Snus is a wet, flavored tobacco product that has been widely used in Scandinavia for more than two centuries. Researchers believe that its popularity may be why Swedish men have low rates of smoking and lung cancer mortality [4]. Snus is traditionally made of ground tobacco, salt, water and flavoring agents to form a soft, wet powder that is placed against the gum under the top lip, where the nicotine from the tobacco can enter the body through the gum's mucus membranes. The inspiration for nicotine gum came, in part, from the use of snus and evidence that it produced fewer health problems than smoking tobacco.
Tobacco was brought to Europe in the early 1500s after colonizers took it from the native people of the Americas who had a long unrecorded history of cultivating and using the plant. It was a hit throughout Europe. By the late 1500s, physicians in Lisbon considered tobacco to be a “sacred herb” and were researching it for medicinal uses, believing it could cure many conditions including (ironically) cancer. From there, samples of tobacco were sent to France by Jean Nicot, a diplomat and ambassador who had visited Portugal to negotiate the marriage of a six-year-old princess to a five-year-old prince [1]. When he returned to Paris from that strange errand, he brought tobacco with him and introduced the French royal court to snuff – a precursor to snus. (Note this guy's name, Jean Nicot – it's where nicotine comes from!)
Snuff is made from tobacco that has been ground or pulverized so finely that it can be inhaled or “snorted” into the nose, delivering a quick dose of nicotine through the thin membranes of the nasal cavity. It's often flavored or scented to make the experience a little more pleasant. Thanks to Nicot's introduction, French royalty found snus to be a useful medicine for curing migraines as well as a tasteful way for ladies to enjoy tobacco. Its popularity quickly boomed amongst nobility across Europe.
Cut to the early 1800s after the French Revolution, decline of the upper class, fall of Napoleon (a big snuff fan), and a ban on snuff from the Vatican – powdered tobacco was no longer popular [2]. Royalty instead smoked cigars and common people throughout most of Europe started smoking cigarettes. Meanwhile, a new development had emerged in Sweden – snus. Tobacco farmers air-dried and fermented tobacco leaves and then ground them into a wet paste which was then placed under the lip. The delivery of nicotine through the mucus membranes is similar to snuff, but taken orally rather than up the nose.
In 1811, a Swedish teen boy named Jacob Ljunglöf worked at a large tobacco factory – by the age of 24, he took over the factory and began manufacturing snus on a large scale under his own name, with a recipe that would become the country's largest snus brand, Ettan. Together with a friend, the chemist Jacob Berzelius, Ljunglöf invented a new recipe for snus that cut down on its traditional, long-fermentation time and improved the flavour. Ettan snus, with its new recipe, quickly grew in popularity. Ljunglöf's son, Knut Ljunglöf, took over the Ettan company and grew it to greater heights following his father's death. Snus popularity continued to grow throughout Sweden, particularly following the 1970s as the public became more aware about the dangers of smoking. While snus is also a highly addictive product, using snus is believed to be 95% - 99% less harmful than smoking cigarettes [3].
Sweden now has the world's lowest rate of lung cancer in men, and the lowest rate of all tobacco-related diseases in Europe [6][7] – researchers believe this is mostly due to snus. One study found that snus use is inversely related to cigarette smoking – the more a population uses snus, the less likely it is to have a smoking habit, too [4]. While Sweden took up snus, the rest of Europe continued smoking. Now experts estimate that if all countries in the European Union had the smoking rates of Sweden, there would be 92,000 fewer lung cancer deaths each year [4]. Snus is also a key tool for quitting cigarettes throughout Scandinavia – an observational study found that almost a third of Swedish people used snus to help break the habit, and those who did were 50% more likely to succeed at quitting and those who didn't [5].
There are other oral tobacco products available across the world, but snus is unique in its production and ingredients. For example, as opposed to American chewing tobacco or dipping tobacco (also known as “snuff” or “snus” in the USA), Scandinavian snus doesn't cause excessive salivation – no spittoon required.
Snus isn't all good. While it is a great alternative for cigarettes, it still contains harmful toxins found in tobacco such as cotinine. It did, however, become inspiration for a more effective and less toxic tobacco alternative – nicotine gum. A 2016 study found that both snus and nicotine gum helped smokers to quit cigarettes, but the participants who used nicotine gum were more satisfied and had less exposure to toxins than those who used snus [8].
From French royalty to modern-day Scandinavia, ground tobacco products have been used as medicinal and risk-prevention drug. But it's time for a cleaner, easier alternative – nicotine gum.
References:
[1] Haas, L. F. (1992) Jean Nicot 1530-1600. J Neurol Neurosurg Psychiatry., 55:6, 430. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014894/
[2] World Health Organization (WHO) International Agency for Research on Cancer (IARC), Title: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 89, Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, Lyon, France, 2007, Historical Overview 1.1.2 Snuff taking, pp. 43–47
[3] Twombly, R.. (2010) Snus Use in the U.S.: Reducing Harm or Creating It? JNCI News, 102:19, 1454 – 1456. https://academic.oup.com/jnci/article/102/19/1454/2516186
[4] Rodu, B. & Cole, P. (2009) Lung cancer mortality: Comparing Sweden with other countries in the European Union. Scandinavian Journal of Public Health, 37, 481 – 486. https://www.ncbi.nlm.nih.gov/pubmed/19535408
[5] Scheffels, J., et al. (2012) Contrasting snus and NRT as methods to quit smoking. an observational study. Harm Reduction Journal, 9:10. https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-9-10
[6] Cancer Research UK (n.d.) https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/incidence Accessed 6th September 2018.
[7] Bates, C., et al. (2003) European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health. Tobacco Control., 12, 360 – 367. https://tobaccocontrol.bmj.com/content/12/4/360
[8] Hatsukami, D. K., et al. (2016) Randomised clinical trial of snus versus medicinal nicotine among smokers interested in product switching. Tobacco Control, 25, 267-274. https://tobaccocontrol.bmj.com/content/25/3/267