How Snus Functions

The Swedes are making waves once again. First, Volvo. Then, IKEA. And now, the world must brace for the latest major Swedish export: snus. Despite its somewhat adorable name, snus (pronounced to rhyme with 'loose') is not a character from Sesame Street. It's a smokeless tobacco product, akin to dip or chew. Although it has only recently appeared on American store shelves, snus has been a staple in Sweden since the mid-1800s. Today, more Swedish men use snus than smoke cigarettes [source: Foulds et al.]

Smokeless tobacco comes in two main varieties: chew and snuff. Any baseball fan from the U.S. is familiar with chewing tobacco — long strands of cut tobacco that release nicotine when chewed, but have been linked to mouth and stomach cancers. Snuff can be inhaled (as was common among European aristocrats in the 18th and 19th centuries), or consumed orally, like with dipping tobacco and snus. Snus users pack the tobacco into their upper lip to get a nicotine rush similar to that of a cigarette. Unlike dip, however, the byproduct is swallowed rather than spit out.

In recent years, U.S. tobacco companies have pushed smokeless tobacco products like snus. Altria (formerly known as Philip Morris), the producer of Marlboro cigarettes, invested over $10 billion in 2008 to acquire the well-known smokeless brands Skoal and Copenhagen. And they didn’t stop there. Both Altria and its major rival R.J. Reynolds (makers of Camel cigarettes) have recently launched their own snus product lines.

Extensive research from Sweden indicates that snus users face a significantly lower risk of cancer compared to smokers and those who use dip and chew tobacco [source: Foulds et al.]. Some experts even believe that snus could aid in smoking cessation. However, like any tobacco product, it is not free from health risks.

Since 1992, the European Union has prohibited the sale of snus, with Sweden being the only exception. (Meanwhile, the sale of cigarettes has remained legal across Europe.) Snus has become so popular in Sweden that lawmakers there threatened to boycott the EU if their beloved tobacco product remained banned.

This article explores snus, the unofficial nicotine of Sweden, and examines why both American tobacco companies and public health experts are so fascinated by it.

Snus Basics

Tobacco made its way to Sweden in the mid-1600s from New Sweden, the brief colonial settlement in present-day Delaware. Not long after, snus was created as a way to make snuff more accessible to the masses. The invention of snus was driven by necessity, as tobacco was too expensive for most Swedes. As a minor player in the global colonial scene, Sweden had less purchasing power in the tobacco market, leading to high prices for imports. The country also became one of the first to tax tobacco as a luxury item. To solve this, snus was developed by blending cheaper tobacco with salt and water, offering a more affordable and, unlike snuff, cleaner alternative that didn't require spitting.

To prepare snus, the tobacco leaves are initially chopped into small strips, then air- and sun-dried before being ground into a fine powder. This powdered tobacco is subsequently subjected to heat for 24 to 36 hours, reaching temperatures around 212°F (100°C).

A 'wet' snuff, snus tobacco is composed of 50 percent water and 30 percent tobacco. It is commonly sold in tea bag-like portions, which the user places under the upper lip. A frequent snus user may keep the tobacco in for 13 to 15 hours a day. With high salt content, moist oral snuff produces less saliva compared to dipping or chewing tobaccos like Skoal, Copenhagen, or Red Man, and the resulting saliva is intended to be swallowed.

After processing, the snus is chilled to below room temperature to preserve its freshness. If snus is carried by American tobacco retailers, they can expect to see refrigerators installed to maintain its quality.

How Snus Differs from Other Tobacco

The process of heating ground snus tobacco below the combustion point is called pasteurization, which sets snus apart from other tobacco types. In most tobacco production methods, the leaves are air-dried to enhance their natural flavor. Air-drying leads to fermentation, where nitrogen microbes in the tobacco mix with oxygen in the air. This fermentation produces ammonia, increasing the tobacco's acidity and helping the body absorb nicotine more effectively. Due to pasteurization, snus contains less ammonia.

