; 109: 438-45. Followed for 5 years, compared with 1900 controls. No increase in hospitalization or mortality in the nicotine gum chewers.

PROPOSED HEALTH WARNING FOR SNUFF

This product is addictive, may cause disease, but is much less harmful than cigarettes

or

This tobacco product can damage your health and is addictive

 

 

 

 

Conclusion

·         Cigarettes are far more dangerous than any other tobacco product.

·         Light cigarette smoking is as dangerous as inhaling cigar smoke.

·         Second hand smoke inhalers' risk exceeds snus risk or the risk of not inhalers of  cigar smoke..

·         The risks of snuff or even chewing on a lit cigar are minimal, as long as no smoke is inhaled. 

·         The safest thing to do is to not smoke at all.

·         Using nicotine gum for 5 years appears to be safe.

 

 

What could be done

·        Lifting the sales ban on the least toxic snuffs would give smokers more options for avoiding lung cancer and smokers’ lung (emphysema).

·        Less harmful tobacco products should attract less tax  to encourage the switch away from combustible tobacco. www.smokeless.org.nz/taxandrisk.htm

·        For the same reason, cigarette taxes, particular taxes on hand rolling cigarette tobacco should be steadily increased. The Royal Australasian College of Physicians recommends a steady annual price increase (of 2 to 5 percent every year) above the level of inflation.

www.racp.edu.au/hpu/policy/tobacco/tobacco_policy.pdf 

·        The toxicity of cigarette smoke emissions should be reduced as far as possible, by regulation. See www.smokeless.org.nz/lesstoxiccigs.htm

Snuffs vary in risk (Table 1 below). Only the least toxic should be allowed into New Zealand whether for personal use or sale, and they should conform to the Swedish standard (Table 2 below).

 

 

 

 

Current situation on alternatives to smoking. See www.smokeless.org.nz/smokersoptions.htm

PROPOSED POLICY TO REGULATE THE HARMFUL CONSTITUENTS OF ALL TOBACCOS:

See www.smokeless.org.nz/snuffregulations.htm

For more about Swedish moist oral snuff see www.smokeless.org.nz/snus.htm

 

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Separating the addiction from the smoke © SmokeLess New Zealand