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Why Snus Is Important

Swedish Snus is very important to the e-cigarette community because it is the proof (not just evidence) that:

  • THR works
  • That it works spectacularly well
  • That it is the only thing that does work, once smoking prevalence is reduced to a certain level
  • That it has dramatic (and unique) benefits for public health
  • That allowing its widespread, unrestricted use results in an impressive (and unique) fall in smoking prevalence throughout the population
  • That it produces a remarkable (and unique) drop in smoking-related death and disease

The long history of consumption of Snus in Sweden is the reason why we know the factual results of the use of consumer THR products, and why there is no need for a debate about the issues or the 'evidence': we already have the facts.

The three main Snus facts

1. Sweden is the world leader in the reduction of smoking, and the world leader in the reduction of smoking-related disease and death.

This is because (and only because) they allowed full, free, unhindered and unregulated access to a consumer THR product: Snus. By 'unregulated' is meant that no more regulations are applied than for any other consumer product. In many countries, such as the UK and Sweden, consumer products have all the regulation needed to ensure they are safe; in fact, consumer products are safer than pharmaceutical products in these countries [1]. That is all that is needed, unless there is a demonstrable problem to fix, and this is certainly not apparent in the case of Snus or e-cigarettes.

Only access to Snus, together with truthful information about the relative risks compared to smoking, is responsible for the dramatic reduction in smoking and the parallel reduction in 'tobacco-related' disease and death.

Sweden is so far ahead of any other developed country in the reduction of smoking mortality that they even have a realistic prospect of reducing smoking deaths to insignificant proportions - something completely out of the question for any other country. Male smoking prevalence falls at 1% per year and will be just 5% by around 2016.

Others talk about measures to reduce smoking. Some waste large sums on projects that cannot possibly produce any visible improvement since the 20% barrier has been reached. None do anything that translates into results. Not only that - some actively work to remove the only realistic options that will reduce smoking. Now why would they do that?


2. Only THR product substitution works for reduction of smoking once the 20% Prevalence Rule operates.

The Swedish experience shows that (a) it is possible to reduce smoking significantly past the 20% barrier for Western countries that can normally expect high smoking prevalence; and (b) is the single example of any such success. THR has either been banned in other countries or only just introduced in the form of e-cigarettes.

We know that, no matter how much money is thrown at the problem, no other methods work - because no other country with previous high smoking prevalence has got significantly below one-fifth of the adult population smoking; and this despite huge sums of money being spent.

All such expenditure is pointless, and a waste of valuable tax revenue. It is simply money flushed down the toilet.

By contrast, in Sweden:

  • Smoking prevalence is less than half the UK's and is still falling
  • Male smoking prevalence falls at 1% per year, a spectacular annual drop
  • The smoking death rate is still falling even though it is already far lower than anyone else's in the EU
  • The smoking disease rate is still falling even though it is already far lower than anyone else's in the EU
  • It cost the taxpayer zero

In contrast, the UK has done nothing except spend huge amounts of money for zero return. Smoking prevalence has stayed constant for the last 5 years - and in fact the number of smokers in the UK has actually risen by about 0.5 million.

Sweden reduced their smoking prevalence to half the UK's numbers at zero cost to the taxpayer. Some MEPs and MPs are trying to prevent British smokers having this option: ask yours where they stand. Are they working for you, or perhaps a commercial client instead? Unless they support unrestricted THR then they certainly aren't working for you; why not ask them who they are working for.


3. The 'Swedish Miracle' proves that THR works, and is the only thing that does work.

The dramatic fall in smoking prevalence, and in smoking-related disease and death, is entirely due to THR adoption and nothing else.

It also means that no one can claim that "THR is a theoretical concept"; or that "There is no proof that THR works"; or that "We don't know if e-cigarettes will work"; or that "We don't know what the risks are"; or that "Nicotine is dangerous and should be avoided"; or that "These products may be a gateway to smoking"; or that "The flavours are marketed to children"; or that "Children will be addicted and move on to a life of smoking", and so on. Such statements either reveal ignorance of the facts, or are simply lies: the person making such a statement should be asked which one applies to them.

- We know that not only does THR work, but that it works spectacularly well; and that it is the only thing so far that is proven to work.

- We know that a THR product - even a whole-tobacco one - can have an elevation of risk for any disease so low that it cannot be reliably identified. The equivalent risk for e-cigarette users will therefore probably be so low as to be impossible to see at population level.

- We know that ad lib consumption of nicotine over many decades has an implication for health so small as to be difficult to reliably identify by statistical methods at population level.

- We know that if all smokers switched to Snus, smoking deaths would be reduced to about 1% of the current figure, and possibly less.

