Snus use and cardiovascular risk factors in the general population: the HUNT3 study
Article first published online: 28 AUG 2013
© 2013 Society for the Study of Addiction
Volume 108, Issue 11, pages 2019–2028, November 2013
How to Cite
Øverland, S., Skogen, J. C., Lissner, L., Bjerkeset, O., Tjora, T. and Stewart, R. (2013), Snus use and cardiovascular risk factors in the general population: the HUNT3 study. Addiction, 108: 2019–2028. doi: 10.1111/add.12313
- Issue published online: 10 OCT 2013
- Article first published online: 28 AUG 2013
- Accepted manuscript online: 30 JUL 2013 03:28AM EST
- Manuscript Accepted: 22 JUL 2013
- Manuscript Revised: 27 NOV 2012
- Manuscript Received: 1 OCT 2012
- Cardiovascular risk;
- smokeless tobacco;
Background and aims
Snus, a form of smokeless tobacco, is increasingly popular in its traditional Nordic markets, and was recently launched commercially in the United States. We examined the cross-sectional associations between snus use and cardiovascular risk factors, and compared them with the corresponding associations of smoking.
The HUNT3 general population survey, Nord-Trøndelag, Norway (2006–08).
A general population sample of n = 25 163.
Measured triglyceride,- glucose- and high-density lipoprotein (HDL)-cholesterol levels, blood pressure and waist circumference, registry information on gender, age and education level, self-reported snus use, smoking, physical exercise and alcohol use.
In age- and gender-adjusted linear regression analyses, extensive snus use was associated with larger waist circumference (b = 1.65, 95% CI = 0.86, 2.43) and higher systolic blood pressure (b = 2.58, 95% CI = 1.48, 3.68), but with higher rather than lower levels of HDL-cholesterol (b = 1.66, 95% CI = 0.79, 2.53). These three differences remained significant after additional adjustment for smoking, education level, physical exercise and alcohol use. Smokers had higher triglyceride and lower HDL-cholesterol than snus users, but lower systolic blood pressure.
After adjusting statistically for major confounding variables, Norwegians who use snus extensively have a mixed profile in terms of cardiovascular risk: slightly higher waist circumference and systolic blood pressure but also higher high-density lipoprotein-cholesterol.