Background
Methods
Study population
Assessment of snus use, potential confounders, and intermediates
Case ascertainment and follow-up
Statistical analysis
Results
Characteristics* | Snus use | |
---|---|---|
Nonusers | Users | |
Number of participants, n (% of total) | 38,862 (94.4) | 2300 (5.6) |
Age at baseline, years, mean (SD) | 69.8 (8.0) | 65.5 (6.7) |
Men, n (%) | 20,988 (54.0) | 2147 (93.4) |
Education, n (%) | ||
≤ 9 years | 11,733 (30.2) | 716 (31.1) |
10–12 years | 18,104 (46.6) | 1164 (50.6) |
> 12 years | 89,291 (23.0) | 412 (17.9) |
Unknown | 96 (0.25) | 8 (0.35) |
Cigarette smoking status, n (%) | ||
Non-smokers | 21,099 (54.3) | 418 (18.2) |
Former smokers | 14,411 (37.1) | 1590 (69.1) |
Current smokers | 3352 (8.6) | 292 (12.7) |
Alcohol intake, n (%) | ||
Never drinkers | 3689 (9.5) | 18 (0.8) |
Past or current drinkers of < 1 drink/week | 8198 (21.1) | 328 (14.3) |
1–< 7 drinks/week | 18,605 (47.9) | 1148 (49.9) |
7–< 15 drinks/week | 7085 (18.2) | 644 (28.0) |
15–21 drinks/week | 957 (2.5) | 116 (5.0) |
> 21 drinks/week | 328 (0.8) | 46 (2.0) |
Walking/bicycling, n (%) | ||
Never/seldom | 2401 (6.2) | 173 (7.5) |
< 20 min/day | 6652 (17.1) | 514 (22.4) |
20–40 min/day | 16,215 (41.7) | 869 (37.8) |
> 40 min/day | 13,031 (33.5) | 719 (31.3) |
Unknown | 563 (1.5) | 25 (1.1) |
Exercise, n (%) | ||
Almost never | 20,868 (53.7) | 1515 (65.9) |
< 1 h/week | 4694 (12.1) | 256 (11.1) |
1 h | 6623 (17.0) | 234 (10.2) |
2–3 h | 5020 (12.9) | 211 (9.2) |
4–5 h | 705 (1.8) | 44 (1.9) |
≥ 5 h/week | 268 (0.7) | 8 (0.4) |
Unknown | 684 (1.8) | 32 (1.4) |
Body mass index category, kg/m2, n (%) | ||
22.5–24.9 | 10,035 (25.8) | 523 (22.7) |
< 22.5 | 6553 (16.9) | 227 (9.9) |
25.0–29.9 | 16,053 (41.3) | 1109 (48.2) |
≥ 30.0 | 4990 (12.8) | 375 (16.3) |
Unknown | 1231 (3.2) | 66 (2.9) |
Hypertension, n (%) | 16,214 (41.7) | 887 (38.6) |
Hypercholesterolemia, n (%) | 9832 (25.3) | 589 (25.6) |
Diabetes, n (%) | ||
No | 34,188 (88.0) | 2005 (87.2) |
Yes | 3560 (9.2) | 225 (9.8) |
Unknown | 1114 (2.9) | 70 (3.0) |
Snus use | ||
---|---|---|
Outcome and model (total number) | Nonusers | Users |
Myocardial infarction (N = 38,844) | ||
Total number of cases | 1610 | 97 |
Age and sex-adjusted model | 1.00 (reference) | 1.01 (0.82–1.25) |
Multivariable model 1† | 1.00 (reference) | 0.95 (0.77–1.18) |
Multivariable model 2†† | 1.00 (reference) | 0.96 (0.78–1.19) |
Heart failure (N = 40,326) | ||
Total number of cases | 1990 | 96 |
Age and sex-adjusted model | 1.00 (reference) | 1.15 (0.94–1.42) |
Multivariable model 1† | 1.00 (reference) | 0.99 (0.80–1.23) |
Multivariable model 2 †† | 1.00 (reference) | 1.00 (0.81–1.23) |
Atrial fibrillation (N = 38,044) | ||
Total number of cases | 3991 | 234 |
Age and sex-adjusted model | 1.00 (reference) | 1.18 (1.03–1.35) |
Multivariable model 1† | 1.00 (reference) | 1.11 (0.97–1.27) |
Multivariable model 2†† | 1.00 (reference) | 1.11 (0.97–1.28) |
