Electronic smoking, harm reduction and the Swedish example.

[SmokeyJoe]

If you take a look at the figures for smoking related deaths and tobacco usage in Sweden, you will come across some fairly startling statistics regarding the use of snus as a smoking alternative:

• In Sweden, 17.1% of men smoke tobacco and 19% of men use snus.
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• In Sweden the number of women smokers equates to the European average (around 30%)
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• Per person, the amount of tobacco used in Sweden is pretty much the same as elsewhere in Europe.
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• Snus use in Sweden is culturally male. The numbers of women who use it are statistically negligable.
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• 25% of all deaths in Europe are tobacco related. For Swedish men, 11% of all deaths are tobacco related. For Swedish women, smoking related deaths follow closely the European average.[/*:m:2gnzr4g5]

In other words, snus doesn't kill people! In fact, it's better than that - We can see from the data that where snus use is culturally integrated, it replaces smoking as the primary tobacco consumption method. Swedish women are the perfect control group, since they don't use snus but follow European average smoking habits.

Swedish Snus is a form of oral snuff contained in small tea-bag like pieces. It is placed between the cheek and gums and left there, sometimes for hours. Tests have shown that snus contains far fewer cancer causing nitrosamines than cigarettes and other forms of smokeless tobacco such as dipping tobacco. It is thought this is due to the curing process.

However, in the EU Sweden is the only place that snus can be purchased legally. Elsewhere, the EU has decided that since it has not been culturally establised, it is a new tobacco product and therefore cannot be sold. Judging by the Swedish example, this is extremely sad, especially when one considers that e-cigarettes may well fall foul of the same restrictions.

This is not news, by the way. I first read of the health statistics quoted above in the New Scientist back in 2003. Nothing has changed since, except that new nicotine products are always coming on the market, the e-cigarette being the latest.

For a new smokeless tobacco product to make it to our shelves, it would have to be licensed as a medical product. Under EU law, the e-cigarette may be a candidate under CE class IIa medical certification, as the nicotine is extracted and held in solution, rather than in plant material. There appears to be no current legal mechanism for Swedish snus. Alternatives to smoking seem to be disadvantaged from the start.

There seems to be an ethcal/philosophical divide with our legislators. One camp is fiercely anti-tobacco, believing any concession to the needs of smokers prevents the anti-tobacco program from being run effectively . The other camp is far more pragmatic, recognising that sensible legislation can prevent excess deaths.

Sadly, the balance of power rests in the hands of the first camp. I do recognise that it is not as simple as this; that there are a whole host of legal factors that also influence the decisions made, but I do hold out hope that as public opinion becomes more educated, better decisions will be taken.

For anyone who cares about these issues, please contact your elected representatives and encourage them to take an interest. Remember that the chances are that they will not have even heard of the electronic cigarette or snus!