The Wonderful World of Snus
March 16, 2008 12:26 PM   Subscribe

This Is 'Snus'. Snus is a form of smokeless tobacco with a very long history in Sweden. Snus is gaining a bit of popularity in America; both Camel and Marlboro are launching their own brand. It is touted as a more discreet way to use tobacco in the wake of increasing bans on smoking, especially bacause it does not require spitting. A few Swedish compaines, such as Northerner and BuySnus.com ship it worldwide affordably. The Anti-Tobacco crowd is already manning the trenches and claiming that Snus is as dangerous as any other tobacco. However, the science that has been done to date appears to reach a very different conclusion.
posted by spirit72 (71 comments total) 5 users marked this as a favorite
 
The science says that people aren't at a hgher risk for heart attack or stroke as near as I can tell but they still die more? I thought the big issue with snuff was mouth cancer anyhow. The "science" really doesn't seem to compare snuff with tobacco, it compares snuff users to non-smokers.
In conclusion, snuff use does not seem to increase the risk of myocardial infarction or stroke. However, an increased risk of fatal diseases was observed among snuff users, both for myocardial infarction and stroke, suggesting that snuff use could influence the severity of these outcomes. Snuff use was also associated with an increased risk for high blood pressure and hypertension.
posted by jessamyn at 12:35 PM on March 16, 2008


Ugh, I've had enough of snus usage by Swedes - it stinks and exponentially increases the repulsiveness of anyone using it.
posted by monocot at 12:39 PM on March 16, 2008


Ugh, snus was the bane of my existence as a teen. Teenage boys in my town had a habit of spitting it (the loose kind, not the portioned kind) in the ceiling of the school common area...

Like Jessamyn says, the study you linked to is just about heart attack/stroke. I was also sure that it was going to be an indicator of oral cancer, but it doesn't seem to be, at least in one study.

Much as I loathe it, at least it's not affecting anyone but the person using it, unlike for smokers. Provided, of course, that there is no spitting of it into ceilings...
posted by gemmy at 12:42 PM on March 16, 2008


I find that the smell isn't so bad, but quite sweet, so if you're repulsed by it I guess the sweetness just is too much.

Here in Norway snus is popular in the military; smoking has it's drawbacks with regards to smell and light, but snus is quite "stealthy". Some people smoke while in barracks and use snus in the field.
posted by Harald74 at 12:44 PM on March 16, 2008


I thought the big issue with snuff was mouth cancer anyhow.

Historically, yes. However, Swedish-style snus appears to beat that trend. Snus is cured by steam pasteurazation, rather than being heat-cured and then fermented, as American-style snuff is. That pasteurization process apparently results in a sharp reduction in the amount of Tobacco-Specific Nitrosamines(TSNA's), which are the substances that tend to be most horribly carcinogenic.

From what I've read, there still appears to be a hightened risk of pancreactic cancer, yet still less than either smoking or American-style smokeless carry. But the video is correct, the Swedes have the highest per capita consumption of smokeless tobacco, yet the lowest rates of oral cancers in the EU. That is particularly striking as smokeless tobacco is actually banned in the EU---one would expect that Sweden's oral cancer problem would be bigger.
posted by spirit72 at 12:48 PM on March 16, 2008


we already have skoal bandits, thank you

love is sweet, but oh, how bitter
when you kiss the lips
of a tobacco spitter
posted by pyramid termite at 12:51 PM on March 16, 2008 [2 favorites]


This featured study of the scientific evidence on snus to date does not "reach a very different conclusion" from the many decades of previous studies that have reported the health hazards of smokeless tobacco. As Jessamyn points out, this study addresses only strokes, high blood pressure, and heart attacks...problems which are probably and unfortunately not even the most serious potential consequences of tobacco use.
posted by applemeat at 12:54 PM on March 16, 2008


"Sweden has Europe's lowest rate of tobacco related diseases."

On the downside, Sweden does have Europe's highest rate of snus-related diseases.
posted by sour cream at 12:54 PM on March 16, 2008


love is sweet, but oh, how bitter
when you kiss the lips
of a tobacco spitter


My experience has been a bit different. My wife says she can't really tell anything when she kisses me while I'm using it, aside from a bit of saltiness. But she despised kissing me while I was a smoker.