Snus users must exercise more patience to achieve their nicotine boost, a result of removing ammonia from the tobacco. A 2-gram portion of snus elevates blood nicotine levels by about 15 nanograms (one-billionth of a gram) per milliliter within 30 minutes. In comparison, a cigarette provides roughly 23 nanograms per milliliter of nicotine in the first five minutes, but by 30 minutes, the nicotine levels between the two products are similar [source: Gartner et al.].

To replace the flavor lost during pasteurization, snus makers add significant amounts of salt and sodium bicarbonate, also known as baking soda. Baking soda helps release nicotine (while ammonia does this in other tobacco products). This makes snus as addictive as cigarettes. But as any avid coffee drinker will tell you, addiction alone doesn't necessarily make a product harmful.

Is Snus Safe?

Even those opposed to snus acknowledge that it delivers "cleaner" nicotine than cigarettes. The pasteurization process eliminates nitrites (chemical compounds made of one part nitrogen and two parts oxygen), particularly tobacco-specific nitrosamines (TSNAs). TSNAs are known carcinogens found in both cigarettes and smokeless tobacco, linked to cancers of the lungs, mouth, esophagus, and liver. Fermented tobacco contains higher levels of TSNAs.

By keeping snus refrigerated after production, the tobacco avoids the fermentation process that affects tobacco stored at room temperature, even after packaging. Storing tobacco at room temperature for six months can increase TSNA levels by 30 to 130 percent, while refrigerated snus tobacco shows no such increase in TSNAs [source: Foulds et al.].

Tobacco researchers suggest that snus users are 90 percent less likely to develop cancer compared to smokers [source: Levy et al.]. Since snus is not combusted, it lacks carcinogenic chemicals like polycyclic aromatic hydrocarbons, which are produced from the burning of tar in cigarettes. In fact, studies show that lung cancer rates are statistically the same between snus users and those who have never used tobacco [source: Foulds et al.].

Unlike dip and chew, which undergo fermentation leading to higher TSNA levels, snus does not carry the same risk for oral or other head cancers [source: Gartner et al.]. However, smoking increases the risk of oral cancer by double and lung cancer by tenfold [source: Gartner et al.].

With tobacco, safety always has its exceptions. A study revealed that nearly nine out of every 100,000 snus users develop pancreatic cancer, compared to 13 out of 100,000 smokers (and just 3.9 out of 100,000 nonsmokers) [source: Foulds and Kozlowski]. Pancreatic cancer is particularly hard to treat as most cases are diagnosed late, once the disease has spread, due to the lack of universal screening methods for early detection.

Pregnant women who use snus give birth to babies that weigh, on average, 1.4 ounces less than those of non-tobacco users, have double the likelihood of premature births, and are more prone to pre-eclampsia than both smokers and nonsmokers [source: Gartner et al.]. Snus also increases the risk of oral lesions and tooth decay.

Despite its inherent risks, tobacco companies have been quick to highlight that snus poses less danger than cigarettes. Continue reading to explore how snus has been marketed and regulated.

American Snus Products

If snus is a foreign concept to you, you're not alone. Both Altria and R.J. Reynolds have rolled out large-scale national campaigns to familiarize Americans with the unfamiliar product. Their advertisements are appearing in magazines and wherever cigarettes are sold. Altria and Reynolds offer their snus products in pre-packaged bundles alongside packs of Marlboro and Camel cigarettes. Prices for a pack of snus range from $2 to $5, depending on local taxes.

In June 2009, Congress passed legislation granting the U.S. Food and Drug Administration (FDA) broader authority to regulate cigarette marketing. Prior to this, tobacco marketing was governed by a patchwork of court rulings. The new rules prohibit the use of terms like "light" and "low tar" in advertisements and will soon require more graphic warning labels such as "Smoking Kills," replacing the traditional Surgeon General's warning. While the bill didn't outline regulations for smokeless products, it does bar manufacturers from claiming that their products are less harmful.

