Tobacco.org

• Diplomats arrested for cigarette smuggling 

Swedish police have arrested two North Korean diplomats on suspicion of smuggling 230,000 cigarettes into the Nordic country, the Swedish Customs Office said Friday.

The pair, a man and a woman who have diplomatic status in Russia, were stopped by Swedish customs officers Wednesday morning as they drove off a ferry from Helsinki, the Finnish capital.

Customs officials discovered Russian cigarettes in the car driven by the couple, Swedish Customs spokeswoman Monica Magnusson told Reuters.

The two North Koreans claimed diplomatic immunity.

"They were accredited as diplomats in Russia, but had no accreditation in Sweden," she said. "They were arrested on suspicion of smuggling."

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• Swedish Match under fire in secret snus substance investigation  

Tobacco company Swedish Match has been accused of adding a substance to moist snuff or 'snus' to purposely increase user dependency and, in turn, boosts sales of their products.

Since 2005, the company has introduced eight new snus products with higher than average nicotine levels.

The usual level for snus is eight milligrams per gram. In one product, levels have almost doubled that figure.

”Certain consumer groups have shown demand for a high nicotine content,” the company’s production director Torbjörn Åkeson explains.

Allegations that the company adds a substance, known as E500, to purposely increase the amount of so-called ‘free’ nicotine – which increases dependency – are presented in a new report by investigative news programme Kalla Fakta. . . .

Yet, Professor Greg Connolly at the Harvard School of Public Health believes that Swedish Match is consciously using the substance to increase addiction and their profits.

”In a study in 2008 he concluded that we are manipulating the pH value, something that we consider hugely speculative,” Brehmer adds.

”It never led to demands from any authority that we need to change something.”

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• Smoking Raises Arthritis Risk and Makes It Harder to Treat  

Smoking cigarettes can lead to the development of rheumatic diseases and make them harder to treat, according to three new studies presented this week at the 2009 annual meeting of the American College of Rheumatology in Philadelphia.

The first study focused on what happens when people with rheumatoid arthritis light up while being treated for the disease.

Researchers looked at the medical records of 1,756 rheumatoid arthritis (RA) patients in Sweden, determined their smoking history or lack thereof and then looked at their response to methotrexate or anti-TNF therapy - two common RA treatments. . . .

Mark Fisher, MD, MPH, a rheumatologist at Massachusetts General Hospital in Boston says he found this the most impressive study of the three. "There aren't any studies that show smoking has an effect on response to methotrexate and it was a really well done study. So for those reasons I think it's significant," Dr. Fisher says.

A second study found that smoking is associated with organ damage and disease activity in people with systemic lupus erythematosus, a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, nervous system and other organs.

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• Smoking pregnant increases baby's asthma risk: study 

Smoking during pregancy increases the risk of a baby developing asthma up to sixfold, said a Swedish study published at the European Respiratory Society's annual congress on Monday.

The study by Professeur Anders Bjerg of the Sunderby central hospital in Norrbotten and his specialists showed that smoking leads to babies being born underweight, a fact that has an impact on the development of asthma.

The Swedish doctors studied asthma in about 3,400 children between 1996 and 2008.

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• Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis  

In conclusion, in studies carried out in the United States and Sweden we detected an association between use of smokeless tobacco products and risk of fatal myocardial infarction and fatal stroke, which is not readily explained by chance. Confounding and other sources of bias, however, cannot be completely excluded on the basis of available data, although we found no strong evidence for their effect. If the association is real, its public health and clinical implications might be substantial, despite the fact that the magnitude of the excess risk is small. Future research should aim to clarify the mechanisms of effect of smokeless tobacco products on deaths from cardiovascular disease and to elucidate whether a similar effect is present for non-fatal myocardial infarction and non-fatal stroke.

What is already known on this topic Smokeless tobacco products are widely used in many populations An association with risk of cardiovascular disease is plausible

What this study adds This systematic review and meta-analysis provided evidence for an association between use of smokeless products and risk of fatal myocardial infarction and stroke . . .

• Increased Risk Of Heart Attack And Stroke With The Use Of Smokeless Tobacco Products 

Research just published on bmj.com reports that people who use smokeless tobacco products like snus (a moist powder tobacco product) have a slightly higher risk of having a fatal heart attack or stroke.

Over the last couple of decades, there has been an increase in the number of people in Europe and North America using smokeless tobacco. Most new users are aged under 40. According to the study, since these products are being promoted as 'safer' alternatives to smoking cigarettes, the number of individuals using them is expected to increase.

Dr Paolo Boffetta at International Agency for Research on Cancer in France led the research team. They examined the results of 11 studies carried out in Sweden and North America on the use of smokeless tobacco products and the risk of developing or dying from a heart attack or stroke.

In order to reduce partiality, variations in study plan and features were considered.

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• Patterns and behaviors of snus consumption in Sweden (FREE Full Text) 

Results: The majority of respondents (96%) used either pouched or loose snus alone. A minority (12.6%) reported dual use of smokeless and combustible tobacco products. Average daily consumption was 11–12 g for pouched snus and 29–32 g for loose snus. The typical duration of use of each pouch/portion was 60–70 min.

Discussion: This survey has provided new insights into contemporary snus use in Sweden, such as the marked differences in daily consumption between loose and pouched snus, length of time that snus users typically keep pouches in the mouth, differential patterns of use in males and females, and the simultaneous use of multiple pouches in a small proportion of users.

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• Adults Important In Reducing Tobacco Use Among Young People 

A clear commitment from adults against the use of tobacco is expected by their children as they grow up, and it can prevent teenagers from starting to smoke or use snuff. This is shown in current research from Umeå University in Sweden.