Then again, I use the "white" portions. Loose users may be a bit different.
posted by spirit72 at 12:56 PM on March 16, 2008


Oh hells yeah, never kiss someone using loose snus. Gross. (and that's coming from someone who's used it)
posted by dabitch at 1:01 PM on March 16, 2008


Kissing a snus user is tons better than kissing a smoker. I wouldn't describe it as more salty though. I'm pretty sure snusers salivate more and that might lead to slobbering but I mostly consider that a good thing.
posted by uandt at 1:04 PM on March 16, 2008


I always thought the point of chewing tobacco was to make smoking seem less disgusting by comparison.
posted by adamrice at 1:22 PM on March 16, 2008


No snus is good snus.
posted by ooga_booga at 1:33 PM on March 16, 2008 [1 favorite]


I know a fellow who takes Adderall (by prescription), chews tobacco, smokes, drinks coffee by the litre, and has been known to have a drink or five of an evening.

I wonder what will kill him first?

Maybe I should tell him about Snus, he could be taking drugs every moment of the day.
posted by sonic meat machine at 1:33 PM on March 16, 2008


Death by Snu Snu
posted by kuujjuarapik at 1:33 PM on March 16, 2008


"I'm pretty sure snusers salivate more and that might lead to slobbering but I mostly consider that a good thing."

Uh, no, IMHO it's not. Being a teen in the Great Plains, I kissed both chewers and smokers, and I have to say, the smokers' kisses were more palatable than the ones bestowed by loose-tobacco guys. I would take either one over the just plain bad breathed.
posted by Fennel B. at 1:43 PM on March 16, 2008


Oh for goodness sakes-- not "being a teen," but rather "having been a teen."
posted by Fennel B. at 1:44 PM on March 16, 2008


I quit smoking by using Cophenhagen snuff. I quit that stuff when my dentist pointed out that I had developed lesions on my gums that would lead to cancer. Freud got lip and gum cancer from cigars (and so too Castro), so different forms of smoking render different places to attack. I can not say anything about the Swede product or its safety but I am suspicious because bleaching out the harmful product also leeches out the quality that users want. Note: my wife always noted that my snuff when opened smelled a bit like cat's piss. I discovered that the makers put in ammonia to "enhance" the nicotine and also what seems like minute slivers of--glass?--to get the stuff into the skin. Perhaps it was not real glass slivers but if you move the stuff around you will spot glistening pieces scattered throught the product.

I no longer use any form of nicotine and have found that sucking my thumb instead is most satisfying.
posted by Postroad at 2:11 PM on March 16, 2008 [1 favorite]


previous discussion of smokeless tobacco, including snus.
posted by unmake at 2:12 PM on March 16, 2008


I knew a couple of guys (when I was in the Finnish army) who could literally stick their fingers through the corroded flesh of their faces to way past their nose. Plus they permanently look like chipmunks now.

I'll stick with my regular cancer sticks, thanks.
posted by slimepuppy at 2:15 PM on March 16, 2008 [1 favorite]


I had Taco Bell for lunch and now I'm suffering from loose snus.
posted by sourwookie at 2:25 PM on March 16, 2008 [3 favorites]


I don't want to be exposed to snus.
posted by ooga_booga at 2:28 PM on March 16, 2008 [2 favorites]


Hm, I was wondering what that stuff was. It's packaged to look like tobacco candy. And whoever decided on the print should be fired because you have to look twice to make sure it doesn't say "anus".
posted by puke & cry at 2:39 PM on March 16, 2008


And whoever decided on the print should be fired because you have to look twice to make sure it doesn't say "anus".

wait til you taste it
posted by pyramid termite at 2:59 PM on March 16, 2008 [1 favorite]


Tobacco Blue {menthol}
posted by humannaire at 3:20 PM on March 16, 2008


I can not say anything about the Swede product or its safety but I am suspicious because bleaching out the harmful product also leeches out the quality that users want. Note: my wife always noted that my snuff when opened smelled a bit like cat's piss. I discovered that the makers put in ammonia to "enhance" the nicotine and also what seems like minute slivers of--glass?--to get the stuff into the skin.

