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PUBLISHER’S WARNING Reader discretion advised. While the jury’s still out on the long-term effects of smokeless tobacco, or, as it is sometimes referred to, “pouch tobacco,” we present scientific evidence in this story that there may be less harmful tobacco products available than cigarettes. Smokeless products may have the potential to significantly lower the societal costs of tobacco-induced illnesses: About 48 million Americans smoke, and half all long-term smokers will die from the habit. However, if you believe all tobacco is bad, or you shun all potentially addictive substances (which include coffee and tea, among others), you may be better off skipping this article. N o 17 VOLUME XIX | NORDIC REACH 47


PHOTOGRAPHY: NIKOLAJ ALSTERADAL

Ulf Hansson, 46, banker, head of foreign exchange and money markets at a Swedish financial institution in Stockholm, has been a user since his early twenties. Hansson was captured in the walkway to Birger Jarlsgatan in the absolute center of Sweden’s capital. “My children, all in their late teens, have urged me to quit, but to me, the use of snus has become the same kind of luxury as a nice glass of red with a good meal.” 48 NORDIC REACH | N o 17 VO L U M E X I X


SWEDISH SNUS:

THE BUMP THAT SATISFIES – AND A SAFER ALTERNATIVE TO SMOKING?

It comes in tiny, porous paper pouches, stacked inside round, palmsized packages. Carefully chilled (freshness is vital), Swedish snus is ground, cured, aged and flavored tobacco that’s suckled gently in the mouth to enjoy the rush and pleasure of nicotine without smoking. The pouches are inserted under the upper lip, leaving a small visible bump that’s common among nearly a quarter of Swedish men (and quite a few Swedish women, too). Few people, even its users, know much more about it. Over two centuries ago, the Swedes discovered that tobacco users’ jittery, nervous quest for nicotine didn’t need to be fiery to satisfy… nor stink from a single wisp of smoke… nor keep you standing outside in all sorts of weather at bars and other places where smoking is banned. Perhaps the best way to describe snus is to let a snus-user himself lend praise in words. Ingvar Kamprad, IKEA founder and long-time snus user, said this about snus in an interview not too long ago: “After a three-course gourmet meal, some people talk about lighting up a cigar… I say nothing is more satisfying than a pinch of fresh snus… pure joy.” As added by another user: “It’s more of an overall and sensuous experience and not just a nicotine rush or a chemical reaction… it’s a sensual, almost carnal feeling, when you have the pinch or pouch under the lip… “It’s very much of a personal thing – you have the taste, the physical aspect of having something under the lip. Nicotine is a very small part of the experience when you think about it… it’s a well-known fact when it comes to food that, smell, taste, looks and the overall texture and total experience of any given dish means more than filling our stomach. “To use snus is a luxury, but so are so many other things of the industrialized world today, even eating to enjoy taste, the ambiance or the company of others… rather than to fill up on energy.” HARMFUL? OR HARM REDUCER? But there’s more to the story of snus than the enjoyment factor, according to many users and experts. Is smokeless snus less harmful than other tobacco products? And if so, does it represent an alternative to cigarettes? Passions run high on both sides of the argument.

While numerous researchers adhere to the belief that no form of tobacco or nicotine is acceptable or safe, a growing number have concluded that snus presents certain advantages of “harm reduction.” That is to say, snus is less damaging to users’ health compared to other forms of consuming tobacco. The lesser of two evils, if you will. “The Swedish government has studied this stuff to death, and to date, there is no compelling evidence that it has any adverse health consequences. Whatever they eventually find out, it is dramatically less dangerous than smoking,” states Kenneth Warner, director of the University of Michigan Tobacco Research Network. The Swedish National Board of Health & Welfare, “Socialstyrelsen,” in its Public Health Report of March 2005, went one step further, stating “For every snus user who takes up smoking there are four smokers who switch to snus when they give up smoking,” and continues, “these results indicate that the net effects of the changed tobacco habits are positive in public health terms, since smoking is so much more dangerous to health than snus.” The thinking goes like this: Because snus is air cured, then steamed, not smoked, as a part of its preparation, it doesn’t generate nitrosamines and other carcinogens in the tar that forms from the partially anaerobic reactions in the smoldering smoked tobacco. Although low nitrosamine levels in snus cannot be deemed completely risk free, if snus is used as a substitute for smoking or a means to quit smoking – sort of like a nicotine patch – the overall effect is positive. One theory proposes that the incidence of tobacco-related mortality among Swedish men is significantly lower in Sweden than any other European country because of the widespread use of snus. Underscoring this conclusion is the fact that tobacco-related deaths among Swedish women have been comparable to those in other EU countries. This may be attributed to the fact that Swedish women have historically been much less likely to use snus than men. (This is changing too – many women are reportedly using snus in mini pouches as a means to quit smoking.)

