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Snus clinical trials

Epidemiological evidence, particularly from Sweden, suggests that snus use is substantially less hazardous than cigarette smoking because it is not associated with increased risks of lung cancer, oral cancer and chronic obstructive pulmonary disease (COPD).

However, other forms of smokeless tobacco are associated with increased risks of oral cancer.  Some public health bodies have also concluded that snus use is associated with increased risks of pancreatic cancer and other diseases.

It has been hypothesised that the lower risks associated with snus are due to two main factors:

  • the form of exposure - oral exposure to a tobacco extract as compared to the inhalation of a smoke aerosol into the lungs; and
  • the levels of chemical constituents - especially tobacco specific nitrosamines.

Some researchers have reported that levels of nitrosamine metabolites in urine can be similar in cigarette smokers and users of some smokeless tobacco products.  There are relatively few published clinical trials of smokers switching to snus products.

We wish to consult with public health scientists on the value and then design of a clinical study to investigate the levels of biomarkers of exposure and - as far as they are available - biomarkers of harm in smokers switched to snus.

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