I was concerned at first, too, mostly because of additives and because American tobacco companies in particular are infamous for having screwed with the whole nicotine delivery/metabolism curve using stuff like ammonia. I think the (fiber)glass thing is an urban legend, though. But don't quote me on that, I wouldn't put it past them.

What I found out though is that, unlike in the US, snus is actually regulated as a food product by Sweden's equivalent of the FDA. What that means is that whatever goes into it must A)be an approved food additive and B)All ingredients must be listed on the container. I was pretty surprised, being an American, to see a tobacco product with ingedients listed on the can, and even more surprised at how short the list was--tobacco, water, salt, and 2 or 3 additives depending on the brand. PM and RJR would be up in arms if they had to follow suit, I suspect.

It's going to be interesting

Good on you for being able to kick nicotine, btw.

I'm pretty sure snusers salivate more and that might lead to slobbering but I mostly consider that a good thing.

Salivation was what kept me from ever getting into Cope and stuff, because I abhor spitting like others abhor tobacco smoke. Having said that, I haven't noticed excessive salivation myself. I've also felt no need to spit, although I hear that some do.
posted by spirit72 at 3:48 PM on March 16, 2008


I was a longtime smoker but was able to quite after trying snus while since visiting Sweden this winter. I'm still hooked on tobacco - Copenhagen Pouches if you must know - but my lungs are much better off. No more coughing, no more endless winter colds. It's like a nicotine patch for your gums. Yum! Since switching over it has occurred to me that this is a much more natural way to get my nicotine fix -- chewing on a plant instead of burning/inhaling it? A no-brainer. Now if I could only get my hands on some fresh Khat...
posted by chiefbluefeather at 3:50 PM on March 16, 2008


Now if I could only get my hands on some fresh Khat...

I don't know where you live, chiefbluefeather, but there are a handful of African greengrocers and Yemeni newsagents who sell it where I live. £5 a bunch, with fresh supplies arriving via Heathrow 3 or 4 times a week.

Afficionados tell me that the Ethiopian stuff is the good stuff -- much stronger than the stuff from the Yemen.
posted by PeterMcDermott at 4:12 PM on March 16, 2008


chiefbluefeather: Yeah, a friend of mine had been fretting over the plan to quit an 18 year two-pack-a-day smoking habit, but with the snus it turned out to be a non-event. Definitely a better alternative if you had to choose.
posted by StickyCarpet at 4:14 PM on March 16, 2008


Yeah, a friend of mine had been fretting over the plan to quit an 18 year two-pack-a-day smoking habit, but with the snus it turned out to be a non-event. Definitely a better alternative if you had to choose.

Precisely my experience too. 15 years, one pack a day. Several months later, and I've never looked back.
posted by spirit72 at 4:18 PM on March 16, 2008


Snuff LJ: My dad chewed dip tobacco, Skoal mostly, when I was a kid. I really tried to emulate him, and let slip once that I wanted to start chewing. I was six. So dad said OK, and he bought a can of Kodiak -- which, I learned from friends in high school who dipped, had a reputation for being much harsher than Skoal -- and we went for a drive in the bigass green Ford LTD. He took a pinch of it and slid the can across to me. I swept out a fistfull of the stuff, because -- I thought -- since I had a smaller hand, the amount would be proportional to what he was chewing. Needless to say, my technique was not good and I wound up not getting the dip securely between my jawbone and cheek. It rapidly found its way into the entirety of my mouth, and tasted "like burning". Fortunately, the window was rolled down and I rapidly spit it out the best I could as dad laughed. But the rest of the day, the flavor stayed with me. Hell, I can still taste it now.

I haven't had a dip since that day.

(I have a more disgusting story from when I was younger, but this one is more on topic.)

And, to clarify re: the "glass slivers" issue, most plug tobacco contains a very little bit of grit or sand. Whether it affects the uptake of nicotine is, I think, still a matter for debate, but it does abrade/erode gums.
posted by cog_nate at 4:29 PM on March 16, 2008


I was trying to find some other snus video when I stumbled onto this: Is "YouTube" telling or selling you something? Tobacco content on the YouTube video-sharing website
posted by dabitch at 4:37 PM on March 16, 2008 [1 favorite]


This post brought to you by the Kool Corporation. "Hey kids, we're Kool!"
posted by Blazecock Pileon at 4:42 PM on March 16, 2008


More likely Altria Group; they're launching snus worldwide.