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“We have studied all forms of tobacco and have come to the conclusion that all forms of tobacco carry carcinogens,” said Terry Pechacek. “A single exposure can cause cancer.” The consumption of snus in Sweden declined until the end of the ’60s, when it was most common among older men. Since the early ’70s, however, snus consumption has increased substantially, and the percentage of snus users increased among both men and women during the ’90s. According to Sweden’s 2004 national public health survey, 22 percent of men and 3 percent of women aged 18–84 used snus. The percentage of snus users was highest in the 30–44 age group, where 29 percent of men and 6 percent of women used snus. Use of snus has also increased over the last few years since Sweden has adopted strict no-smoking laws that cover taverns, bars, restaurants and nearly all enclosed public places. Enforcement of this statute has brought some reduction in the tavern crowds, and groups huddling outside to smoke have become a common sight. However, the laws seem to have driven the use of portion snus as an alternative to smoking while at such establishments. With the exception of Sweden, snus is banned in the EU, although other smokeless tobacco products are currently being sold. Officially, the ban is for health reasons, based on results of a 1986 report from the International Research Agency on Cancer (part of the World Health Organization). But many in Sweden believe that snus has in fact become a pawn in European politics that involve much larger financial stakes, as

PHOTOGRAPHY: HENRIK OLUND

Users come from all walks of life and society. Sofie Moritz, priest at the Swedish Church in Manhattan, became a user during a strive for independence in her late teens and used the stimuli of nicotine to stay up late to study for exams. 50 NORDIC REACH | N o 17 VO L U M E X I X

far as Sweden is concerned. The EU is attempting to de-monopolize Swedish pharmaceutical, alcohol and other market and industry. Regulations and restrictions that apply to business in general, labor, transportation, banking and a diversity of other matters are in the balance. Although banned, a previous warning label on snus cans, which simply stated “Causes cancer” was changed by EU in 2001, to “This tobacco product can damage your health and is addictive.” The European parliaments in an Explanatory Memorandum (COM/99/0594) stated that “…scientific opinion no longer supports a strong warning label as is currently set out in Directive 92/41/EEC (“Causes Cancer”). It is therefore proposed to replace this warning with a more general one. This will better reflect the established health risks for such products…” Everybody agrees that cigarettes kill, but while you may freely export cigarettes from, say Greece, to the rest of EU, snus remains banned, regardless of – EU words – “scientific opinion.” Meanwhile, a 2002 Swedish study found that not only did the use of moist snus contribute to a much lower smoking rate among 80,000 people surveyed, but there was no substantial cancer increase among snus users, including oral cancer. FINDING THE TRUTH Only Sweden and the USA have a significant amount of users of moist snuff. So what about in the U.S? “The U.S. Surgeon General believes there is no safe form of tobacco.” Remember those words. It is the mantra of every major health organization out there. The top doctor in the U.S. says all tobacco is bad. Well, case closed. But is it? That smoking kills thousands of people each year is beyond dispute. When a smoker lights up a cigarette, cigar or pipe, he or she inhales a noxious blend of fumes that, when mixed with enzymes and chemicals in the human body, can cause a variety of cancers and heart disease. The Surgeon General’s Web site, www.surgeongeneral.gov, contains a chilling warning: “Tobacco-related illnesses are the leading cause of death and kill 435,000 people each year.” Even a cursory reading of that statement tells a reader that yes, all tobacco is equally bad. The numbers the Surgeon General uses, however, are those for smoking. According to other scientists, smokeless tobacco kills, well, no one. And not all of those scientists are in Sweden. For example, in a December 2002 report titled “Protecting Smokers, Saving Lives,” Britain’s Royal College of Physicians concluded that “the consumption of noncombustible tobacco is on the order of 10 to 1,000 times less hazardous than smoking, depending on the product.” And an article in the December 2004 issue of Cancer Epidemiology Biomarkets and Prevention, a journal published by the American Association for Cancer Research, claims the risk of dying from smokeless tobacco is 90 percent less than the risk associated with


