title: Is moist snuff use associated with excess risk of IHD or stroke? A longitudinal follow-up of snuff users in Sweden.
abstract: BACKGROUND
  The potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results.
  
  
  OBJECTIVE
  The aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use.
  
  
  METHODS
  The Swedish Survey of Living Conditions from 1988-89 was record-linked to the Swedish Cause of Death Register and the Swedish Hospital Discharge Register to investigate excess mortality and hospitalization from IHD and stroke. A Poisson regression model was used and incidence rate ratios (IRRs) for snuff and smoking were calculated controlling for age, physical activity, self-reported health, number of longstanding illnesses, residential area, and socioeconomic position.
  
  
  RESULTS
  Among snuff users there were no excess risks of mortality or hospitalization from IHD (IRR 0.8; 0.5-1.2,) or stroke (IRR 1.1; 0.7-1.8), but, as expected, clear excess risks were found for smokers (IRR 1.7; 1.4-2.1 for IHD, and IRR 1.4; 1.0-1.9 for stroke).
  
  
  CONCLUSIONS
  This study has not shown any excess risk among users of snuff for IHD or stroke. If there is a risk associated with snuff it is evidently much lower than those associated with smoking.
authors.affiliation: Centre for Epidemiology, Swedish National Board of Health and Welfare, Stockholm, Sweden. Bengt.Haglund@socialstyrelsen.se
authors.forename: Bengt
authors.initials: B
authors.lastname: Haglund
authors.forename: Mats
authors.initials: M
authors.lastname: Eliasson
authors.forename: Magnus
authors.initials: M
authors.lastname: Stenbeck
authors.forename: Måns
authors.initials: M
authors.lastname: Rosén
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000209:etiology*; D014030:Tobacco, Smokeless / Q000009:adverse effects*