With more freedom to market smokeless products than cigarettes, tobacco companies are optimistic about snus. They've tried to position snus as a tool to help smokers quit. In a controversial letter to the FDA, Altria claimed that its smokeless products are meant to "complement proven prevention and cessation strategies, not to compete with them" [source: Wilson and Creswell]. The companies have promoted snus as a way to get a nicotine fix when smoking isn't an option, similar to nicotine gum.

Tobacco control specialists caution against jumping to conclusions. They highlight that American snus products aren't true snus, as they contain significantly lower nicotine levels than traditional Swedish snus. This means Marlboro and Camel snus are less effective in alleviating nicotine cravings when compared to nicotine replacement therapy (NRT). If you believe this challenges the companies’ assertion that snus helps smokers quit, you're not alone.

This raises an important question: are the tobacco companies using snus to attract new smokers? Unlike Swedish snus, which only uses subtle flavor additives, American versions are available in a variety of mint flavors, often considered appealing to younger users. For instance, one type of Skoal, Altria’s flavored dipping tobacco, contains eight times the amount of wintergreen flavoring (methyl salicylate) compared to Wint-O-Green Life Savers [source: Wilson and Creswell]. Though no studies have confirmed the exact flavor quantities in Altria and R.J. Reynolds’ snus products, the companies have shown a tendency to stretch the boundaries of the truth — or in this case, the definition of snus.

Can Snus Help You Quit Smoking?

In Sweden, one in five men and one in 25 women use snus [source: Gartner et al.]. Due to its widespread use, Sweden has become a testing ground for tobacco researchers examining whether smokeless tobacco products can play a role in helping individuals quit smoking cigarettes. Swedish snus delivers more nicotine than over-the-counter NRT products like nicotine patches or gum. (In comparison, Marlboro and Camel snus have lower nicotine content, making them ineffective as cessation tools.) If Swedish snus provides more nicotine than NRTs, could it be the key to helping even the most resistant smokers quit?

The Swedish snus industry claims that it can offer health benefits. The European Smokeless Tobacco Council, a research group for the trade industry, notes that although Swedes consume similar amounts of tobacco as the rest of the European Union, they smoke less and have fewer tobacco-related illnesses and deaths. Despite the large number of snus users, Sweden has one of the lowest tobacco-related mortality rates in the developed world. Across the EU, 30% of men smoke, and 22% of male deaths are attributed to smoking-related diseases. In contrast, only 12% of Swedish men smoke, and smoking-related deaths account for just 8% of fatalities. As a result, Swedes are healthier and live longer lives. In 2000, a 35-year-old man in Sweden had a 3% risk of dying from a smoking-related illness before reaching 70, compared to a 9% average risk across the EU.

Cigarette smoking in Sweden has significantly decreased over the past 30 years, while snus consumption has surged. A study examining smoking rates among Swedish men revealed that daily smoking dropped from 40% to 12% between 1976 and 2002, while snus use increased from 10% to 20% during the same period [source: Foulds et al.].

A significant portion of individuals who quit smoking switched to snus instead. The study found that 71% of daily smokers who used snus were able to quit smoking, compared to just 54% of those who didn't use snus. Among men who successfully quit smoking, 62% reported using snus as an aid, while only 38% used nicotine replacement therapy (NRT) products. This indicates that Swedish snus was more effective in helping people quit smoking than other nicotine-based products like gum and patches.

Despite these positive findings, snus remains banned in the EU and Australia. Lawmakers in these regions view snus as a 'gateway' product that might lead users to smoke. Critics argue that promoting snus could undermine existing tobacco control policies, such as public smoking bans, advertising restrictions, and high taxes on tobacco products. They reference the introduction of light cigarettes in the 1960s and 1970s, which were marketed as safer options, only for later research to show that light cigarette smokers experience the same health risks as regular smokers. These critics believe it is more effective to help people quit smoking with established pharmaceutical methods rather than replacing one tobacco product with another.

While snus has helped many Swedes quit smoking, American snus, which contains lower levels of nicotine than nicotine replacement therapy (NRT), is unlikely to have the same impact. There is much more to consider regarding the health effects of smoking and smokeless tobacco, which will be explored in the next section.