smoking. The report based its conclusions on Swedish snus, noting its significantly lower levels of nitrosamine – also compared to many U.S. smokeless tobacco products. So, why the disconnect? “We have studied all forms of tobacco and have come to the conclusion that all forms of tobacco carry carcinogens,” said Terry Pechacek, Ph.D., associate director of science at the Centers for Disease Control Office on Smoking and Health. “A single exposure can cause cancer.” Pechacek said the CDC bases its views upon the 1986 IARC research used by the EU, which the U.S.-based National Institutes of Health continues to follow up on, as well as the work of the American Cancer Society. In all those studies, the CDC said, smokeless tobacco rated just as high a risk as smoking. But not everyone agrees with this conclusion. Brad Rodu, D.D.S., head of the Endowed Chair on Tobacco Studies at the Brown Cancer Center at the University of Louisville, said there is a fundamental flaw with those studies. Rodu is the author of “For Smokers Only,” a stop-smoking help guide in which he advocates using smokeless tobacco – specifically, moist snus – as a replacement for smoking. “They don’t compare cancer rates of smokeless users to smokers,” said Rodu, an oral pathologist, specializing in mouth disease, especially oral cancers. “The CDC has never conducted a side-by-side study of smokeless tobacco as compared to smoking.” “Smokeless tobacco is 98 percent safer than smoking, 98 percent,” claims Rodu, whose research is presently funded by a five-year grant from U.S. Smokeless Tobacco. “We have solid epidemiological evidence that shows this. The CDC and NIH and IARC never spoke with a single oral pathologist when they did their studies. If they did, they would have come to different conclusions.” SCIENCE AS PING-PONG Both sides in the smokeless tobacco debate can point to volumes of evidence, one side claiming snus causes cancer, the other claiming it doesn’t. The difference, however, may be in the products the groups study. Swedish moist snus differs from other tobacco in how it is made. After roughly 1985, the main U.S. smokeless tobacco producer, US Tobacco, copied the Swedish manufacturing process, albeit with taste and texture directed at the American market. Of these two moist snus types, the Swedish brands were studied in the mid-80s and are the subject of continuing research. These are the products Rodu backs. No health groups have yet to study the U.S.-produced Swedish-style snus. Instead, the NIH and IARC studies looked at older and less used products, including broad leaf chewing tobacco, sometimes called “spit tobacco.” Even the CDC concedes in a 2000 report on smoking cessation techniques that it “…exclusively addressed treatments for cigarette smoking, as opposed to the use of other forms of tobacco, as the small number of studies on the use of non-cigarette tobacco products precluded their separate analysis.”

Ingvar Kamprad, founder of Swedish furniture store IKEA, a long-time user, must have been among the first in Sweden to use snus as a means to abstain from smoking.

Yet it is this very type of study, Rodu said, that shows not only that moist snus has an almost negligible cancer rate, but that moist snus can and does help smokers quit. “The risk of snus is so low as to be on a general magnitude of dying in an automobile crash,” Rodu said. “In comparison with cigarettes, smokeless tobacco is 98 percent safer. I do the research and I worked at one of the largest cancer centers in the country. I’ve been on the lung cancer wards and seen these people walking around with lung cancer. We have a product that can help these people. I say do the research.” While Rodu trumpets the safety of moist snus, the major health organizations are even louder in shouting it down. Both the American Cancer Society (ACS) and the CDC say smokeless tobacco causes not only oral cancer, but lung cancer as well. The ACS, in a 2005 report titled “Two large prospective studies of mortality among men who use smokeless tobacco,” said use of snus led to a “significant” association of “death from coronary heart disease, stroke and all cancers combined and cirrhosis.” The CDC agreed with those results. Dr. Jonathan Foulds, head of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey, took on the ACS when he and Swedish scientist Lars Ramström questioned the conclusions of the 2005 report. “There was an 18-year gap in the study from when people enrolled and when they conducted their results,” Foulds said. “The study doesn’t account for any lifestyle changes.” Foulds and Ramstrom also questioned the conclusion that moist snus causes oral cancer. “In their own study – and it is something I pointed out

“The risk of snus is so low as to be on a general magnitude of dying in an automobile crash,” Rodu said. “In comparison with cigarettes, smokeless tobacco is 98 percent safer.” N o 17 VO L U M E XIX | NORDIC REACH 51


Terese Bonnevier, 28, photographed on the counter at Nada bar on Åsögatan 140 in Stockholm’s trendy “Söder” (Stockholm’s South). Bonnevier, a former model and presently assistant at a film production company in Stockholm pursues her dream right now – studying with the Ward Acting Studio in New York. She became a user during a period of feeling low in the winter, 2005, isn’t really sure to which extent she is addicted but is no longer feeling low.

