LATE-BREAKING ABSTRACT: Increased vascular stiffness in Swedish snus users - Can snus really be considered for smoking cessation?

Abstract

Background: The Swedish oral moist snuff called snus has recently been introduced to the US market. There is a debate whether to introduce snus as a smoking cessation aid. Proponents for this are often affiliated with the tobacco industry and refer to the low percentage of smokers in Sweden as compared to other countries. There are contradictory results regarding the cardiovascular risk of snus use.

Aim: The aim of our study was to identify potential adverse vascular effects in healthy daily snus users compared to non-users.

Methods: 50 healthy men (24 snus users and 26 age-matched, non-users of snus) were included into the study. Subjects first completed a health examination, resting ECG, blood pressure (BP) control and routine blood tests. During the study, after 20 minutes of rest, BP, heart rate (HR) and arterial stiffness were measured with pulse wave velocity (PWV, Vicorder) and pulsewave-analysis (AiX75, SphygmoCor).

Results: There was no significant difference in BP or HR between snuff users and non-users of snus. Snus users had significantly higher vessel stiffness compared to non-snuff users (PWV: 7.1 vs 6.6 m/s, p=0.026; Aix75: 7.3 vs. 0.1 %, p=0.023).

Discussion: Our study shows significantly increased arterial stiffness in healthy snus using men. Swedish snuff is often regarded as harmless with negligible adverse health effects compared to smoking. Increased arterial stiffness is a BP independent risk factor for the onset of cardiovascular disease.

Conclusion: With the current scientific knowledge snus should not be recommended for smoking cessation. Snus research should be highlighted to a greater extent to break the myth of snus as a harmless form of tobacco.