Using Swedish snus doesn’t increase the likelihood of developing oral cancer, according to a new study.

The results are based on a sample of more than 400,000 men, the largest sample size to date for such a study.

“Swedish snus use does not appear to be implicated in the development of oral cancer in men,” the authors write in the study, which was published in the Scandinavian Journal of Public Health (SJPH).

Snus and oral cancer

Previous studies had found a link between oral cancer and smokeless tobacco products commonly used in the US and Asia. However, the relationship between use of the Swedish snus and oral cancer was less clear.

To look for potential associations between use of Swedish-style snus and oral cancer, researchers examined pooled individual data from the Swedish Collaboration on Health Effects of Snus Use. This data was then cross referenced with data from the Swedish National Cancer Register. 

READ MORE: Learn about the Swedish Experience with tobacco harm reduction

The mean age of entry in the study was 40 years and 30 percent of participants had never used snus at the time they entered the study. Smoking and snus use was categorised into never, former and current use. Since snus use among women is rare, the study was restricted to men only.

Overall, the analysis was based on more than 9.2 million person-years of observation of 418,369 participants, 628 of whom developed oral cancer. 

No increased risk of oral cancer

The study revealed that, compared to never-snus use, use of Swedish was not associated with oral cancer. Moreover, lower intensity snus use (fewer than five cans per week) was associated with a reduced risk of developing oral cancer.

“Our results contrast convincing evidence of an increased risk of oral cancer with use of other types of oral smokeless tobacco, including those commonly used in the USA, India, Pakistan and Sudan, but are in line with most studies from the Nordic Countries,” the authors write.

“Risk from Swedish snus is clearly less than from smokeless tobacco products used in North America and South Asia, but this does not imply that snus is harmless.”

READ MORE: Discover more about snus and the Swedish Experience