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Moist
(Swedish) oral snuff (snus)
WHAT MOST SMOKERS DO NOT
KNOW AND MAY NOT HAVE BEEN TOLD
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Tobacco for smoking
- Sale legal, causing 4000+ deaths p.a.
- Addictive.
- Of cigarette smokers continuing to
smoke after age 35 years, 1 in 2 will die early.*
- Quitting smoking is the best policy.
- ¾ million smokers continue to smoke.
95% of the harm from cigarettes is to
be found not in the tobacco, but in the inhaled tobacco smoke.
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Tobacco in the form of moist snuff (snus)
- Sale banned: can be imported for personal
use.
- As addictive as cigarettes.
- 20 times less risky than
cigarette smoking**
- Snus allows smokers to quit smoking’s risks without giving up
nicotine or tobacco.
- Users few – university students
from Scandinavia.
A can of snus as shown
here contains about 24 cachets (like small teabags) of about 0.8 g
moist tobacco each – providing a similar amount of nicotine as a
cigarette, effective within 10 minutes. This contains finely ground
tobacco similar to that in a cigarette. Absent the smoke, the harm is
95% less.
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*Peto
1994. **Levy 2004, data applied to NZ mortality in 2000.
For smokers seeking a less dangerous
nonsmoking alternative
Snus can be legally imported into New Zealand for personal use, and in any quantity, as
long as it is not on-sold. (NZ Customs letter to SmokeLess
NZ, 2 June 06). Price per day (postage included) is much less than the
cost of smoking manufactured cigarettes. Nicotine from snus is absorbed
more rapidly than from 4 mg nicotine gum. (Fig 1 below). Average
consumption is about 10 portions daily, held under the upper lip on one
side or the other of the mid-line. Snus is sold in 10-can rolls.
Table 1.
Price, and nicotine dose absorbed, from cigarettes, snuffs, and nicotine
gum.
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Nicotine in smoke
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In gum
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In snuffs
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Product
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Manufactured
Cigarettes
Dec 06
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RYO
cigarettes
Dec
06
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Nicotine
gum
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Oral
Snus
General
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Oral
Snus Catch Dry Mini
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Nasal
snuff
Singleton Menthol
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Retail cost per day, tax paid
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$8.91
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$4.21
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$4.79
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$6.171
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$3.54
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$3.95
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Tobacco
excise per day2
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$5.20
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$2.34
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0
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$3.62
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$1.09
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$1.26
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Price
per piece tax paid
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$0.50
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$0.23
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$0.53
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$0.62
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$0.35
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$0.23
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Price
per packet or can
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$9.90 /20
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$19.40/30g
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$15.95/30
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$7.33/241
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$4.881/20
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$3.95/3.5g
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Pieces
per packet
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20
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83#
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30
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24
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20
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17 snuffs
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Sticks/pieces
per day
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18#
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18#
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9
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10
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10
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17 snuffs
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Tobacco per piece
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0.72
g
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0.36
g3
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0
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1.0g
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0.3g
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0.2 g
/snuff
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Tobacco
per day
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13.1 g
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6.6 g
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0
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10 g
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3 g
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3.5 g
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Nicotine
content /piece
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13 mg
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6.5 mg
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4 mg
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8.8 mg9
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4.8 mg
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1 mg /snuff
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Nicotine
absorbed/ stick or pouch ,or 2 pinches4
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1.4 mg
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1.4 mg
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2 mg
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1.5 mg
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0.6 mg
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0.5 mg /snuff
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Daily
nicotine absorbed
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25 mg
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25 mg
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18 mg
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15 mg
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6 mg
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5 mg5
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Increase
in plasma nicotine after single dose ng/mL
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10 within 5 minutes
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10 within 5 minutes
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10 after 30 mins.6
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10 after 10 minutes7.
Peaks at 15 at 30 mins7
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138
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Levels after multiple doses ng/mL plasma
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37:7 48 in heavy smokers8
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377
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20 with patch6
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329 - 377
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129-377
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548
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Speed
of action
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Seconds: full effect over 10 puffs over
5 minutes
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5-10 minutes
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< 5 minutes
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< 5 minutes
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<3 minutes
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1. Internet prices, June 2006. 1 Euro =
NZ$ 2.00. Postage not included. For
nicotine gum prices, see www.endsmoking.org.nz/nrt.htm Does not include tax.
2 From
Dec. 2006, 36 cents per gram of tobacco. See http://www.customs.govt.nz/manufacturers/Excise+Duty.htm
3. Recommended
Retail Price from Swedish Match, for sale by tobacconists from 23 April 2007. Includes $0.44 GST. and tobacco tax $1.26.
3. Fraser T,
McRobbie H et al. Evaluation
of Smokestop an internet based smoking
cessation programme. Auckland
, 2006. See www.endsmoking.org.nz/ryotax.htm
4. 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.
