Snus Becomes Sweden's Strange Cultural Product of Neither Smoking Nor Chewing

Today’s news, April 2: According to foreign media reports, this is one of the cultural peculiarities that the European Union would normally be eager to protect and promote, yet snus has never enjoyed the popularity of Parma ham or Champagne. In fact, every EU member state except Sweden bans it, even though it is a safer tobacco product than cigarettes.

Tobacco that is neither smoked nor chewed is a strange Swedish cultural product, Patrik Hildingsson cheerfully admits.

He is vice president of Swedish MATch, the largest snus manufacturer. Strange, perhaps, but successful. Snus consumption never disappeared, even when it fell out of fashion as Swedes embraced the global smoking trend. Now the snuff-like product placed between the upper lip and gum has reclaimed the top spot.

Ever since the link between smoking and cancer was definitively established in the 1960s, more and more Swedes seeking nicotine have come to believe the old way is best. Cigarette consumption has fallen to 4%, the lowest in the EU, making Sweden the only European country to surpass the World Health Organization’s endgame target of 5%.

Sweden now also has the lowest cancer incidence in the EU, including oral cancer. There was never any formal campaign urging smokers to switch to snus; rather, it was a kind of consumer-led rebellion as people made the choice themselves. More recently, the same phenomenon has appeared in Norway, although hard data has played a bigger role in spreading the message there.

In the United States, where Swedish immigrants first brought snus, it is also increasingly regarded as a safer alternative to cigarettes. One study found that snus carries the lowest carcinogenic risk among 10 tobacco products, at only 3.18% of the cancer risk of cigarettes. (Cigars were 41.1%, and chewing tobacco 11.18%.)

Part of what has made snus more attractive to modern consumers is that it now comes in pouches that can be conveniently placed under the lip, rather than as loose tobacco. This has also led to the emergence of tobacco-free alternatives, in which substitute fibers are treated with nicotine. Their carcinogenic risk is 0.22% of that of cigarettes, slightly lower than that of e-cigarettes.

The Snus Commission, a body funded by manufacturers but operating without their involvement in its work, estimates that if all EU countries switched from cigarettes to snus, deaths would be reduced by 355,000. The commission’s chairman, Anders Milton, is a physician and former president of the Swedish Medical Association.

He is well aware that snus is not a healthy product and that pregnant women should avoid it. But, much like vaping, snus means you can live, while smoking can kill. One of his colleagues on the commission, Professor Karl Olov Fagerstr?m, believes that while nicotine is addictive, in terms of harm it is closer to coffee and far less harmful than alcohol.

“It is smoking that is dangerous,” he explained. “If we smoked coffee, the situation would be very similar.” It is science, in fact, that makes the Snus Commission critical of the World Health Organization’s position that smoking should not be banned outright (despite strong opposition), while other tobacco products should be prohibited.

Tommaso Di Giovanni, vice president at PMI, owner of Swedish Match, compared the situation to Galileo being forced to renounce the scientific fact that the Earth revolves around the Sun, while declaring that it still moves.

Whether Sweden’s unusual cultural product can reshape Europe’s public health doctrine remains to be seen.