Quitting tobacco boosts survival after heart attack

A new study suggests that heart attack patients who stop using snus — a specific type of moist chewing tobacco that is popular in Sweden — could greatly reduce their risk of dying within a couple years.

The findings don’t directly prove that stopping the use of this type of smokeless tobacco actually affects cardiac health, and ethical constraints may prevent researchers from ever understanding the full value of quitting. There are other caveats, and it’s not clear that quitting the main kinds of smokeless tobacco used in the United States would have the same potential effect.

Still, the study “indicates that quitting snus use after a heart attack might be as equally beneficial as quitting smoking after a heart attack,” said study author Dr. Gabriel Arefalk, a cardiologist at Uppsala University Hospital in Uppsala, Sweden.

The health risks of smokeless tobacco have been in the news over the past week because of the death of baseball legend Tony Gwynn at the age of 54. Gwynn blamed his initial salivary gland cancer on a long history of chewing tobacco, although doctors say there’s no definitive link between that kind of tobacco and that type of cancer.

It’s clear, however, that smokeless tobacco poses major risks to health and causes other kinds of cancer.

Smokeless tobacco comes in a variety of forms, including traditional chewing tobacco (which may come in loose leaves or “plugs”) and snuff (finely cut or powdered tobacco), according to the US National Cancer Institute.

The new study examines snus (rhymes with “moose”), a kind of moist snuff that doesn’t need to be spit out because users typically swallow the tobacco juices.

“Snus is very different from American chewing tobacco such as Red Man or American moist snuff such as Skoal or Copenhagen,” explained Dr. John Spangler, a professor of family and community medicine and psychiatry and behavioral medicine at Wake Forest School of Medicine.

“Snus is pasteurised by steam, while American smokeless tobacco is cured in a heated environment over time. Curing generates more cancer-causing agents, so some tobacco experts argue that snus is safer and want tobacco companies to be able to market snus as safer.”

Snus is especially popular in Sweden, where 20 per cent of adult men and three per cent of adult women use it.

The researchers tracked almost 2,500 snus users, mostly men, who were younger than 75 and had heart attacks between 2005 and 2009. Only about one-fourth — 675 — quit using snus, while the rest continued.

Fourteen of those who quit and 69 of those who continued to use snus died over an average of about two years.

Those who quit were about half as likely to die as those who continued using the smokeless tobacco, after researchers adjusted their statistics so they wouldn’t be thrown off by high or low numbers of people of certain ages or genders.

-New York Times News Service.