Death sells. Like it or not, that is a reality. Whether it is two people in a car accident or 435,000 from diseases directly related to smoking, death is a story that sells.

TOBACCO-FREE CRUSADE The real bugaboo when it comes to tobacco, whether smoked or smokeless, is nicotine. Right behind nicotine is the equally hysteriacausing word, addictive. Everyone knows nicotine is addictive. Moist snus, in fact, packs more nicotine than a cigarette. That, however, does not mean moist snus causes cancer, and that is often the problem. Ask anyone on the street what causes cancer in tobacco and nine times out of ten the answer is nicotine. Look at ACS or CDC Web sites and the words nicotine and addiction are everywhere, as is the word cancer. The association is: nicotine causes cancer. The fact, however, is nicotine is no more harmful to the human body than caffeine, something even the CDC admits. But because nicotine is linked to tobacco, it is a target. TobaccoFree America, one of the largest and most vocal of the nation’s anti-tobacco groups, was founded by Patrick Reynolds, grandson of the founder of the R.J. Reynolds tobacco company. TobaccoFree America specifically targets children in its anti-smoking campaigns and also offers help to adults that want to quit smoking. The group does not mention the use of smokeless tobacco such as moist snus to help smokers quit. That, however, is really not surprising, given the stance of the CDC. “We will never advocate the replacement of one toxic substance with another,” the CDC’s Pechacek said. “We don’t recommend anyone start using smokeless tobacco nor do we advocate telling smokers to trade one cancer-causing substance for another.” The idea of replacement therapy isn’t new, however. In fact, the CDC advocates that very approach in helping those addicted to a drug it labels as just as dangerous as nicotine, namely heroin. The CDC backs the use of methadone in helping heroin addicts kick their habit and “methadone maintenance” is an established and federally funded treatment. 52 NORDIC REACH | N o 17 VO L U M E X I X

PHOTOGRAPHY: NIKOLAJ ALSTERADAL

– there is only a 0.9 percent increase in oral cancers among snus users and non-snus users,” Foulds said. “It is a claim the data doesn’t support.” As for the 1986 IARC report that led to the EU ban on snus, the Swedish government, as well as Swedish snus manufacturers, continue to fight to overturn the ban. The IARC study, they say, didn’t look at Swedish moist snus but non-European – mostly Indian – tobacco products. Those products, however, contain any number of non-tobacco and cancer-causing ingredients, including areca nut, betel leaves or even arsenic. Despite the difference between Swedish- and American-made products and those the IARC studied, the WHO and the CDC stand by the report. “We looked at the toxicology and epidemiologic data and we believe it is as complete as it can possibly be,” Pechacek at the CDC said. “Smokeless tobacco contains one of the highest concentrations of nitrosamines, the substance that causes oral cancer and that with multiple ingestions will cause lung cancer.”


Yet, while the CDC and ACS rank heroin as being just as addictive – and just as difficult to kick – as nicotine, it has a simple response to why it doesn’t favor the use of moist snus as a replacement for smoking. “Methadone doesn’t cause cancer,” Pechacek said, “and there is no evidence smokeless tobacco can help people quit smoking. There are no studies we would consider sufficient.” “We are always willing to go back and review our data,” Pechacek at the CDC said. “We are constantly re-analyzing our work and always looking for data that would support other conclusions. We are not afraid to discuss anything.” But Pechacek dismissed the study of Swedish snus users as being particular to Sweden only, although he did say its results “remain under study.” As for Rodu’s work, the CDC believes there are “insufficient data” to make any conclusions. PROPAGATING PROPAGANDA Death sells. Like it or not, that is a reality. Whether it is two people in a car accident or 435,000 from diseases directly related to smoking, death is a story that sells. When it comes to tobacco, add anti-corporate sentiments, decades of lies about the effects of smoking, and, as Robert Levy, a senior fellow on constitutional studies at the Washington-based Cato Institute puts it, “a great big ATM machine labeled Big Tobacco,” and any death attributable to tobacco sells even more. All of this, said Levy, creates a self-propagating wheel of hysteria.

