Summary of the epidemiological evidence relating snus to health
Summary of the epidemiological evidence relating snus to health
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DOI：
10.1016/j.yrtph.2010.12.002
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发表时间：
2011-03-01
影响因子：
3.4
通讯作者：
Lee, Peter N.
中科院分区：
文献类型：
--
作者：
Lee, Peter N.
人们对鼻烟（瑞典式湿鼻烟）作为吸烟替代品的兴趣有所增加。这篇广泛的综述总结了鼻烟与健康以及吸烟和戒烟相关的证据。纳入荟萃分析。调整吸烟后，鼻烟与口咽癌无关（荟萃分析RR 0.97，95% CI 0.68 - 1.37），食管（1.10，0.92 - 1.33），胃（0.98，0.82 - 1.17），胰腺（1.20，0.66 - 2.20），肺（0.71，0.66 - 0.76）或其他部位，或患有心脏病（1.01，0.91 - 1.12）或中风（1.05，0.95 - 1.15）。在从不吸烟者中没有明显的联系，鼻烟的任何可能风险都比吸烟小得多。“鼻烟壶病变”不能预测口腔癌。鼻烟使用者体重增加，但糖尿病和慢性高血压似乎不受影响。尽管有未经证实的报告称，鼻烟与出生体重减轻和其他一些情况有关，但证据很少支持鼻烟对健康的任何重大不利影响。虽然一些声称鼻烟减少启动或鼓励戒烟的说法是不合理的，但鼻烟似乎不会增加启动，因为很少有吸烟者在开始之前使用鼻烟，并且目前鼻烟的使用与成人吸烟无关（儿童的关联可能是由于不受控制的混淆），并且没有报告说鼻烟不鼓励戒烟。(C)2010年爱思唯尔公司All rights reserved.
Interest in snus (Swedish-type moist snuff) as a smoking alternative has increased. This wide-ranging review summarizes evidence relating snus to health and to initiation and cessation of smoking. Meta-analyses are included. After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97,95% Cl 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites, or with heart disease (1.01, 0.91-1.12) or stroke (1.05, 0.95-1.15). No clear associations are evident in never smokers, any possible risk from snus being much less than from smoking. "Snuff-dipper's lesion" does not predict oral cancer. Snus users have increased weight, but diabetes and chronic hypertension seem unaffected. Notwithstanding unconfirmed reports of associations with reduced birthweight, and some other conditions, the evidence provides scant support for any major adverse health effect of snus. Although some claims that snus reduces initiation or encourages quitting are unsoundly based, snus seems not to increase initiation, as indicated by few smokers using snus before starting and current snus use being unassociated with smoking in adults (the association in children probably being due to uncontrolled confounding), and there are no reports that snus discourages quitting. (C) 2010 Elsevier Inc. All rights reserved.