uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Snus (Swedish smokeless tobacco) use and risk of stroke: pooled analyses of incidence and survival
Show others and affiliations
2014 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 276, no 1, 87-95 p.Article in journal (Refereed) Published
Abstract [en]

Background. Snus is a moist smokeless tobacco product with high nicotine content. Its use has a short-term effect on the cardiovascular system, but the relationship between snus use and stroke is unclear. Objective. The aim of this study was to assess the associations between use of snus and incidence of and survival after stroke, both overall and according to subtypes. Methods. Pooled analyses of eight Swedish prospective cohort studies were conducted, including 130 485 men who never smoked. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of incidence and death after diagnosis using Cox proportional hazard regression models and case fatality and survival using logistic regression and Kaplan-Meier methods, respectively. Results. No associations were observed between the use of snus and the risk of overall stroke (HR 1.04, 95% CI 0.92-1.17) or of any of the stroke subtypes. The odds ratio (OR) of 28-day case fatality was 1.42 (95% CI 0.99-2.04) amongst users of snus who had experienced a stroke, and the HR of death during the follow-up period was 1.32 (95% CI 1.08-1.61). Conclusion. Use of snus was not associated with the risk of stroke. Hence, nicotine is unlikely to contribute importantly to the pathophysiology of stroke. However, case fatality was increased in snus users, compared with nonusers, but further studies are needed to determine any possible causal mechanisms.

Place, publisher, year, edition, pages
2014. Vol. 276, no 1, 87-95 p.
Keyword [en]
smokeless tobacco, snus, stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:uu:diva-228690DOI: 10.1111/joim.12219ISI: 000337787500011OAI: oai:DiVA.org:uu-228690DiVA: diva2:734959
Available from: 2014-07-22 Created: 2014-07-21 Last updated: 2014-07-22Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Hallqvist, Johan
By organisation
Family Medicine and Preventive Medicine
In the same journal
Journal of Internal Medicine
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 177 hits
ReferencesLink to record
Permanent link

Direct link