In 1993 a program called Tobacco-Free Duo was started in collaboration between the Country Council of Västerbotten County and the schools in the county’s municipalities. The target group was young people between 13 and 15 years of age, and the program is still going on. A central component of the program was to include adults in the task of supporting adolescents in saying no to tobacco.

In her dissertation, Maria Nilsson evaluates the effects of the program and studies the attitudes of young people to how adults, and especially parents, should approach the use of tobacco among their children.

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• Snuff is not to be sniffed at  

Sweden's trade minister Ewa Bjorling fired the first shots, calling on Brussels to lift the EU ban on exports of Swedish moist snuff, describing the prohibition as discriminatory.

EU internal markets commissioner Charlie McCreevy has also experienced her wrath amid claims that the prohibition amounts to banning the export of French wine or Danish meat.

But Swedish candidate for the Christian Democrats in the forthcoming European elections, Ella Bohlin, has now taken her to task, arguing that there is no demand for legalising snus from other EU member states. She says Sweden should concern itself with more pressing export issues.

A rival European parliamentary candidate, Anders Edberg of the Folkpartiet, has turned snus and its legalisation abroad into an election pledge, saying there is no evidence that it is harmful to people's health.

An alliance of researchers and anti-tobacco activists recently suggested that forms of snuff - including snus - might help people to quit smoking, stressing, nevertheless, that no form of smokeless tobacco was completely harmless.

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• BJORLING: The snuffing out of snus  

How would the people of France react if the European Union wanted to prohibit them from selling wine in other member states on health grounds? Or their wonderful cheeses . . .

Swedish snus was outlawed in the EU in 1989, six years before Sweden became a member of the Union in 1995 and four years before the establishment of the internal market in 1993. . . .

The Commission's case for acting as guardian of Swedes' health is unproven. As for its role as guardian of the principle of free trade and every member state's equal right of access to the internal market, it has failed to prove a clear answer as to why the ban on snus is reasonable. The ban has not been sufficiently discussed from the point of view of free movement of goods in the EU. Swedes need an answer that is reasonable, fair and just in the light of the principles of the internal market.

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• Swedes accuse European Union of snuffing out smokeless tobacco 

As Stockholm prepares to host the rotating EU presidency in July, Bjorling is spearheading a campaign to lift the bloc's prohibition on snus, a moist tobacco product as steeped in Swedish tradition as pickled herring or crispbread.

"I get upset when I think about how unfair this is," the former dental surgeon told The Associated Press in a recent interview, noting that the snus pouches she slips under her upper lip helped her quit smoking about three years ago.

For years Sweden fought a lonely battle against the directive that bars sales of snus - pronounced snoos - in all EU countries except Sweden. But the government's renewed snuff crusade comes amid growing debate internationally about smokeless tobacco's potential as a less harmful alternative for smokers who fail to shake the nicotine habit.

Pragmatists say snus should be allowed to compete with nicotine replacement products in the effort to snub out the much bigger threat of cigarettes. Anti-snus campaigners counter that snus is a highly addictive product whose health effects are unclear. Embracing it, they say, would only serve tobacco companies looking for new ways to deliver nicotine as smoking rates decline in the developed world.

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• Swedes smoking less tobacco  

Swedish health officials say the number of people who smoke regularly has dropped by 200,000 in the past five years.

The Swedish National Institute of Public Health said the drop is attributable in large part to the number of women who have quit smoking, The Local newspaper said Monday. . . .

the number of regular smokers dropped from 19 percent to 14 percen

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• Patients Who Gave Up Smoking Before Surgery Had Half As Many Complications Afterwards 

More than a third of patients who took part in an eight-week smoking cessation programme before and after planned surgery were able to give up and most of them were still smoke free after a year, according to new research.

They also experienced half as many complications after surgery as the patients who did not receive help to give up smoking, with 21 per cent experiencing problems as opposed to 41 per cent.

Researchers randomly assigned 117 patients who were due to undergo general or orthopaedic surgery to an intervention and control group.

"The intervention group attended weekly meetings or received telephone support and were provided with free nicotine replacement therapy, while the control group just received standard pre-operative care" says lead author Dr Omid Sadr Azodi from the Karolinska Institute in Stockholm, Sweden.

"Patients were then assessed at regular intervals before and after surgery and after 12 months.

"One interesting thing to emerge from the study was the high refusal rate. A further 76 patients declined to take part in our research because they were unwilling to give up smoking or were stressed by their forthcoming surgery."

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• Swedish Women Get Hooked on Snus, Letting Lips Bulge (Update1)  

Louise Lennersten wasn’t going to let pregnancy make her kick a snuff habit.

The 26-year-old Swede switched to Onico, a nicotine-free brand that uses flavored vegetable fibers to imitate the taste of tobacco. Following the birth of her son Wilmer last month, she intends to return to real snuff, called snus in Sweden.

“I was a smoker but switched to snus when my job didn’t allow smoke breaks,” Lennersten said. “This way I could get my nicotine fix without going outside.”

Women are breaking into a smokeless bastion of male tobacco culture in Sweden, one of the few places where more women smoke than men. A public smoking ban, unpleasantly cold outdoor cigarette breaks in winter, and marketing by industry leader Swedish Match AB have led more women to try sucking on packets of snus for a nicotine fix.

Daily snus use among women rose to 4 percent of the total in 2007 from 0.6 percent in 1988

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• Quitting Cigarettes Completely or Switching to Smokeless: Do U.S. Data Replicate the Swedish Results?  

Conclusion: The Swedish results are not replicated in the U.S. Both male and female U.S. smokers appear to have higher quit rates for smoking than have their Swedish counterparts, despite greater use of smokeless tobacco in Sweden. Promoting smokeless tobacco for harm reduction in countries with ongoing tobacco control programs may not result in any positive population effect on smoking cessation.

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