Journal article

Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation

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Author list: Knutsson, Anders

Publication year: 2014

Start page: 872

End page: 876

Number of pages: 5

ISSN: 1044-3983

DOI: http://dx.doi.org/10.1097/EDE.0000000000000169

View additional information: View in Web of Science


Abstract

Background: Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable ""harm-reduction"" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate. Methods: To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression. Results: The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers. Conclusion: Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.


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