Dr. Lars-Erik Rutqvist; MD, PhD; is one of the worlds leading authorities on tobacco, snus, cigarettes and their implications on the health, scientific and political fronts. He is Board Certified in Medical Oncology and Radiation Therapy with a PhD in Clinical epidemiology.
From 2000 to 2006, Dr. Rutqvist was with the Karolinska Hospital and Institute where he served as Professor and Head of the Department of Oncology at Huddinge/Södersjukhuset. Dr. Rutqvist joined Swedish Match AB in 2006 and today is Senior Vice President for Scientific Affairs.
The following excerpt from an interview Dr. Rutqvist gave a few years ago and shows his philosophy clearly on cigarettes versus snus:
Based on his long experience as a physician and researcher, Lars Erik Rutqvist is convinced that a pragmatic rather than dogmatic approach to harm reduction would lead to significant gains for public health."We know after all that half of smoking related deaths occur in middle age. The victims lose perhaps as much as 20 years of their life expectancy," he says. "In the light of these statistics, it is both counterproductive and irresponsible to adopt a moralizing tone. Dogmatic public-health representatives keep both the public and many doctors believing that it is as dangerous to use snus as to smoke. If that is what people believe, how are you supposed to motivate smokers to quit?"In view of this situation, he sees one of his own main tasks as being to help make the full picture regarding what we know today about snus and smoking better understood among decision-makers, researchers, physicians and the general public. People must be given a better opportunity to make a well-informed decision, based on facts rather than ideology. When asked what is his own most important health advice, he does not hesitate for a second:"Give up smoking entirely!"
The following is the English translation of an article Dr. Rutqvist wrote today in Aftenposten.no. This is a link to the original article by Dr. Rutqvist.
Smokeless tobacco is 90 percent less harmful than cigarettes. You know Tom K. Grimsrud in the Cancer Registry. Yet he chooses in Aftenposten on 14 August to continue to spread disinformation about the link between tobacco and adverse health effects. A debate about the health effects of pleasure products is important, but only if it is based on facts and not scare.
In the article in Aftenposten Grimsrud argues that it is a bad idea to replace cigarettes with snuff and snus increases the risk of cancer. Royal College of Physicians has concluded that smokeless tobacco is at least 90 percent less harmful than cigarettes. It is now over 10 years since the EU from a scientific standpoint removed cancer warning on snuff box. Fact is that if everyone who smoked went over to snuff it would have had major positive health effects.
Life could have been spared the Norwegian smokers had been advised of the health difference between snus and cigarettes. This has happened in Sweden, and is about to happen in Norway.....
These are indeed interesting times for snus lovers on both sides of the Atlantic. Concerning tobacco control and snus, the tobacco regulatory authorities in Europe (EU Directorate General for Health and Consumer Protection, DG SANCO) and the U.S. (Food and Drug Administration’s Center for Tobacco Products, FDA-CTP) are both currently struggling with what to make of this 200-year old Swedish invention.
In 1992 the EU introduced a strange ban on “all oral tobacco products” provided they were “not intended to be smoked or chewed”. In practice, this means that all forms of traditional, European smokeless tobacco products are allowed, except – snus. The logic behind this is indeed obscure as it has nothing to do with health effects, addictiveness, attractiveness, or any product feature related to these issues. It is solely based on how the product is intended to be used by the consumer.
The story goes back to U.K. in the 1980s. At that time, an American manufacturer of U.S.-type moist snuff had set up a factory in Scotland. They were accused of marketing their pouched products to children and near schools. The ensuing media attention led to a public outcry, parliamentary debates, and calls for prohibition.
While not wanting to outlaw traditional products such as chewing tobacco or nasal snuff, a ban was introduced on all forms of oral tobacco “not intended to be smoked or chewed”. The ban singled out pouched products as being particularly pernicious. When the British joined the European Union in 1992 they brought the ban with them. This did not raise any opposition in the other member states as snus was not a widespread habit at the time outside Scandinavia.
Sweden joined the union in 1995 and was granted derogation from the ban. Polls showed that Sweden was (and still is) one of the most “eurosceptic” member states. Many analysts have said that, given the long tradition and widespread use of snus in Sweden, it is unlikely that Sweden ever would have entered the EU had not the derogation been granted. It would have been like trying to get the French to accept a ban on red wine or Roquefort cheese....
Swedish Snus produces a nicotine “kick” that habitual consumers find satisfying. The flip side of the coin, however, is that it is precisely this “kick” that explains the risk of nicotine dependence with snus. Most snus brands have a nicotine content of 0.8% corresponding to 8 mg in a standard 1.0 gram pouch. Brands with somewhat higher nicotine content, about 1.1-1.3%, have been recently introduced on the Scandinavian market as a response to consumer trends. On average, snus users expose themselves to roughly the same total nicotine doses as cigarette smokers. However, the patterns of blood nicotine levels are quite different.....
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