“Do a Google search on smokeless tobacco and the results you get are 99.9 percent negative,” Rodu said. “I want to cast a sunlight on the issue. We’ve got to move the issue back toward the area of scientific discussion and away from making it merely a moral issue.” PHOTOGRAPHY: NIKOLAJ ALSTERADAL

“It’s deceptive and misleading argument and polemics,” Levy said. “Frankly it is in part brought on by cigarette makers like Morris and Reynolds (for deceptive advertising). There is now a hatred toward smoking and (Big Tobacco’s) deep pockets mentality really poisoned the atmosphere.” While no one will ever again defend smoking as being anything other than potentially deadly and completely stupid, the question of how to get people to quit is becoming one with more than one answer. The CDC points to various pharmacological and therapeutic stopsmoking aids as being successful in helping smokers to quit. The most popular, the nicotine patch and nicotine gum, are also the easiest to acquire. The CDC also lists “intensive behavioral therapy” as another stop-smoking means. None, however, is foolproof. For the patch, the CDC found only a 17.7 percent success rate. A placebo produced a 10 percent success rate.

The strongest nicotine gum, which delivers a 2 mg dose, has a 23 percent success rate. What the CDC studies didn’t say was how long smokers who quit actually remained abstinent. Their abstinence rates are estimates only. “It’s more like 7 percent,” said Rodu at the Brown Cancer Center. “Do you think aspirin would be popular as a pain killer if it only had a 7 percent rate of success? I doubt it. Yet that is what we have when it comes to other stop-smoking treatments.” Rodu’s advocates using smokeless tobacco to help chronic smokers quit. The CDC is quick to condemn his theory. “There is no scientific evidence to support his work,” Pechacek said. It is the hysteria surrounding tobacco products that keeps smokers from knowing the whole truth about alternative means to quit, Rodu said. “Do a Google search on smokeless tobacco and the results you get are 99.9 percent negative,” Rodu said. “I want to cast a sunlight on the issue. We’ve got to move the issue back toward the area of scientific discussion and away from making it merely a moral issue.” He questioned how many smokers die every year that might be alive if the CDC and other health organizations put all the information concerning smokeless tobacco before the public. So did Levy at the Cato Institute, who saw a parallel between smokeless tobacco and needle exchange programs for drug addicts to help combat the spread of HIV/AIDS. “A lot of people argued needle exchange programs for addicts are a valuable tool for reducing HIV and hepatitis, so why doesn’t the same apply with harm reduction for smokeless tobacco?” Levy said.

Kenneth Erlandsson and Madeleine Gustafsson together run Stockholm’s largest marine fashion store, Pir 19 (www.pir19.com). Erlandsson is a former hockey player, an occupation where “everybody was a user.” He was once a smoker, but now uses the smallest variety of portion snus, mini catch. “It helped me get away from the habit of smoking, which is something I unfortunately picked up during my military training.” Gustafsson quit smoking with the help of snus after the arrival of their son in the mid-90s. N o 17 VO L U M E XIX | NORDIC REACH 53


At the same time, a social stigma attached to smokeless tobacco also mitigates against its use a stop-smoking aid. Rodu admitted the stereotype of a tobacco chewer – someone who is less than socially acceptable and hails from “Redneck Country” – is one that is hard to shake. “That is the single biggest hurdle we have to cross,” Rodu said. “There is this image out there of baseball players with a big wad of tobacco or cowboys spitting on the trail.” New products that are clean to use and that don’t require spitting have so far done little to lessen that stigma. Health organizations do their part, however, to continue that stereotype. The ACS, CDC and Mayo Clinic continue to refer to smokeless tobacco as “spit tobacco,” immediately conjuring that negative image. It is just one more method, Rodu said, of how anti-tobacco groups prevent discussion. Subtle and not-so-subtle digs at smokeless tobacco may be more than mere hype. Levy at the Cato Institute saw them as a broader assault on the public’s right to know. “We are moving in the wrong direction and tobacco is just the beginning of it,” Levy said. “We’re now seeing the same thing with obesity and it’s likely to extend itself into engaging in dangerous behavior like motorcycles or skiing. It is a pernicious trend. The only thing that is going to stop it is when the public sees it has gone too far and the pendulum swings the other way, but it’s certainly not going to happen with tobacco. The hatred runs too deep.” Foulds at the University of Medicine and Dentistry of New Jersey agreed. “We believe the public has a right to know the pros and cons without all the hysteria,” Foulds said. “The groups out there that fight against tobacco should stop their scare tactics and let science be the determinant.”

PHOTOGRAPHY: NIKOLAJ ALSTERADAL

“We believe the public has a right to know the pros and cons without all the hysteria,” Foulds said. “The groups out there that fight against tobacco should stop their scare tactics and let science be the determinant.”

