05. Health Contribution

Maximising our health contribution requires top-class insights.

Introduction

No one knows more than we do about the benefits of oral nicotine – and the positive effects it can have on global tobacco-related illnesses and death. As snus contains nicotine, it can act as a substitute for cigarettes – and it is a lot less harmful to your health than smoking. Snus is often used by smokers as a means to quit smoking and some people choose to start using snus instead of starting to smoke. For these reasons, snus can be seen as a consumer product that helps reduce the negative effects of smoking. With these factors in mind, Haypp Group wants to assess how snus and similar nicotine products can help to reduce the damage from smoking.

Initiative

We address a number of difficult questions:

  • How many positive health differences can be attributed to snus?
  • How has snus and different conditions contributed to health effects in Sweden and Norway – the two countries where snus is most common?
  • Has the ban on snus in the EU contributed to deteriorating public health?
  • How could public health in the EU be improved if snus were permitted?
  • Exploring different ways of thinking about the health effects – and how we can measure them.

The purpose is to see how  snus contributes to reducing smoke-related damage. For an accurate result, different calculations should be performed, with different assumptions, and based on different starting points.

An important part of this work is to ensure that calculation methods are simple and transparent. Ensuring that as many people as possible understand the assumptions on which they are based, thus alleviating uncertainty.

The full study can be downloaded in pdf format here.

The potential of snus as a life-saver

Snus is many times less harmful to health than tobacco smoking. As snus contains nicotine, snus acts as a substitute to smoking. Snus is used by smokers to quit and some choose to start using snus instead of start smoking. Snus can therefore be seen as a consumer product with a potential to reduce the harm from smoking. Against this background Haypp Group has commissioned Lakeville to assess the potential of snus as an instrument to reduce the public health harm from tobacco smoking.

The aim of this study is to assess the potential of snus as an instrument to reduce the harm from smoking. More specifically the report tries to estimate the potential of snus in reducing the number of smoking-attributable deaths and the incidence of smoking attributable cancer cases.

The Swedish tobacco strategy

About 6 per cent of the male adult population in Sweden smoke, by far the lowest share of smokers in the EU which has an average of about 28 per cent. The lower smoking prevalence in Sweden has had clear effects on public health. Sweden has the lowest number of smoking-attributable male deaths in Europe, the lowest number of smoking-attributable lung cancer deaths, and the lowest number of smoking-attributable new cancer cases

The higher price on cigarettes in Sweden is insufficient to explain the full difference in smoking behaviour compared to other EU member states. Countries such as Ireland, the United Kingdom and France has had significantly higher prices on cigarettes than in Sweden for a long period of time. The higher prices in these countries have not been able to cut smoking rates among males to Swedish levels.

Compared to other EU member states, Sweden do not stand out neither as an exceptionally early adopter, nor as an exceptionally strict user of smoking control measures. Furthermore, some countries like Finland and Italy can in some smoking regulation areas be seen as forerunners, but still with larger shares of male smokers than in Sweden.

From a policy perspective the only remaining difference between Sweden and the EU to explain the lower Swedish smoking prevalence among men is the tradition of snus use in Sweden and the prohibition of the sales of snus in the rest of EU. Snus is a nicotine substitute to smoking and reduce the uptake of smoking and help smokers to quit smoking.

Male smokers and male smoking-related health in Sweden and the EU (Per cent and per 100,000 males)

Share of current smokers (%) Smoking-attributable deaths (per 100,000) Smoking-attributable lung cancer deaths (per 100,000) Smoking-attributable new cancer cases (per 100,000)
Sweden 6 135 42 93
Average EU 28 296 109 251
Difference SE-EU 22 pp -162 -67 -157
Difference (%) -55 -61 -65

Consequences of lifting the EU ban on snus

An EU policy allowing the sales of snus can be estimated to reduce the number of male smoking-attributable deaths with about 210 000 per year. The number of smoking-attributable lung cancer deaths is estimated to be reduced with about 75 000 and the number of smoking-attributable new cancer cases with 175 000 per year. This calculation presumes an uptake of, and substitution to, snus among European men to the same degree as in Sweden.

The potential of snus to reduce smoking-related harm among men in the EU (Number of males 35+ and change in per cent)

Smoking-attributable Current EU policy EU policy allowing snus Reduction Reduction (%)
Deaths 441 354 230 447 -210 907 -48 %
Lung cancer deaths 143 247 69 372 -73 875 -52 %
New cancer cases 330 059 155 203 -174 856 -53 %