title: Snus use and cardiovascular risk factors in the general population: the HUNT3 study.
abstract: OBJECTIVE
  Snus, a form of smokeless tobacco, is increasingly popular in its traditional Nordic markets, and was recently launched commercially in the United States. We examined the cross-sectional associations between snus use and cardiovascular risk factors, and compared them with the corresponding associations of smoking.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The HUNT3 general population survey, Nord-Trøndelag, Norway (2006-08).
  
  
  METHODS
  A general population sample of n = 25 163.
  
  
  METHODS
  Measured triglyceride,- glucose- and high-density lipoprotein (HDL)-cholesterol levels, blood pressure and waist circumference, registry information on gender, age and education level, self-reported snus use, smoking, physical exercise and alcohol use.
  
  
  RESULTS
  In age- and gender-adjusted linear regression analyses, extensive snus use was associated with larger waist circumference (b = 1.65, 95% CI = 0.86, 2.43) and higher systolic blood pressure (b = 2.58, 95% CI = 1.48, 3.68), but with higher rather than lower levels of HDL-cholesterol (b = 1.66, 95% CI = 0.79, 2.53). These three differences remained significant after additional adjustment for smoking, education level, physical exercise and alcohol use. Smokers had higher triglyceride and lower HDL-cholesterol than snus users, but lower systolic blood pressure.
  
  
  CONCLUSIONS
  After adjusting statistically for major confounding variables, Norwegians who use snus extensively have a mixed profile in terms of cardiovascular risk: slightly higher waist circumference and systolic blood pressure but also higher high-density lipoprotein-cholesterol.
authors.affiliation: Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway; Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Division of Mental Health, National Institute of Public Health, Bergen, Norway.
authors.forename: Simon
authors.initials: S
authors.lastname: Øverland
authors.forename: Jens Christoffer
authors.initials: JC
authors.lastname: Skogen
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.forename: Ottar
authors.initials: O
authors.lastname: Bjerkeset
authors.forename: Tore
authors.initials: T
authors.lastname: Tjora
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D001794:Blood Pressure / Q000502:physiology*; D002784:Cholesterol / Q000097:blood*; D003430:Cross-Sectional Studies; D004522:Educational Status; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D014030:Tobacco, Smokeless; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D002784:Cholesterol
keywords: Cardiovascular risk; smokeless tobacco; smoking; snus