Showing posts with label Swedish miracle. Show all posts
Showing posts with label Swedish miracle. Show all posts

Thursday, March 14, 2024

The Japanese Tobacco Miracle the World is Overlooking


Smokers in Japan consumed 92.4 billion cigarettes in 2023 -- less than half as many as they did in 2014.  Since vapor products are illegal there, the impressive decline is likely due to the introduction of heat-not-burn tobacco products, which didn’t exist in 2014, but accounted for 38% of the Japanese tobacco market in 2023.  Notably, this progress occurred in an overall declining tobacco market. 

UK tobacco harm reduction advocate Clive Bates previously opined: “The only mystery is why the skies over Tokyo are not dark with chartered planes bringing officials from WHO, FDA, Truth Initiative, the Campaign for Tobacco-Free Kids, the European Commission and others on an emergency mission to learn about this most extraordinary shift.  What is the secret they would find? ‘Do nothing, stay out of the way....’  There was very little involvement from tobacco control – the demise of cigarettes in Japan has been driven by the market and consumer preference.”

Those officials should also be landing in Stockholm, the capital of the only country that has had comparatively minuscule smoking rates among men and is close to being officially smoke-free.

Instead, the WHO and its nicotine/tobacco prohibitionist allies persist in meddling with the natural demise of smoking that will result from the proliferation of vastly safer and satisfying cigarette substitutes.

One positive development to note: The U.S. FDA authorized the IQOS heat-not-burn system as a reduced exposure alternative to cigarettes on July 7, 2020, greenlighting these claims:

“AVAILABLE EVIDENCE TO DATE:

  • The IQOS system heats tobacco but does not burn it.
  • This significantly reduces the production of harmful and potentially harmful chemicals.
  • Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals.

The FDA advised that its approval “is expected to benefit the health of the population as a whole.

Unfortunately, a patent dispute in 2021 blocked U.S. IQOS sales, but there is still hope for American smokers for re-introduction of the brand in 2024.

Back in 1995, I wrote (here), “It is not surprising to find that Swedish lung cancer mortality rates have been the lowest in Europe over the past 40 years.  These large scale vital statistics from Sweden…strongly support the suggestion that if tobacco is to be used, it should be in the form of [smokeless tobacco, ST] and not cigarettes. The population that uses ST in lieu of smoking is, in effect, protected from lung cancer and other major smoking-related diseases and suffers little or no increased risk of oral cancer.”  Seven years later I spent six months conducting research in Sweden and publishing a series of real-world tobacco harm reduction articles (here). 

The Japanese and Swedish miracles weren’t the result of government programs or anti-tobacco campaigns.  They arose organically, as tobacco users in those countries made rational choices to use smoke-free substitutes instead of cigarettes.

 

 

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. https://www.ncbi.nlm.nih.gov/pubmed/12528757 

 

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. https://www.ncbi.nlm.nih.gov/pubmed/12755962

 

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. https://www.ncbi.nlm.nih.gov/pubmed/14687245

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. https://www.ncbi.nlm.nih.gov/pubmed/15074568  

 

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. https://www.ncbi.nlm.nih.gov/pubmed/15257722

 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.  https://pubmed.ncbi.nlm.nih.gov/15470264/ 

 

Stegmayr B, Eliasson M, Rodu B.  The decline of smoking in northern Sweden.  Scandinavian Journal of Public Health 33: 321-324, 2005. https://www.ncbi.nlm.nih.gov/pubmed/16087495

 

Rodu B, Nasic S, Cole P.  Tobacco use among Swedish schoolchildren.  Tobacco Control 14: 405-408, 2005. https://www.ncbi.nlm.nih.gov/pubmed/16319364

 

Rodu B.  Snus and the risk of cancer of the mouth, lung, and pancreas.  Lancet 370:1207-1208, 2007. https://www.ncbi.nlm.nih.gov/pubmed/17920914

 

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. https://www.ncbi.nlm.nih.gov/pubmed/19535408

 

Rodu B, Heavner KK, Phillips CV.  Snuff use and stroke. Epidemiology 20(3):468-469, 2009. https://www.ncbi.nlm.nih.gov/pubmed/19363361

 

Rodu B, Heavner KK.  Errors and omissions in the study of snuff use and hypertension.  Journal of Internal Medicine 265: 207-208, 2009. https://www.ncbi.nlm.nih.gov/pubmed/19019185  

 

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. https://www.ncbi.nlm.nih.gov/pubmed/24052339  

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.