- We know that, since e-cigarettes are more popular with smokers than Snus, there is a very real prospect that reductions in smoking prevalence due to Snus (of around 50% in Sweden compared to the UK) will be eclipsed by ecigs. This means there is a possibility of at least a 60% reduction in smoking, in countries where e-cigarettes are equally unrestricted.

- We now know that regulation = death. There is no simpler way to put it. Deregulation saved tens of thousands of lives in Sweden.

- We can see the huge and unequalled benefits for public health: Sweden's national health statistics are unique in the western world.

- We can estimate that if all smokers switched to e-cigarettes, smoking mortality would be reduced so much that it would be impossible to identify it by statistical methods; it is even possible that only those with known pre-existing medical conditions would have any quantifiable risk.

The experience with Snus in Sweden is proof that THR products are safe; that they work; and that they are the only thing that does work.

The facts of the Swedish approach

Sweden has the lowest tobacco-related mortality [the smoking death rate] of any developed country by a wide margin.
- Phillips, Rodu

- The death rate is about half the EU average.

- Sweden has the lowest male lung cancer and oral cancer rate in the EU.

- They have a smoking prevalence of about 11% @2013 (various different sources quote from 11% to 13% for 2012). 'Prevalence' is the percentage of the population who smoke, averaged across male/female, generally measured as any adult who smoked within the last 30 days (although this figure is not exact since there are multiple different results published even for the UK; it should be considered as +/- 2 points on any figure quoted). Sweden's is about half the UK's figure.

- They have a male smoking prevalence of about 8% (probably about one-third of the UK figure). This means that Sweden may additionally be the only country to have reduced male smoking prevalence below the female figure (believed around 15%).

- The number of male smokers is still falling by 1% per year (2003 male smoking = 17%, 2012 = 8%).

- By around 2016, Sweden will have a male smoking prevalence of 5%. This is a phenomenally low figure. It indicates that they even have a realistic chance of reducing smoking disease and death to insignificant proportions - something absolutely out of the question for any other country. It has been achieved by deregulation - not more regulation.

- It is therefore very clear that, in this field of public health, regulation kills.

Conclusion

This is the value of Snus to us: we know that THR works spectacularly well, and that the incredible value of THR cannot be denied. We know that it is the only solution for European countries to significantly reduce smoking below the 20% barrier. We know that the dramatic improvements in public health as a result are impossible to deny any longer. We know that deregulation saves lives, regulation kills.

We know that if allowed to happen elsewhere instead of just in Sweden, the overall benefit to public health would be the most important since the invention of antibiotics.

The bright aspect of this picture for us is that there is no reason to suppose that results will not be as good or even better here, as long as free and unhindered access to e-cigarettes is allowed to continue in the UK. The reasons why this is not a popular choice with those in power clearly has nothing to do with public health; the financial pressures overrule the health issue.

We have been told quite clearly by a leading figure in tobacco control, Prof J Britton of the RCP, that, just in the UK, 5 million lives of those alive today could be saved if all smokers switched to e-cigarettes. That is some statement - especially from within a group that traditionally pushes a "quit or die" mantra.

The big question

We need to ask ourselves: "Would it be fair and equitable to discriminate against black people, or women, or the disabled, in the same way that smokers are discriminated against in the EU? Would it be allowable to take measures that inevitably result in the death of members of such minority groups, for financial reasons?". Normally the answers to these questions are an unequivocal "No".

For some reason it seems acceptable, to some people, to kill off smokers rather than allow them free consumer choice of viable options to stay alive.

It is high time that people demand public health takes precedence over the financial rewards of protecting smoking.

 


[1] Consumer products such as e-cigarettes must comply with 17 separate statutes controlling aspects such as contaminants, safe packaging, labelling and marketing. If any person sold a consumer product that killed someone, the product would be removed from the market temporarily and there would be an inquiry; if they did it again they would be in jail, the product would be removed from the market permanently, and the company would be finished. In contrast, pharmaceutical products only have to comply with 1 statute, they can kill on an ongoing basis, no one is held responsible (and this applies even if they are ineffective and there are better alternatives), and it is impossible to remove proven lethal products from the market. In addition, deaths attributable to deadly pharmaceuticals in the UK are covered up by the regulatory authority. For example, the MHRA do not publish the statistics for UK varenicline deaths even though the FDA have admitted several hundred deaths attributed to it, plus over 10,000 serious adverse incident reports submitted to them, and France removed varenicline from the prescribing list due to the risk for suicide, psychotic episodes and cardiac events.

Pharmaceuticals are allowed to kill freely, the statistics are hidden, and lethal drugs cannot be removed from the market. In contrast, consumer products such as e-cigarettes have an enviable safety record and will destroy the cigarette trade, but are at risk of being banned ('regulated'). It is abundantly clear that this has nothing to do with health.

 


created 2013-08-24
last update 2014-01-20