Snus or smoking tobacco: Which one is more harmful

Question

Recently, governments in developed countries have been trying to reduce smoking. In Sweden, perhaps due to these efforts or because of the cold climate (because it's impossible to smoke outside in winter at -30 Celsius), it is difficult to find a smoker. Instead, many Swedes use snus. The most popular type is "portion snus" (moist tobacco in a small pouch held under the lip).

Both of them are harmful in different ways but I wonder, which one is more harmful? Is there any research about this?

Notes

• The snus is illegal in European Union, except Norway and Sweden, which suggests it may be more harmful. In the EU countries, cigarettes are legal but they create smoke that affects the lungs and cause lung cancer.

• All the affects of snus are still not clear, but causes mouth, tongue and pancreatic cancer. It also allows nicotine and other chemicals (e.g. salt crystals, E1520, E500) to flow directly to your salivary & your circulatory system.

• Snus is consumed for a period of around an hour, but a cigarette lasts at most 5 minutes.

Answer 1

First of all, smoking statistics in Sweden has followed a trend very similar to that of the rest of the world. I do not think that there is reason to assume that climate is a factor here, and I wouldn't even say that there's much of a difference to be explained in the first place.

Tobacco consumption
^*OECD

Second, as Hendy points out in comments, the legalization of different substances has little relation to their relative health effects. That is rather a question of policy, and a general trend is often that you seek to criminalize harmful substances if possible, but make exceptions where it is shown or assumed that the implications of smuggling etc would be worse than the direct health effect. However, there are other ways to approach the problem as well, and this is not the forum for political discourse, so I shan't dwell on that beyond having pointed out that this is not a good indication of the health effect of a product.

Now, as far as the actual health implications of snus are concerned:

• Unlike smoking, snus isn't fire-cured, and as such, doesn't have the cancerogenic effect that you otherwise see due to anaerobic combustion.
• Unlike smoking, snus isn't inhaled, and as such, does not affect the lungs.
• Research has shown that snus consumption increases your risk of pancreatic cancer (article in Swedish)
• Excessive consumption appears to negatively affect cholesterol levels.

The ailments are different, and it is hard to compare different ills across the board. The relative harm is still being debated, but official Swedish government health recommendations currently cite the health implications of snus as less than those of smoking, while still pointing out that both are detrimental to your health (source in Swedish, again).