ArticleBMC medicine2021
Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe.BMC public health · 2025Pooled it
- Smoking Status and Type 2 Diabetes, and Cardiovascular Disease: A Comprehensive Analysis of Shared Genetic Etiology and Causal Relationship.Frontiers in endocrinology · 2022Pooled it
- Cardiovascular and metabolic changes following 12 weeks of tobacco and nicotine pouch cessation: a Swedish cohort study.Harm reduction journal · 2025Trial
- Snus, nicotine pouches and cardiovascular disease: Evidence, mechanisms, and the challenge of novel nicotine products.Journal of internal medicine · 2026Review
- Associations between common mental disorders, cardiovascular risk factors and lifestyle in adults participating in targeted health dialogues in Sweden.Preventive medicine reports · 2026Article
- Decreasing aortic diameter and decreasing prevalence of infrarenal aortic aneurysms in a population-based screening programme.The British journal of surgery · 2025Article
- Snus and Cardiometabolic Health Markers Among Swedish Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Smokeless, not harmless: Understanding Naswar's cardiovascular risks in the northwestern Pakistan.Preventive medicine reports · 2025Article
- Social Isolation and Mortality in Older Adults in Sweden: A Cohort Study.International journal of public health · 2025Article
- Scoping of Policy Impacts for Regulating E-cigarettes (SPIRE): findings from a data and decision analytic model mapping project.NIHR open research · 2025Article
- Beyond smoking: Risk assessment of nicotine in pouches.Toxicology reports · 2024Article
- Abdominal aortic aneurysm repair in Sweden vs. Finland: benefits of population-wide screening.European heart journal · 2024Article
- Is smokeless tobacco a healthier option in patients with AUD? A follow-up study during treatment.Harm reduction journal · 2024Article
- Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study.BMJ open respiratory research · 2024Article
- TRENDING CULTURAL DRIVERS OF SMOKELESS TOBACCO: FOR RECENT REFUGEE AND IMMIGRANTS AS KNOWLEDGE, ATTITUDES, AND BEHAVIOR DETERMINANTS: A SOUTH TEXAS ORAL HEALTH NETWORK COLLABORATIVE STUDY.Texas dental journal · 2024Article
- Nicotine and Cardiovascular Health: When Poison is Addictive - a WHF Policy Brief.Global heart · 2024Article
- Association of Cardiovascular Disease Risk Factors with Exclusive Smokeless Tobacco Use among US Males: Cross-Sectional Analysis of NHANES Data 2003-2018.American journal of health promotion : AJHP · 2023Article
- Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey.Annals of translational medicine · 2023Article
- Dietary habits among snus users: a population-based cross-sectional study.Food & nutrition research · 2023Article
- Phenotype Harmonization in the GLIDE2 Oral Health Genomics Consortium.Journal of dental research · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCigarette smoking is a well-known risk factor for cardiovascular disease (CVD), but whether smokeless tobacco such as snuff is associated with the risk of CVD is still unclear. We investigated the association of the use of Swedish oral moist snuff (snus) with a broad range of CVDs and CVD mortality.
methodsWe used data from a population-based cohort of 41,162 Swedish adults with a mean baseline age of 70 (56-94) years who completed questionnaires regarding snus use and other lifestyle habits and health characteristics. Participants were followed up for incident cardiovascular outcomes and death over 8 years through linkage to the Swedish National Patient and Death Registers. Hazard ratios (HR) were estimated by Cox proportional hazards regression. We conducted analyses among all subjects as well as among never smokers to reduce residual confounding from smoking.
resultsAfter adjustment for smoking and other confounders, snus use was not associated with myocardial infarction, heart failure, atrial fibrillation, aortic valve stenosis, abdominal aortic aneurysm, stroke, or CVD mortality. However, in never smokers, snus use was associated with a statistically significant increased risk of total and ischemic stroke (HRs [95% confidence intervals] = 1.52 [1.01-2.30] and 1.63 [1.05-2.54], respectively) and non-significantly positively associated with some other CVDs.
conclusionsIn this middle-aged and elderly Swedish population, current Swedish snus use was not associated with the risk of major heart and valvular diseases, abdominal aortic aneurysm, or CVD mortality in the entire study population, but was linked to an increased risk of stroke in never smokers.
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