2014/08/28 by Maria‐Pia Hergens, Maria Rosaria Galanti, Jenny Hansson +13 · 1 citation
Medicine · Biochemistry, Genetics and Molecular Biology · #Smoking Behavior and Cessation #Alcohol Consumption and Health Effects #Heme Oxygenase-1 and Carbon Monoxide
paper · doi:10.1097/ede.0000000000000169
openalex publication_date 2014/08/28 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
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.