Much as I loathe it, at least it's not affecting anyone but the person using it

I pay taxes to subsidize healthcare costs in my country, so it affects me greatly when others use smokeless tobacco.

spirit72: Swedish-style snus appears to beat that [cancer] trend. Snus is cured by steam pasteurazation, rather than being heat-cured and then fermented, as American-style snuff is. That pasteurization process apparently results in a sharp reduction in the amount of Tobacco-Specific Nitrosamines(TSNA's), which are the substances that tend to be most horribly carcinogenic.

Wow. Right out of the promotional literature of the Tobacco Institute. How much did you get paid to educate the MetaFilter community about this, spirit72?

Makes me want to break into song: Snu Blue, baby I love you..
posted by ikkyu2 at 6:21 PM on March 16, 2008 [1 favorite]


ikkyu2, smokers die early and don't burden health care as much as long-lived nonsmokers do. The beautiful thing about snus is that they don't take other people with them. From a harm reduction perspective, ALL smokers should use this stuff.

My taxes pay for health care too, and I don't give two shits of a flying fuck if people use this. No second-hand smoke, no problem. Snus away.
posted by ethnomethodologist at 6:39 PM on March 16, 2008


What about Ariva, the "dissolvable tobacco"? Have you guys heard of that? It's an interesting time for smokeless tobacco. There are some other links about it on Buzzfeed.
posted by PM at 6:53 PM on March 16, 2008


I pay taxes to subsidize healthcare costs in my country, so it affects me greatly when others use smokeless tobacco.

I do too, so it affects me when others eat too much fatty food. Really, this argument is old hat.

Wow. Right out of the promotional literature of the Tobacco Institute. How much did you get paid to educate the MetaFilter community about this, spirit72?

I hate to burst your bubble, but I'm doing it for free, and am associated with no one but myself. I'm just a former smoker who turned snuser, and thought one or more segments of MeFi might take interest. You're entitled to your take.

I've not claimed that it's safe, but it does appear to be as safe as tobacco gets. Certainly safer than cigs.
posted by spirit72 at 6:57 PM on March 16, 2008 [1 favorite]


Heh. The neighborhood of Ballard, in Seattle, was once a very, very Scandinavian place, populated by a lot of fishermen and their families, and until very recently you could hear old folks with Norwegian accents chatting away almost any time you walked down Market in Ballard.

Now it's getting all trendy and yuppified and it's Scandinavian character is fading away. But people who live in Ballard should never forget that it used to be called Snoose Junction. Because of the snus, you know.

My grandpa, half Swedish, grew up in Ballard and told us what "Snoose Junction" meant. :)
posted by litlnemo at 6:57 PM on March 16, 2008


Argh. "...its Scandinavian character", not "it's". Darn these fingers.
posted by litlnemo at 6:58 PM on March 16, 2008


Well, how about that? I've always thought 'snus' was a local Northern BC idiom for that stuff.

Now you're going to tell me that 'ginch' or 'gonch' for y-front underwear is in general use outside of the Narth, too.
posted by stavrosthewonderchicken at 7:03 PM on March 16, 2008


I pay taxes to subsidize healthcare costs in my country, so it affects me greatly when others use smokeless tobacco.

Does it affect you as much or as directly as walking into a room full of smokers would? Probably not. All I'm saying is that if you are going to have a nicotine habit, then snus is better from my perspective than smoking - given that I use neither.

If you are going to start arguing health care costs, then there are other things to worry about first. Do you glance disapprovingly at heavy people eating too, since obesity is the number one drain on the health care system?
posted by gemmy at 7:10 PM on March 16, 2008


I'm disappointed that this thread reverted to the typical "tobacco is unhealthy and a tax burden" line. We've heard it before. It's not novel. Snus, however, is.

Of course universal nicotine abstinence is preferable. But just as with abstinence-only sexual education, it's a mistake to halt the discussion there. It's just not going to work. We have addicts and we have people who don't give a shit.

