The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts.

@article{Levy2004TheRR,
  title={The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts.},
  author={David T. Levy and Elizabeth A. Mumford and Kenneth Michael Cummings and Elizabeth A. Gilpin and Gary A Giovino and Andrew J. Hyland and David T. Sweanor and Kenneth E. Warner},
  journal={Cancer epidemiology, biomarkers \& prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology},
  year={2004},
  volume={13 12},
  pages={
          2035-42
        }
}
  • D. LevyE. Mumford K. Warner
  • Published 1 December 2004
  • Medicine
  • Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
A nine-membered panel of experts was asked to determine expert opinions of mortality risks associated with use of low-nitrosamine smokeless tobacco (LN-SLT) marketed for oral use. A modified Delphi approach was employed. For total mortality, the estimated median relative risks for individual users of LN-SLT were 9% and 5% of the risk associated with smoking for those ages 35 to 49 and > or =50 years, respectively. Median mortality risks relative to smoking were estimated to be 2% to 3% for lung… 

Tables from this paper

Similar Exposure to a Tobacco-Specific Carcinogen in Smokeless Tobacco Users and Cigarette Smokers

Results show similar exposures to the potent tobacco-specific carcinogen NNK in smokeless tobacco users and smokers, and do not support the use of smokeless Tobacco as a safe substitute for smoking.

Health Risks of Smoking Compared to Swedish Snus

Seven studies are identified that provide quantitative evidence that, for certain health outcomes, the health risks associated with snus are lower than those associated with smoking.

Meta-analysis of the relation between European and American smokeless tobacco and oral cancer

Smokeless tobacco, as used in America or Europe, carries at most a minor increased risk of oral cancer, however, elevated risks in specific populations or from specific products cannot definitely be excluded.

Pilot study on lower nitrosamine smokeless tobacco products compared with medicinal nicotine.

With the exception of medicinal nicotine products, low-nitrosamine ST products have the greatest potential to result in reduced toxicant exposure compared with other combustible reduced exposure products and have promise for reducing individual risk for disease.

Grass roots approach to control levels of carcinogenic nitrosamines, NNN and NNK in smokeless tobacco products.

The appeal of smokeless tobacco products among young Canadian smokers: the impact of pictorial health warnings and relative risk messages.

INTRODUCTION Although the health risks from smokeless tobacco (ST) are lower than cigarettes, it remains unclear how smokers might use ST products, including as a substitute, a cessation aid, or

University faculty perceptions of the health risks related to cigarettes and smokeless tobacco.

The risks of ST use are overestimated and conflated to that of cigarettes among highly educated professionals, demonstrating the need for better education about the risks of tobacco use and for communication of accurate information by health organisations and agencies.

Evaluation of biomarkers of exposure in adult cigarette smokers using Marlboro snus.

  • M. SarkarJ. Liu H. Roethig
  • Medicine
    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
  • 2010
The proportionate reduction in exposure when reducing the number of cigarettes by 50% and using MSNUS, under the consumption patterns observed, suggest that the AS did not appear to alter their smoking behavior.

Relative Risk Perceptions between Snus and Cigarettes in a Snus-Prevalent Society—An Observational Study over a 16 Year Period

Perceptions of relative risk between snus and cigarettes is inconsistent with estimates from medical expert committees, which assess the overall health risk from use of Swedish snus to be minor when compared to the risk from smoking.
...

References

SHOWING 1-10 OF 51 REFERENCES

Effect of smokeless tobacco (snus) on smoking and public health in Sweden

Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a notably less harmful form of nicotine dependence.

Chronic disease mortality in a cohort of smokeless tobacco users.

Combined use of smokeless tobacco and cigarettes did not increase overall mortality beyond that expected from use of the individual products.

Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers.

Although the risk of cardiovascular disease associated with the use of smokeless tobacco users and smokers face a higher risk of dying from cardiovascular disease than nonusers, the excess risk gives cause for preventive actions.

Smokeless tobacco use and cancer of the upper respiratory tract.

  • B. RoduP. Cole
  • Medicine
    Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
  • 2002
This review describes 21 published studies of the cancer risks associated with smokeless tobacco use, 20 of which are of the case-control type, and describes each study according to the specific anatomic sites and to the type of smokeless Tobacco products for which it provides relative risks of cancer.

Oral snuff, smoking habits and alcohol consumption in relation to oral cancer in a Swedish case‐control study

A multivariate analysis suggested that the most important risk factors were beer and liquor consumption, followed by smoking, followedBy smoking, which showed the strongest risk for oral cancer.

Smoking and drinking in relation to oral and pharyngeal cancer.

Risks of oropharyngeal cancer tended to combine more in a multiplicative than additive fashion and were increased more than 35-fold among those who consumed two or more packs of cigarettes and more than four alcoholic drinks/day.

Smokeless Tobacco as a Possible Risk Factor for Stroke in Men: A Nested Case-Control Study

Whereas regular smoking doubles the risk of stroke in men, snuff use is not associated with any apparent excess risk.

Carcinogenic agents in snuff.

The findings from this study, the biologic activity of snuff in animal models, and the epidemiologic studies on snuff use and oral cancer strongly suggest the need for reduction of carcinogens and especially of nitrosamines and polonium-210 in snuff.

Tobacco and myocardial infarction: is snuff less dangerous than cigarettes?

In middle aged mensnuff dipping is associated with a lower risk of myocardial infarction than cigarette smoking, and smoking, but not snuff dipping, predicted myocardia infarctions in a multiple logistic regression model that included age and level of education.
...