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Snus (Swedish smokeless tobacco) use and risk of stroke: Pooled Analyses of Incidence and Survival
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2014 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 276, no 1, 87-95 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Snus is a moist smokeless tobacco product with a high nicotine content. Its use has a short-term effect on the cardiovascular system, but the relationship between snus use and stroke is unclear.

OBJECTIVE: The aim of this study was to assess the associations between use of snus and incidence of and survival after stroke, both overall and according to subtypes.

METHODS: Pooled analyses of eight Swedish prospective cohort studies were conducted, including 130 485 men who never smoked. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of incidence and death after diagnosis using Cox proportional hazard regression models, and case fatality and survival using logistic regression and Kaplan-Meier methods, respectively.

RESULTS: No associations were observed between the use of snus and the risk of overall stroke (HR 1.04, 95% CI 0.92-1.17) or of any of the stroke subtypes. The odds ratio (OR) of 28-day case fatality was 1.42 (95% CI 0.99-2.04) among users of snus who had experienced a stroke, and the HR of death during the follow-up period was 1.32 (95% CI 1.08-1.61).

CONCLUSION: Use of snus was not associated with the risk of stroke. Hence, nicotine is unlikely to contribute importantly to the pathophysiology of stroke. However, case fatality was increased in snus users, compared to non-users, but further studies are needed to determine any possible causal mechanisms.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 276, no 1, 87-95 p.
Keyword [en]
smokeless tobacco, snus, stroke
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:umu:diva-86815DOI: 10.1111/joim.12219ISI: 000337787500011PubMedID: 24548296OAI: diva2:704186
Available from: 2014-03-11 Created: 2014-03-11 Last updated: 2014-08-22Bibliographically approved

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Eriksson, MarieJansson, Jan-Håkan
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