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Snus use and cardiovascular risk factors in the general population: the HUNT 3 study
Author(s) -
Øverland Simon,
Skogen Jens Christoffer,
Lissner Lauren,
Bjerkeset Ottar,
Tjora Tore,
Stewart Robert
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12313
Subject(s) - medicine , snus , waist , blood pressure , population , cross sectional study , confounding , smokeless tobacco , demography , environmental health , obesity , pathology , tobacco use , sociology
Background and aims Snus, a form of smokeless tobacco, is increasingly popular in its traditional N ordic markets, and was recently launched commercially in the U nited S tates. We examined the cross‐sectional associations between snus use and cardiovascular risk factors, and compared them with the corresponding associations of smoking. Design Cross‐sectional study. Setting The HUNT 3 general population survey, N ord‐ T røndelag, N orway (2006–08). Participants A general population sample of n = 25 163. Measurements Measured triglyceride,‐ glucose‐ and high‐density lipoprotein ( HDL) ‐cholesterol levels, blood pressure and waist circumference, registry information on gender, age and education level, self‐reported snus use, smoking, physical exercise and alcohol use. Findings I n age‐ and gender‐adjusted linear regression analyses, extensive snus use was associated with larger waist circumference ( b = 1.65, 95% CI = 0.86, 2.43) and higher systolic blood pressure ( b = 2.58, 95% CI = 1.48, 3.68), but with higher rather than lower levels of HDL ‐cholesterol ( b = 1.66, 95% CI = 0.79, 2.53). These three differences remained significant after additional adjustment for smoking, education level, physical exercise and alcohol use. Smokers had higher triglyceride and lower HDL ‐cholesterol than snus users, but lower systolic blood pressure. Conclusions After adjusting statistically for major confounding variables, Norwegians who use snus extensively have a mixed profile in terms of cardiovascular risk: slightly higher waist circumference and systolic blood pressure but also higher high‐density lipoprotein‐cholesterol.