A large study of almost 10,000 Swedish men published in the International Journal of Cancer in 2008 was unable to statistically confirm a risk elevation for the combined category of oral and pharyngeal cancer.[9] Other studies and opinion pieces in renowned journals such as the British Medical Journal and the Lancet suggest a probable increased risk of pancreatic cancer as a result of snus use.[10][11]
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The European Union banned the sale of snus in 1992, after a 1985 WHO study concluded "oral use of snuffs of the types used in North America and western Europe is carcinogenic to humans",[13] but a WHO committee on tobacco has also acknowledged the evidence is inconclusive regarding health consequences for snus consumers.[14] Only Sweden and EFTA-member Norway are exempt from this ban. A popular movement during the run-up to the 1994 referendum for Sweden's EU membership made exemption from the EU sale ban of snus a condition of the membership treaty.
Recent actions by many European governments to limit the use of cigarettes has led to calls to lift the ban on snus, as it is generally considered to be less harmful than cigarette smoke, both to the user[15] and to others.
Since snus is not intended nor recommended for inhalation, it does not affect the lungs as cigarettes do. Because it is steam-cured, rather than fire-cured like smoking tobacco or other chewing tobacco, it contains lower concentrations of nitrosamines and other carcinogens that form from the partially anaerobic heating of proteins - 2.8 parts per million for Ettan brand compared to as high as 127.9 parts per million in some American brands, according to a study by the Commonwealth of Massachusetts Department of Health.[16] The World Health Organization (WHO) acknowledges Swedish men have the lowest rate of lung cancer in Europe, partly due to the low tobacco smoking rate, but does not argue for substituting snus for smoking, citing the effects of snus still remain unclear. Around 2005, several reports,[which?] partially funded by the snus industry, pointed to the fact that no carcinogenic effects could be attributed to Nordic snus and this resulted in the removal of the warning label that claimed snus could cause cancer.[citation needed] It was replaced with the more vague label "May affect your health negatively".[citation needed] Research is still going on, but no conclusive reports have been made regarding the health effects of snus.[citation needed]
