Snus Use Steeply Increases Odds for Alcoholism


Use of the smokeless tobacco product snus can sharply increase the chances that an adult will develop alcoholism by the time he or she reaches middle age, according to new research findings from a team of Swedish scientists.

Consumption of nicotine/tobacco in the form of cigarettes is firmly linked to increased odds for the eventual development of physical alcohol dependence (commonly known as alcoholism). In a study published in February 2015 in the journal Drug and Alcohol Dependence, researchers from several branches of Sweden’s Umea University explored the potential connection between alcohol dependence and the use of a form of smokeless tobacco called snus. These researchers concluded that snus use substantially increases the risks for developing this condition during middle age.

Alcohol Use and Smoking

In the U.S. and many other countries, alcohol consumers are unusually likely to smoke cigarettes or use other forms of nicotine-containing tobacco. In fact, in America, tens of millions of drinkers also smoke. There is a clearly established reciprocal relationship between the odds that a smoker will develop a diagnosable case of alcoholism/alcohol abuse (known more formally as alcohol use disorder) and the odds that a drinker will develop a diagnosable case of nicotine addiction (known more formally as tobacco use disorder). Americans affected by alcoholism smoke cigarettes roughly 200 percent more often than Americans not addicted to alcohol. Conversely, Americans addicted to nicotine/tobacco develop alcoholism roughly 300 percent more often than Americans not addicted to nicotine/tobacco.

Men consume some combination of alcohol and cigarettes/tobacco more often than women, the National Institute on Alcohol Abuse and Alcoholism reports. In terms of age, young adults have the highest rates of combined alcohol and cigarette use and also have unusually high rates for alcohol use disorder and tobacco use disorder. In terms of racial/ethnic background, the group most likely to combine cigarettes with alcohol is American Indians/Alaska natives. People affected by an anxiety disorder (e.g., panic disorder or social phobia) or a mood disorder (e.g., major depression or bipolar I disorder) are unusually susceptible to both alcohol use disorder and tobacco use disorder.

Smokeless Tobacco and Snus

Smokeless tobacco is the generally accepted term for forms of tobacco that deliver nicotine to the bloodstream and brain through tissues in the mouth or nose rather than through the lungs. In the U.S., the most well-known of these tobacco forms are chewing tobacco and a loose, wet or dry substance called snuff. The term snus refers to a wet type of snuff contained in a small, water-permeable package that looks roughly like a miniature packet of tea. Although snus originally comes from Scandinavia, current law forbids its sale in most European countries except Sweden. Swedish manufacturers of this substance have largely turned their attention to the U.S., which has laxer smokeless tobacco laws than Europe. Rates of snus use in America, although still relatively low, have increased considerably in recent years.

Snus Use and Alcoholism Risks

In the study published in Drug and Alcohol Dependence, the Umea University researchers used long-term data gathered from 21,037 Swedish adults to explore the potential connection between snus use and the development of alcoholism. All of these adults were initially tested for alcoholism at some point between 1991 and 1997; 10 years after the first test, each of the participants underwent a second alcoholism assessment. The researchers collated the findings from these tests with reported rates of involvement in snus consumption.

At the time the study began, 2,800 of the 21,037 total study participants were snus users unaffected by alcoholism. Over the course of the next decade, 756 members of the larger participant group developed diagnosable alcoholism symptoms; 217 of these individuals had a history of snus use that predated their alcohol problems. The researchers concluded that snus use steeply increases the odds that a young adult will develop alcoholism by the time he or she reaches middle age. They also concluded that higher levels of snus use lead to higher levels of exposure to the onset of alcoholism. Finally, the researchers concluded that the snus-related risks of developing alcoholism are separate and distinct from any alcoholism risks associated with the use of cigarettes. Snus use makes alcoholism more likely to occur in people who currently smoke, people who used to smoke in the past and people who have never used cigarettes.

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