Amanda Sandström, 30, a dental nurse in Stockholm, started using snus a couple of years ago to avoid the occasional smoking at parties. She uses the “general portion,” not the typical female snus, and feels the habit gives her comfort, but is careful not to show it at work.

MAKING THE CHOICE In the end, smoking or using smokeless tobacco is a matter of personal choice. What Rodu, Foulds and Levy say is they believe the public has a right to know all the data about using those products, not just the data one side or the other in the tobacco debate wants made available. Let’s hope that all of the effects of tobacco, smokeless and smoked, emerge – and that all individuals will then be in a position to decide for themselves. Agnes-Lo Åkerlind, 26, who begins her studies again this fall, is a former reporter at Sveriges Radio, and promotor for Versity Music and a music festival in northern Sweden. She uses snus as a less dangerous alternative to smoking and picked up the habit after the smoking ban in 2005.

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Chef Erik Lallerstedt. Eriks Gondolen, an elegant restaurant for business dinners and high-society with a million-dollar view of the Stockholm skyline from panorama windows, is offering the world’s most exclusive snus in the bar.

SNUS IN EXC LUSIVE COMP ANY at Eriks Gondolen, whose guests include members of the Royal Family, how-powered business people, and tourists who have read in guidebooks about Gondolen, one of the country’s most famous restaurants. The restaurant is run by Erik Lallerstedt, whose name is legendary in Swedish gastronomy. The restaurant perched on the island of Södermalm close to the Slussen subway station is a major landmark in Stockholm. One takes a elevator called Katarinahissen (10 kronor) to the viewing parapet in order to enter the restaurant, whose cuisine mixes Swedish classics with French and modern influences. Several of Erik’s previous ventures have earned stars in the Guide Michelin. Erik Lallerstedt rarely uses snus himself, and when he does it is mainly as a means to cut down on his beloved pipe-smoking. But what type of snus does the master chef favor? “I might use eucalyptus or mint-flavored snus. They’re all ghastly,” he says with a laugh. For more info, see: www.eriks.se

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PHOTOGRAPHY: NIKOLAJ ALSTERADAL

The decision to ban all smoking in Swedish restaurants, cafes, bars and nightclubs June 1st 2005 has led to some interesting changes in nightlife. During the winter, it isn’t unusual to see a small group of hardy souls huddled outside the entrance to a club or café hopping about in an effort to stay warm in the sub-zero temperatures. They aren’t waiting in line to get in, but braving the cold to get their nicotine fix. Another wintertime phenomenon is the creation of tent-like outside urban bars warmed by enormous heat lamps, where it is still possible to legally drink and smoke at the same time. The smoking ban might also be encouraging people to use snus in places where one wouldn’t always expect to find it. The bar at Eriks Gondolen, for example, an elegant restaurant for business dinners and high-society with a million-dollar view of the Stockholm skyline from panorama windows, is now offering its guests Kardus, the world’s most exclusive snus. Each square canister of Kardus is marked with the year of its packaging, and signed by the person who does the final quality control. Traditionally, snus has been associated with the working class. It is not a product which one might expect to find


SNUSTORY:

