Public health experts have expressed a concern about the long-term effects of shifting product use among tobacco and nicotine users.
“Some studies indicate that tobacco snus can increase the risk of four types of cancer,” said Lisa L. Ermann, an expert on tobacco and the environment with the Cancerfonden, or Swedish Cancer Society, who points to stomach, pancreatic, and rectal and esophageal cancers. “We don’t have the body of evidence to be sure.”
Snus research has mostly been conducted on men, but Rosaria Galanti, professor emerita at the department of global public health at the Karolinska Institutet, is worried about how nicotine pouch use among women will affect maternal and fetal health. Very small numbers of women still smoke during pregnancy, but data about the prevalence of nicotine pouch use is limited.
“The thing that we can surely watch for right now is to look for the use during pregnancy. That’s what I fear right now, mostly,” said Galanti. “Since young women perceive this problem as safe, we don’t know actually how many quit during pregnancy.”
Louise Adermark, a researcher in the University of Gothenburg’s pharmacology department, compared pouch use to that of gum. A user replaces their piece when the flavor is gone.
In comparison, typically male snus users may use one snus dose for several hours. This makes it more difficult to draw apples-to-apples comparisons about how nicotine exposure is affecting the brain and the rest of the body: short bursts versus gradual absorption.
“I think that one thing that we have to always keep in mind is that we don’t have to use nicotine,” said Adermark. “But I think that when it comes to the argumentation about different things, people sometimes forget about that.”
This story is part of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.
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