5. Absorption
varies between individuals. Estimate is based on one tin of 6 g
tobacco snuff =30 snuffs (1 snuff = 1 pinch per nostril)
= 10 snuffs per day, one tin
lasting 3 days. This is the usual consumption in South African women,
assuming 55% absorption of nicotine, as for buccal
mucosa. See www.endsmoking.org.nz/nasalsnuff.htm
6. Data
sheets. www.medsafe.govt.nz/Profs/datasheet/h/Habitrolgum.htm
7. Holm H, Jarvis
MJ, Russell MA, Feyerabend C. Nicotine intake and dependence in Swedish
snuff takers. Psychopharmacology (Berl) 1992;
108: 507-11. Nicotine data for RYO cigarettes taken as equal to that for
manufactured cigarettes.
8. Russell MAH, Jarvis MJ, Devitt G.
Feyerabend C. Nicotine intake by snuff users. Br Med J 1981;283: 814-7. www.endsmoking.org.nz/nasalsnuff.htm
9. Lunnell
E, Lunnell M. Steady-state nicotine plasma
levels following use of four different types of Swedish snus compared
with 2-mg Nicorette chewing gum: a crossover
study. Nicotine Tob Res 2005; 7: 397-403.
SmokeLess’ proposed
health warning for New Zealand on all snuff cans:
This
tobacco product is addictive, and may damage your health, but is much
less harmful than cigarettes.
Some basic truths about smoke,
tobacco and addiction
With respect to major
health risks, as the packet warning says, SMOKING kills.
·
The use
of smoking tobacco products (cigarette, pipe or cigar) kills; whereas
using non-smoking tobacco products seldom kills.
- The unburnt
tobacco as sold in a cigarette, when tested in the unburnt state contains very few of the poisons
created by burning that same tobacco, as tested in the
cigarette’s smoke.
[Smoke contains 1014 reactive oxygen molecules
(free radicals) per puff].
- In New Zealand, nicotine addicts can only buy
addictive nicotine in the form of cigarettes.
- Pure nicotine (such as gum) is not
addictive and though safe for adults may not be safe for the fetus.
- Adults
can use it for 5 years without major ill-effect. (Murray RP, Bailey WC,
Daniels K. et al. Safety of nicotine polacrilex
gum used by 3,094 participants in the Lung Health Study. LHS
Research Group. Chest 1996; 102: 438-45.)
With
respect to addiction
·
Addiction
to the smoking of tobacco kills
by driving the smoker to smoke toxic smoke for years.
- Nicotine and the poisonous gases are
inhaled in the same breath, so addiction to smoking and disease go together. Those inhaling most will
be most addicted. Those most addicted will inhale more. Those most
addicted, are at greatest risk of diseases caused by smoking –
and the least likely to quit.
- Tobacco
(smoked or sucked) commonly addicts, whereas pure NRT nicotine
seldom does.
- Smoking
tobacco addicts fatally; oral tobacco addicts, but seldom kills.
- NRT whether
sucked, chewed or worn on the skin, seldom addicts.
Also see: Tobacco
Policy, using evidence for better outcomes, Sydney: Royal Australasian College of Physicians, May
2005: www.racp.edu.au/hpu/policy/tobacco/tobacco_policy.pdf pp.62-4.
To import snus
for personal use after failing to quit by other means: See http://www.northerner.com/html/snus.html
or http://www.buysnus.com NZ Customs Department says any quantity
can be imported, but only for personal use.
THE EFFECT OF USING ORAL SNUFF THROUGHOUT
THE DAY
Hourly snuff taking results in higher
nicotine levels during the day, approximating the levels obtained from
repeated cigarette smoking. (Figure 1).
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Plasma
nicotine levels from hourly use of Swedish oral snuff, compared with 2
mg nicotine gum
General, a most popular brand in Sweden, raises plasma nicotine to 2.5 times that
from 2 mg gum, and would produce higher levels than 4 mg gum. Catch Dry Mini produces levels
close to 2 mg gum, while Catch
Licorice and Catch Mini
raise nicotine by about as much as 4 mg nicotine gum, but probably more
rapidly than would gum.
Lunnell E, Lunnell M.9
For the levels
during the first hour, see Figure 2 below.
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General snus (1g tobacco) contained 8.8 mg nicotine, of which the snuff
taker extracts 2.7 mg. Of the amount extracted, 40 to 60% is absorbed,
resulting in plasma nicotine peaking at 29 ng/ml.9
THE EFFECT OF A SINGLE DOSE OF ORAL SNUFF ON
PLASMA NICOTINE, HEART RATE AND STRENGTH OF THE NICOTINE EFFECT
The graphs below (US brands only) show that a single dose of
oral (tobacco) snuffs rapidly increases serum nicotine levels, thus
mimicking the effect of smoking a cigarette, and increase those levels much more rapidly than the mint
(non-tobacco) placebo snuff.
Figure 2. Mean plasma nicotine
concentration, heart rate, and visual analogue scale (VAS) score (product
"strength") after administration of each of four smokeless
tobacco products, or mint snuff.
Reginald
V Fant, Jack E Henningfield,
Richard A Nelson, and Wallace B Pickworth Pharmacokinetics and pharmacodynamics
of moist snuff in
humans Tob. Control, Dec 1999; 8: 387 -392.
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