Chewing the fat

Manufacturers, aficionados and researchers talk snus in St. Louis.

By Taco Tuinstra

Snus enthusiasts gathered on May 27–28 in St. Louis, Missouri, USA, for the first Snus Con, a conference featuring experts from Sweden and the United States. Organized by Chad Jones of the popular snus blog www.snubie.com, the event tackled topics such as tobacco harm reduction, regulation and science. It also highlighted a remarkable innovation—Sting Free Snus—and featured several tasting panels.

Snus represents only a small share of global tobacco sales, but the product has a dedicated following, which became clear during the St. Louis meeting. Attendees passionately discussed their beloved smokeless tobacco, sharing news, tips and experiences. Illustrating the attachment some snusers feel to their product, one prospective participant was detained by U.S. immigration authorities after refusing to surrender a snus can containing Cuban tobacco.

The main snus markets are Sweden, with about $1 billion in annual sales, and the United States, with annual sale of approximately $800 million. The product is also gaining popularity in Norway. Due to a misguided risk assessment, snus is illegal in all EU member states bar Sweden—although that may change soon. The European Court of Justice is set to hear a legal challenge to the ban, and industry representatives are cautiously optimistic it will rule in snus’s favor.

Without the disease-causing byproducts of combustion, smokeless tobacco is considerably less harmful to health than are cigarettes. Unlike smoking, it presents no significant risk for emphysema, heart disease and stroke.

Brad Rodu, professor at the department of medicine of the James Graham Brown Cancer Center at the University of Louisville in Louisville, Kentucky, USA, kicked off the conference by detailing “the Swedish experience.” Sweden has the lowest rates of lung cancer and other smoking-related diseases in Europe, which Rodu attributes to tobacco consumers using snus instead of cigarettes. The country has the highest rate of male smokeless tobacco use and the lowest rate of male smoking in Europe. “If men in other EU member states smoked at the rate of Swedish men, almost 274,000 lives per year would be saved,” said Rodu.

Regrettably, this enviable state of affairs doesn’t extend to Swedish women, who are less likely to obtain nicotine through snus than are their male counterparts. According to Rodu, Swedish women are more likely to smoke. But while snus is still considered a male habit, women under 30 appear less hesitant to pop a pouch underneath their upper lip. If the trend holds, quipped Rodu, “it would be the first time in history that women adopted a healthier behavior from their husbands.”

Joe Ackerman, director of marketing at Swedish Match North America, spoke about his employer’s vision: “a world without cigarettes.” He described a continuum of risk, with cigarettes residing at the very top and smokeless products near the bottom. “We operate at the safer part of the continuum,” he said. Ackerman marveled at the sheer variety of nicotine products, which had come about in response to concerns about the health effects of smoking.

The cigarette remains the ultimate nicotine-delivery device, he noted. “Without the health concerns about smoking, the other categories would not exist.” Ackerman went on to describe one of Swedish Match’s latest offerings, Zyn, which is currently being marketed in the western United States. A smoke-free and spit-free nicotine pouch, Zyn contains nicotine salt derived from tomatoes and tobacco leaves, along with food-grade ingredients, such as pH balancers and sweeteners. Careful to avoid health claims, Swedish Match markets Zyn as a “clean” product.

Swedish Match’s commitment to responsibility became evident also from the fact that Zyn’s child-safety lid—a first in the industry, according to the company—is sufficiently secure to deter even some adults. “I can kill a bear with my hands, but I am unable to open your can,” a burly audience member complained to Ackerman.

Jonas Yden, global director of Skruf Snus, told the story of his company’s meteoric rise. Created only in 2003, Skruf has managed to carve out a respectable niche in a business dominated by centenarians. In its first year of operations, the company packed 400,000 cans of snus; this year, it expects to manufacture 94 million.

While such rapid growth is exciting, it also presents challenges. “We are building the rocket ship while flying it,” said Yden. With machines running 24/7, it is difficult to test new innovations. Yden attributed Skruf’s success to its startup culture, which includes “the freedom to screw up,” and the fact that the company offers to snus users “something other than tradition.” Impressed by the company’s performance, Imperial Tobacco (now Imperial Brands) took a minority stake in Skruf in 2005 and purchased the remaining shares in 2008. As Scruf continues to grow and becomes more corporate, Yden said it must take care to retain its entrepreneurial spirit.

