Scandinavian moist snuff (snus)

Scandinavian moist snuff (snus) has been proposed as a less harmful alternative to smoking, but precise data on the independent associations of snus use with site-specific cancers are sparse.

Detailed information about tobacco smoking and snus use was obtained from 279 897 male Swedish construction workers.
125 576 workers reported to be never-smokers at entry.

60 cases of oral, 154 of lung, and 83 of pancreatic cancer were recorded in never-smokers.
Snus use was independently associated with increased risk of pancreatic cancer (relative risk for ever-users of snus 2·0; 95% CI 1·2–3·3, compared with never-users of any tobacco), but was unrelated to incidence of oral (0·8, 95% CI 0·4–1·7) and lung cancer (0·8, 0·5–1·3).