Wednesday, October 14, 2020

Swedish Research Proving HPV Vaccine Prevents Cancer Mirrors that Country’s Life-Saving Snus Experience


Research from the Karolinska Institute in Stockholm and Lund University, published in the New England Journal of Medicine, proves beyond a shadow of a doubt that the human papillomavirus (HPV) vaccine protects women from cervical cancer.  It showed that vaccinated women had only 37% of the risk of contracting that cancer compared with women who weren’t vaccinated (incidence rate ratio [IRR] = 0.37, 95% confidence interval [CI] = 0.21 – 0.57).

Earlier vaccination was even better.  Girls younger than 17 years were 88% less likely to get cervical cancer (IRR = 0.12, CI = 0.00 – 0.34), while protection among women age 17 to 30 was over 50% (IRR = 0.47, CI = 0.27 – 0.75).

These critical findings mirror the Swedish tobacco experience: Snus use helps Swedes avoid the deadly consequences of smoking, acting to some extent as a “vaccine.”  I began chronicling the Swedish experience in 2002, with a series of published studies and, in 2003, Congressional testimony in which I demonstrated how use of snus protected Swedish men from smoking-related lung cancer.

Here is a full list of my published work on the Swedish snus experience, with PubMed links.  Proof of the Swedish snus vaccine is documented in # 10.

Rodu B, Stegmayr B, Nasic S, Asplund K.  Impact of smokeless tobacco use on smoking in northern Sweden.  Journal of Internal Medicine 252: 398-404-2002. 


Rodu B, Stegmayr B, Nasic S, Cole P, Asplund K.  Evolving patterns of tobacco use in northern Sweden.  Journal of Internal Medicine 253: 660-665, 2003.


Rodu B, Stegmayr B, Nasic S, Cole P, Asplund K.  The influence of smoking and smokeless tobacco use on weight among men.  Journal of Internal Medicine 255:102-107, 2004.

Rodu B, Cole P.  The burden of mortality from smoking: comparing Sweden with other countries in the European Union.  European Journal of Epidemiology 19: 129-131, 2004.  


Eliasson M, Asplund K, Nasic S, Rodu B.  Influence of smoking and snus on the prevalence and incidence of type 2 diabetes amongst men: the northern Sweden MONICA study.  Journal of Internal Medicine 256: 101-110, 2004.

 Rodu B, Jansson C. Smokeless tobacco and oral cancer: a review of the risks and determinants.  Critical Reviews in Oral Biology and Medicine 15: 252-263, 2004. 


Stegmayr B, Eliasson M, Rodu B.  The decline of smoking in northern Sweden.  Scandinavian Journal of Public Health 33: 321-324, 2005.


Rodu B, Nasic S, Cole P.  Tobacco use among Swedish schoolchildren.  Tobacco Control 14: 405-408, 2005.


Rodu B.  Snus and the risk of cancer of the mouth, lung, and pancreas.  Lancet 370:1207-1208, 2007.


Rodu B, Cole P.  Lung cancer mortality: comparing Sweden with other countries in the European Union.  Scandinavian Journal of Public Health 37: 481-486, 2009.


Rodu B, Heavner KK, Phillips CV.  Snuff use and stroke. Epidemiology 20(3):468-469, 2009.


Rodu B, Heavner KK.  Errors and omissions in the study of snuff use and hypertension.  Journal of Internal Medicine 265: 207-208, 2009.  


Rodu B, Jansson J-H, Eliasson M.  The low prevalence of smoking in the northern Sweden MONICA Study, 2009.  Scandinavian Journal of Public Health 41: 808-811, 2013.  

I have also explored the Swedish experience in my blog (examples herehere, here, here, and here).

The new Karolinska/Lund publication also indirectly addresses a topic I’ve discussed: why randomized clinical trials don’t work well for harm reduction.  The NEJM authors underscore the key deficiencies: “Randomized, controlled trials cannot readily evaluate vaccine effectiveness against invasive cervical cancer because of the long lead time (the time from HPV infection to the clinical detection of cervical cancer) and the low risk of cervical lesions after vaccination.”

The long lead times for smoking-attributable diseases and the minuscule risks of vastly safer smoke-free products make population-based studies far more informative for analysis of tobacco harm reduction.


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