Epidemiological evidence relating snus to health – an updated review based on recent publications

Table 1 RR/OR of IHD/AMI for current (vs. never) snus use in never smoking Swedish men

Source	Study	Type^a	Period^b	Cases^c	End-point^d	RR/OR (95% CI)	Adjustment factors^e
Bolinder et al. [41]	Construction Workers	PC	1971-74/1985	172	F	1.35 (1.13-1.62)^f	age, res
Haglund et al. [42]	Survey of living conditions	PC	1988-89/2003	28	F + NF	0.77 (0.51-1.15)^g,h	age, exe, hea, ill, res, ses
Wennberg et al. [43]	VIPⁱ and MONICA^j	NCC	1985-99/1999	21	F + NF	0.82 (0.46-1.43)	age, bmi, cho, edu, lei, phy
Huhtasaari et al. [44]	1^st MONICA^j study	CC	1989-91	59	F + NF	0.89 (0.62-1.29)^g,h	age
Huhtasaari et al. [45]	2^nd MONICA^j study	CC	1991-93	59	F + NF	0.93 (0.65-1.34)^f,h	none
Hergens et al. [46]	Two counties	CC	1992-94	10	F + NF	0.73 (0.35-1.50)	age, res
Hansson et al. [20]	Construction Workers^k	PC	1978-93/20y	309	F + NF	1.01 (0.90-1.14)	age
	Malmö diet and cancer^l	PC	1991-96/13y	4	F + NF	1.00 (0.37-2.70)	age
	MONICA N.Sweden	PC	1986-2004/11y	7	F + NF	0.77 (0.35-1.69)	age
	National March Cohort	PC	1997/9y	0	F + NF	-	age
	SALT^m	PC	1998-2002/8y	21	F + NF	1.56 (0.98-2.48)	age
	Stockholm Public Health	PC	2002/5y	5	F + NF	1.21 (0.48-3.08)	age
	Scania Public Health	PC	1991-2000/8y	8	F + NF	1.90 (0.90-4.00)	age
	WOLFⁿ	PC	1992-98/9y	2	F + NF	3.30 (0.63-17.1)	age
Total	13 estimates				Fixed^o	1.07 (0.98-1.16)	Het p = 0.06
					Random^p	1.06 (0.91-1.23)
Excluding [41]	12 estimates				Fixed^o	1.00 (0.91-1.10)	Het p = 0.34
					Random^p	1.00 (0.88-1.13)

^aPC = prospective cohort, NCC = nested case-control, CC = case-control.
^bFor case-control studies, the period of interviewing is shown. For prospective cohort or nested case-control studies, the baseline period is shown before the /, and either the final year of follow-up or, where this is not available, the mean person-years of follow-up after the /.
^cThe number of cases exposed to snus.
^dF = fatal, NF = non-fatal.
^eAbbreviations used: bmi body mass index, cho cholesterol level, edu education, exe exercise, hea self reported health, ill longstanding illness, lei leisure time, phy physical activity, res area of residence, ses socioeconomic status.
^fEstimated from data in source article.
^gEstimate is for current v non-current snus users.
^hEstimate is for non-current smokers.
ⁱVIP = Vasterbötten Intervention Program.
^j MONICA = Multinational Monitoring of trends and determinants in Cardiovascular disease.
^kResults supersede those reported earlier [38].
^lResults supersede those reported earlier [39].
^mSALT = Screening across the lifespan twin study, results supersede those reported earlier [40].
ⁿWOLF = Work, lipids and fibrinogen.
^o“Fixed” – the result of the fixed effect meta-analysis is shown on the right followed by the between-study heterogeneity p value (“Het p”).
^p“Random” – the result of the random-effects meta-analysis is shown on the right.

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