Larry Waters of SnusCentral introduced himself in the way a heavy drinker might present himself at an alcoholics support group meeting. “Hello, I am Larry, and I am a nicotine addict,” he said to an amused audience. A former smoker, Waters credits snus with the fact that he’s alive today. He started snusing with R.J. Reynold’s Camel Snus—a product that was simultaneously scoffed (for its taste) and lauded (for introducing Americans to the category) throughout the St. Louis conference—and quickly “upgraded” to Swedish snus.

Within one week, Waters transitioned from using cigarettes and snus side by side to using only snus—and like a true convert he couldn’t stop telling people about his experience. He started blogging, reviewing products, sharing tips and commenting on industry developments. “I wanted to create a site where Americans could find everything about Swedish snus—a one-stop shop,” said Waters. In 2009, he visited Sweden at the invitation of snus manufacturers, who recognized the potential of the U.S. market. Unable to contain his excitement at being in the “Walhalla of snus,” Waters kissed the tarmac upon arrival.

A particularly interesting contribution to the St. Louis conference came from Lars Rutqvist, senior vice president for scientific affairs at Swedish Match, who also managed to quit smoking with snus. Prior to joining Swedish Match, Rutqvist led the oncology department of the Karolinska Institutet in Stockholm. Among other projects, he researched the risk factors for head, neck and mouth cancers.

Rutqvist’s studies quickly confirmed the roles of smoking and drinking but not the link with snus use. Because his findings went entirely against conventional wisdom in the 1990s, the department was reluctant to accept them. “In medical school we were taught that snus is a major risk factor for cancer,” said Rutqvist. But even after rechecking the basic data, he got the same results: Snus was not a contributor to any of the researched diseases. As it turned out, many of the prior studies supposedly linking snus to cancer related to powdered snuff instead.

When Sweden joined the EU, it received an exemption on cultural grounds from the bloc’s snus ban but was required to start printing cancer warnings on cans. Confronted with the new science, the EU in 2001 allowed Sweden to replace the warning with a more generic one. Rutqvist is hopeful that the EU will soon take the next step: lifting the snus ban. While the European Court of Justice rejected an earlier legal challenge, many things have changed since 2004, according to Rutqvist. Not only is the science more conclusive today; the European Commission has, under pressure from consumers, also been forced to accept e-cigarettes in its new Tobacco Products Directive. What’s more, leaving the snus ban in place would be discriminatory now that a regulatory route for novel products has been introduced.

Rutqvist was also optimistic about Swedish Match’s modified-risk tobacco products (MRTP) application in the U.S.—to the extent that he felt comfortable to bet a bottle of whiskey on its approval in 2018. In its MRTP application, Swedish Match asked the U.S. Food and Drug Administration (FDA) for permission to modify snus health warnings to more accurately reflect the current science. Even though the agency denied Swedish Match’s initial petition, it left the door open by allowing the company to submit an amended application.

Rutqvist noted that the level of scientific expertise at the FDA’s Center for Tobacco Products is much higher than that among its EU counterpart, which he said is staffed primarily by career administrators.

During Snus Con, speakers repeatedly stressed the importance of consumers, who are able to interact with authorities in ways that snus manufacturers cannot. Inspired by the World Health Organization’s Framework Convention on Tobacco Control, many lawmakers keep tobacco companies at arm’s length, preventing meaningful discussions and often resulting in ill-informed legislation.

Alex Clark, executive director of the Consumer Advocates for Smoke-free Alternatives Association (CASAA), which is best known for its work on behalf of vapers, stressed his organization’s support of snus users in the U.S. “People know us as ‘the vaping people,’” he said, “but CASAA talks about all alternatives to smoking.”

Rutqvist, too, spoke approvingly of consumer involvement. “I once naively thought that science could solve all problems—but politics trump science,” he said. Fortunately, Rutqvist added, politicians in many countries are beholden to consumers, who are also potential voters. The EU exception for snus in Sweden and the European Commission’s capitulation on e-cigarettes can both be attributed to consumer pressures, according to Rutqvist. “So, consumers trump politics,” he said. “That’s why conferences such as Snus Con are so important.”

The next Snus Con will be held in the summer of 2018. The date and location will be announced at www.facebook.com/snuscon.