Aortic valve stenosis (N = 40,873) | ||
Total number of cases | 421 | 19 |
Age and sex-adjusted model | 1.00 (reference) | 0.86 (0.54–1.37) |
Multivariable model 1† | 1.00 (reference) | 0.82 (0.51–1.32) |
Multivariable model 2†† | 1.00 (reference) | 0.83 (0.52–1.33) |
Abdominal aortic aneurysm (N = 40,853) | ||
Total number of cases | 480 | 55 |
Age and sex-adjusted model | 1.00 (reference) | 1.37 (1.03–1.81) |
Multivariable model 1† | 1.00 (reference) | 1.06 (0.79–1.40) |
Multivariable model 2†† | 1.00 (reference) | 1.07 (0.80–1.42) |
Total stroke* (N = 39,399) | ||
Total number of cases | 2071 | 105 |
Age and sex-adjusted model | 1.00 (reference) | 1.09 (0.89–1.34) |
Multivariable model 1† | 1.00 (reference) | 1.04 (0.85–1.27) |
Multivariable model 2 †† | 1.00 (reference) | 1.04 (0.85–1.27) |
Total ischemic stroke (N = 39,399) | ||
Total number of cases | 1726 | 88 |
Age and sex-adjusted model | 1.00 (reference) | 1.12 (0.90–1.39) |
Multivariable model 1† | 1.00 (reference) | 1.05 (0.84–1.31) |
Multivariable model 2†† | 1.00 (reference) | 1.05 (0.84–1.32) |
Total hemorrhagic stroke (N = 39,399) | ||
Total number of cases | 317 | 20 |
Age and sex-adjusted model | 1.00 (reference) | 1.21 (0.76–1.93) |
Multivariable model 1† | 1.00 (reference) | 1.16 (0.73–1.86) |
Multivariable model 2 †† | 1.00 (reference) | 1.15 (0.72–1.85) |
CVD mortality (N = 34,355) | ||
Total number of deaths | 1333 | 58 |
Age and sex-adjusted model | 1.00 (reference) | 1.17 (0.89–1.53) |
Multivariable model 1† | 1.00 (reference) | 1.03 (0.78–1.35) |
Multivariable model 2†† | 1.00 (reference) | 1.02 (0.78–1.35) |
Snus use | ||
---|---|---|
Outcome and model (total number) | Nonusers | Users |
Myocardial infarction (N = 20,501) | ||
Total number of cases | 852 | 21 |
Age and sex-adjusted model | 1.00 (reference) | 1.35 (0.87–2.10) |
Multivariable model 1† | 1.00 (reference) | 1.36 (0.87–2.11) |
Heart failure (N = 21,130) | ||
Total number of cases | 1066 | 14 |
Age and sex-adjusted model | 1.00 (reference) | 1.04 (0.61–1.78) |
Multivariable model 1† | 1.00 (reference) | 0.92 (0.54–1.57) |
Atrial fibrillation (N = 19,852) | ||
Total number of cases | 2193 | 43 |
Age and sex-adjusted model | 1.00 (reference) | 1.33 (0.98–1.81) |
Multivariable model 1† | 1.00 (reference) | 1.29 (0.95–1.75) |
Total stroke* (N = 20,620) | ||
Total number of cases | 1160 | 24 |
Age and sex-adjusted model | 1.00 (reference) | 1.57 (1.04–2.37) |
Multivariable model 1† | 1.00 (reference) | 1.53 (1.02–2.32) |
Total ischemic stroke (N = 20,620) | ||
Total number of cases | 957 | 21 |
Age and sex-adjusted model | 1.00 (reference) | 1.69 (1.09–2.63) |
Multivariable model 1† | 1.00 (reference) | 1.65 (1.06–2.57) |
CVD mortality (N = 18,189) | ||
Total number of deaths | 780 | 15 |
Age and sex-adjusted model | 1.00 (reference) | 1.70 (1.01–2.87) |
Multivariable model 1† | 1.00 (reference) | 1.58 (0.94–2.67) |