A HISTORY OF THE STUFF THAT’S NOT SNUFF

The use of tobacco probably dates back to prehistory, and accounts of its origins vary. Rewinding the clock to the late 1400s, Columbus and followers were said to observe the local “Indians” funneling powder into their nostrils using a pipe called tabago. The leaf with which they created the powder got the same name – tobacco, anglicized. When Columbus set foot in the New World, the American-style leaf known today as tobacco had been chewed and smoked for centuries – from Brazil to Canada. And within 50 years of its European debut, it was sprouting in gardens throughout the Iberian Peninsula. Tobacco first appeared in Sweden in 1638, brought home by a ship returning from the Swedish colony on the Delaware River. Ground and dried, tobacco found medicinal uses by French physician Jean Nicot. Honoring Nicot, the famous Swedish botanist Carl von Linné named the basic tobacco substance “nicotine.” Tobak became so popular in Sweden that it was a major farm crop within a century after it arrived. Snuff was all the rage among white-wigged aristocratic Europeans, who sniffed it from jeweled mini-boxes and sneezed it into lace handkerchiefs. A century later, when the working class chopped their way through these finest heads in Europe, snuff became as detested as the overlords who (had) used it. The Swedish tobacco industry began production in the 1700s, when the under-the-lip alternative to snuff, known today as “loose” snus, was invented. Snus is placed in the mouth against the gum line, where the nicotine is absorbed. Snus was originally sold in the form of a loose, moist powder to be taken a bit at a time, rolled into a small ball or cylinder with the fingertips (there’s a tool available for this today). This is called a pris (pinch) prilla or prell (slang for pris) and is placed inside the upper lip. Every snus “recipe” involves choosing the best leaves, cutting and running them through a crusher, and milling and sifting them into a fine powder. Water and salt are added, and the mixture is spread on a tray to “sweat” (age or lightly ferment). This “sweat” phase, conducted in rooms heated by wood-burning stoves, originally took up to six months. Flavoring is next – and the lion’s share of any snus’ appeal comes from its flavor. After a week of “sweating,” the snus is blended with potash, salmica and alum. Further additions could include cognac, whiskey, flavored oils, or ginger. SOARING POPULARITY Snus soon became popular and ousted both snuff and chewing tobacco. Between 1810-1820, snus consumption rose to dominate the Swedish market. Growing tobacco became an important agricultural pursuit, remaining so until the 19th century. As tobacco use continued to grow, taxmen levied a tax on it to control consumption. Nobility, priests and burghers 56 NORDIC REACH | N o 17 VO L U M E X I X

had to pay more to use tobacco than farm hands and maids, for example, while soldiers, boatmen and miners were exempted from the tax. In 1822, Jacob Fredrik Ljunglöf began manufacturing snus using a new process that shortened the fermentation phase and boosted the product’s popularity. His “Ettan” brand (meaning “Number One” – an indication of its superiority) overtook the Swedish market. Only one producer was larger than Ljunglöf at the turn of the 20th century – Ettan’s world placement was second, and as validation of their firm’s respect, one of its devoted customers was Pope Leo XIII. Today, Stockholm’s tobacco museum is home to many of the most popular recipes for snus. Ljunglöf’s Ettan is not one of them however – the founder’s son withheld it when, in 1916, the entire tobacco industry was nationalized to pay for military and pension costs. Today’s production is said to be a close replica of the original, but according to legend, Ljunglöf burned the only written copy before dying and took the secret with him to the hereafter.

The result of consuming and flinging aside snus, resulted in literal snus rivers throughout North America. In Chicago the usage along Chicago Avenue was so abundant that the street was nicknamed “Snoose Boulevard” SNUS IN AMERICA Between the mid-1800s and the Great Depression, over a million Swedes immigrated to America, bringing with them their yearning for Swedish snus. Swedes commiserated about the lack of snus in letters home. The newspaper “Göteborgs-Posten” in 1869 printed one that stated: “The real trouble for the Swedes [over here] is that tolerable snus can’t be bought for love or money.” Nearly every Swedish enclave in America had its own newspaper, and notices appeared every time a new shipment of snus arrived from Sweden. But snus is classified as “fresh produce” and must be refrigerated or consumed while fresh. There were no means for adequate preservation during the Atlantic passages, so few parcels from Sweden delivered the satisfaction that Swedish-American customers remembered from “back


home.” Not until metal foil wrapping was invented, and subsequently used by Ljunglöf for his “Ettan”, did fresh Swedish snus reach America. Fond memories did not deter Swedes from attempting to produce their own snus varieties. After all, the tobacco in Ljunglöf’s snus came from Virginia. But the trick of treating and preparing it eluded American tobacco companies, who resorted to adopting Swedish brand names or buying existing factories for such brands as “Copenhagen” or “Red Seal” (the latter, under the brand Röda Lacket, being one of Sweden’s most popular brands to this day). Despite the complaints about poor quality by Swedish-American snus consumers, buying and trying new product versions continued, in astounding volumes. The result of consuming and flinging aside snus, resulted in literal snus rivers throughout North America. In Chicago the usage along Chicago Avenue was so abundant that the street was nicknamed “Snoose Boulevard”, as snus-using Swedes crowded here in the 1800s. Heaps of discarded snus remains grew on the sidewalks, and it is repulsive to imagine the stench and mire it created during sultry summer months. Neighborhoods in other towns with large Swedish populations had their own “Snoose Boulevards.” Among the most colorful was Minneapolis’ Cedar Avenue, an entertainment center offering attractions like dance halls, billiard parlors, saloons, and shows from Sweden. Celebrations kept beer and snus handy for newly landed Swedes. THE FUTURE OF SNUS Portion snus, pouched pre-measured snus, was introduced in Sweden in 1973. Delivered in paper bags from the same material as teabags, portion snus is easily handled and discarded. Historically, snus has been sold in lavish tins of porcelain, wood, silver or gold. Most of today’s snus canisters (in the shape of a hockey puck) are made of compressed paper or plastic. Last year, the world’s major snus manufacturer Swedish Match founded what is being called the world’s most advanced snus factory, with a production capacity of some 120 million cans per year, devoted exclusively to portion snus. Mini pouches are a recent addition popular with women. Introduced a few years ago, these come in flavors including mint, licorice and eucalyptus. Because the pouch is about half the size of portion snus, it is nearly unnoticeable under the lip. Don’t be surprised someday to find flavors like lemon, orange – maybe even chorizo. Snus lovers used to judge snus by its color. But with the new packages of portion snus, it’s a matter of taste, so creativity and originality play a big part in today’s and tomorrow’s marketplace. ULF MÅRTENSSON

