Risker med snus

RISKER MED SNUS 

Tillsammans med de senaste publicerade resultaten av svensk forskning kan läget nu sammanfattas på följande sätt.

Snusning ökar risken för

  • dödlig hjärtinfarkt (Arefalk 2014, Cnattingius 2005, Hergens 2007, Hergens 2008a, Boffetta 2009, Hansson 2012
  • permanenta och irreparabla munslemhinneförändringar med blottade tandhalsar (Cnattingius 2005)
  • diabetes typ 2, gäller för en konsumtion av minst 5 dosor/vecka (Persson 2000, Östenson 2012)


Vissa indikationer* finns även på att snusning ökar risken för

  • cancer i matstrupen, magsäcken och oral cancer (Luo 2007, Zendehdel 2008, Boffetta 2008)
  • oral cancer (Roosaar 2008)
  • förhöjt blodtryck (Bolinder 1992, Hergens 2008b)
  • metabolt syndrom, en rubbning i ämnesomsättningen kopplat till fetma, högt blodtryck, höga blodfetter, diabetes och hjärtkärlsjukdom (Norberg 2006)
  • dödlighet vid cancerdiagnos (Nordenvall 2013, Wilson 2016)
  • idrottsskador i muskler, leder, ligament och senor samt stukningar och skelettskador (Heir 1997, Reynolds 2000)
  • alkoholberoende (Norberg m.fl. 2015
  • rökning hos ungdomar – inkörsport (Joffer m.fl.2014).


Vid graviditet kan snusning öka risken för

  • havandeskapsförgiftning, reducerad födelsevikt, förtida förlossning, missfall och intrauterin fosterdöd (England 2003, Wikström 2010, Baba 2012, Dahlin 2016)
  • gomspalt (Gunnerbeck 2014)
  • andningsstörningar hos det nyfödda barnet som tros kunna leda till plötslig spädbarnsdöd (Gunnerbeck 2011). Då nikotin övergår i bröstmjölken skulle en sådan riskökning kunna förekomma även vid amning. Snusning kan därför inte heller anses säkert vid amning.


* Med indikationer kan menas att:

  • det finns motstridiga studier
  • det råder viss osäkerhet om personerna varit rena snusare eller också rökt
  • det bara finns enstaka studier.

REFERENSER

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  • Baba, S., Wikström, A. K., Stephansson, O., et al. (2012). Influence of smoking and snuff cessation on risk of preterm birth. Eur J Epidemiol, 27(4), 297-304.
  • Boffetta P., Hecht S., Gupta P., et al. (2008) Smokeless tobacco and cancer. Lancet Oncol. 2008(9), 667-75.
  • Boffetta P., Straif K. (2009). Use of smokeless tobacco and risk of myocardial infarction and stroke: Systematic review with meta-analysis. BMJ 2009(339), b3060.
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  • Cnattingius S., Galanti R., Grafström R., et al. (2005). Hälsorisker med svenskt snus. Rapport A nr 2005:15. Stockholm: Statens folkhälsoinstitut.
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Av Hans Gilljam och Barbro Holm Ivarsson 2016-10-18

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