Using snus doubles the risk of alcohol dependency

February 25, 2015

People who use snus run twice the risk of developing alcohol dependency compared with non-users, and the more one uses snus, the higher the risk. This has been found in a study from Umeå University which was published in the journal Drug and Alcohol Dependence.

"This is the first time research has succeeded in showing that middle-aged people who use snus run an increased risk of developing alcohol dependency. Something that makes the results extra interesting is that the relationship between using snus and alcohol dependency does not seem to be independent of smoking habits,  income, education and other socio-economic factors", says Margareta Norberg, Adjunct lecturer, ALC programme, Ageing and Living Conditions, at Umeå University, which is behind the study.

The study is based on the Västerbotten Intervention Programme that annually invite those aged 40, 50 and 60 (30-year olds only until 1996) in the county to health centres for a health examination and a dialogue with a trained nurse with the aim of preventing ill-health with a focus on cardiovascular disease. The participants also fill in a comprehensive survey which, among other things, is about lifestyle and problems related to .

In the current study, 21 000 people are included who participated in the study between 1991-1997 when they were aged 30, 40 or 50. None of the participants then showed signs of alcohol dependency. Of these participants, approximately 75 percent returned to a similar study 10 years later. A quarter of the men, 25 percent, and slightly less than 4 percent of the women used snus upon the first examination.

The study shows that alcohol dependency developed during the ten-year period for just under 8 percent of snus users and 3 percent among those who did not use snus. Men showed slightly higher figures for alcohol dependency than women. In total, 499 men and 257 women developed alcohol dependency.

The relationship between using snus and an increased risk of developing alcohol dependency remained, even when taking into account smoking habits and socio-economic conditions such as education, income, marital status and where in the county the people lived. The more the participants stated that they used snus, measured by the number of consumed snus boxes per week, the higher was the risk of becoming alcohol dependent for both men and women.

Furthermore, it was found that the relationship between using snus and the risk of developing alcohol dependency increased over time, and that the risk was higher for people with higher education compared with those who did not have a higher education degree. Income, however, had no relevance. Those who, upon the first investigation, where aged 50, had a lower risk than those aged 30.

That there is a connection association between smoking and alcohol dependency has been known for a long time. Even if it is not possible to determine from this study what is the underlying cause of the relationship between snus and alcohol dependency, Margareta Norberg points out that nicotine dependency is a common factor for both smoking and snus use that cannot be overlooked. She believes that the risk increase with using snus observed in the current study must be taken seriously.

"A doubled risk of alcohol dependency can be a seemingly quite moderate risk increase seen from the individual perspective, but if using snus is common in a population, it means that the overall use of snus might have an impact on public health. It is therefore important that the research results are made known to the general public and start being discussed", says Margareta Norberg.

Explore further: Snus use in Norway has tripled in five years

More information: Margareta Norberg, Gunnar Malmberg, Nawi Ng, Göran Broströma, "Use of moist smokeless tobacco (snus) and the risk of development of alcohol dependence: A cohort study in a middle-aged population in Sweden," Drug and Alcohol Dependence, DOI: 10.1016/j.drugalcdep.2015.01.042

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