“Smokeless tobacco is not a safe alternative to cigarettes.” – U.S. Surgeon General Because (or in spite) of that admonition, a number of articles on the pros and cons of smokeless tobacco have appeared in American mainstream media over the past few years. Most recently, a New York Times Magazine article (June 18, 2006) by Joe Nocera calls for a new approach to tobacco and smoking: regulation through the Food and Drug Administration, a move actually supported by a tobacco executive from Philip Morris. The article reports some stunning facts, including the fact that “despite everything,” some 20 percent of the adult population in the U.S. still smokes – that’s about 48 million people, 400,000 of whom will succumb this year to smokingrelated diseases. Nocera also notes that, “Cigarettes aren’t going away. Nobody is about to ban tobacco, nor is anybody about to put the cigarette companies out of business, much as they would like to.” The article revives the issue of federal regulation of tobacco through an interview with a Philip Morris exec, who at least on that level seems to be very much in agreement with the larger anti-tobacco lobby. At the end of the article, Nocera mentions “reduced-harm” tobacco products such as smokeless “pouch tobacco.” Jonathan Foulds, who was also interviewed for our article, is quoted as an advocate of the reduced risks of smokeless tobacco, along with tobacco policy expert David Sweanor, who notes simply, “It’s the smoke, stupid.” While stopping there on the harm reduction argument, the writer does address the intricate challenges facing a tobacco industry already tainted by years of perceived lies and deceit resulting from public hearings of tobacco execs. How do you communicate the message of a less harmful product to the public? And is it desirable? Will the use of one tobacco product lead to the use of another? What if snus is a gateway to cigarettes? They’re all legitimate questions. Valerie Reitman, writing in the L.A. Times in June 2004, brought up the issue of public knowledge, stating, “Many Americans may be unaware that most scientists and researchers say that smokeless tobacco is less hazardous than cigarettes in causing deadly disease. That’s not surprising. For years, some private and government medical organizations have disseminated outdated information on the subject.” Reitman’s article described the Swedish phenomenon, but also raised issues about the long-term effects of making smokers switch to the less harmful product for good. A May 2004 column in the Chicago Tribune took the issue of harm reduction a step further, quoting research in Sweden and the program by Professor Brad Rodu, also mentioned in our story. Writer Steve Chapman, who has never been a user of any tobacco product, recalled in a recent phone interview what triggered his interest: “My memory is that a friend of mine met Rodu, found out about his research and suggested I look into it. It seemed like a novel idea, and I was also struck by the opposition among anti-smoking groups. I think it’s a reasonable option in trying to encourage smokers to give up cigarettes.” The Swedish Public Health Report of March 2005 stated that “…for every snus user who takes up smoking, there are four smokers who switch to snus when they give up smoking.” The U.S. Surgeon General, Vice Admiral Richard H. Carmona, addressed the possible negative consequences of a proven less harmful tobacco product in an interview on ABC’s 2005 series “Quit to Live.” However, he also noted, “If there [were] scientific evidence to show that there was some relative risk improvement by using another tobacco product, I’m willing to discuss that…”

N o 17 VO L U M E XIX | NORDIC REACH 57

Snus, the bump that satisfies...  

.. few people, even its users, know much more about it. A Special Report on snus in Nordic Reach: Over two centuries ago, the Swedes discove...

Snus, the bump that satisfies...  

.. few people, even its users, know much more about it. A Special Report on snus in Nordic Reach: Over two centuries ago, the Swedes discove...

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