It's valuable to talk about reducing the risks associated with tobacco use because often that's the most we can hope for.

Thanks for the thorough, interesting, relevant post, spirit72.
posted by PM at 7:28 PM on March 16, 2008 [1 favorite]


I know a fellow who takes Adderall (by prescription), chews tobacco, smokes, drinks coffee by the litre, and has been known to have a drink or five of an evening.


Jeez. He probably needs the booze at night to come down!
posted by spirit72 at 7:31 PM on March 16, 2008


Gave snus a try on the somewhat smirking suggestion of a Swedish friend. Kept it in my mouth too long. Head was spinning for ages. But then, I'm not a smoker.
posted by Durn Bronzefist at 7:39 PM on March 16, 2008


I'm disappointed that this thread reverted to the typical "tobacco is unhealthy and a tax burden" line.

Yeah, I knew going in that it would be controversial. Tobacco is a pretty polarizing issue in both America and Europe, with a lot of politics and agenda-driven stuff going on at both ends.

It's not novel. Snus, however, is.

That's what's so interesting about it to me, because it's not a new thing, it's actually centuries old.

It's valuable to talk about reducing the risks associated with tobacco use because often that's the most we can hope for.

Exactly. I can't imagine ever advocating a non-tobacco user to start using, but for those of us who do and either cannot quit or don't wish to, I'd recommend snus pretty strongly. In a perfect world, there would be no addiction, but we don't live there.

Thanks for the thorough, interesting, relevant post

Metafilter: Thorough, Interesting, Relevant.
posted by spirit72 at 7:42 PM on March 16, 2008


Hey, if using it lowers your overall cancer risk, means you can get your fix in public without producing second-hand smoke or leaving vomit-inducing cups of brown spit everywhere, and might provide a gateway to quitting, then bring that shit on.
posted by middleclasstool at 8:07 PM on March 16, 2008 [1 favorite]


So is this stuff finally available in stores now? I didn't register for those Camel and Marlboro pages.

Either way, I will ask again:
Can I get Swedish snus over the counter in Los Angeles?
posted by redteam at 10:23 PM on March 16, 2008


puke&cry: And whoever decided on the print should be fired because you have to look twice to make sure it doesn't say "anus".

Right data, wrong conclusion, puke. These tobacco companies know they're appealing to the death wish, a term used to cover a broad swath of psychological phenomena, including coprophagia. They even add skatole to their "tobacco," which is really a shredded blend of chemical-soaked plant shavings that has as much in common with real tobacco as a Big Mac has in common with a real hamburger.

Tobacco use as it is advertised and marketed today is the manufacture and sale of self-hatred, self-loathing, self-harm. The market has never been better.
posted by ikkyu2 at 10:59 PM on March 16, 2008 [2 favorites]


Full disclosure, by the way: I own shares of Altria Corporation.
posted by ikkyu2 at 11:00 PM on March 16, 2008


Snus and Snuff are two totally different types of tobacco. Snus is quite disgusting. Snuff is a fine powdered tobacco and has a much more interesting history as well as certain strict etiquette rules on how to properly use it.

This is where I buy my snuff, from Wilsons & Sharrow, Ltd. in the UK. I would never, ever buy American snuff, as they put too many chemicals in it. The snuff from the UK is much more pure, basically snorting flower tops. Wilsons & Sharrow have been making snuff for nearly three centuries, and from what I have read about snuff, if you are going to consume tobacco, this is probably the safest form if you are going to do it.

I used to smoke two packs of smokes a day (I quit six years ago) and have been imbibing in snuff for two years now, one small snort maybe three times a week, if even that much.

On one forum I have visited, there are those who snuff up to 20 GRAMS a say, and some even use straws. But like with anything i.e. alcohol, gambling, eating fast food, etc, it should be taken in moderation.
posted by MizMadame at 1:21 AM on March 17, 2008 [1 favorite]


*a say=a day
posted by MizMadame at 1:26 AM on March 17, 2008


So is this stuff finally available in stores now? I didn't register for those Camel and Marlboro pages.

I believe it's still being test marketed in several cities, neither has been launched nationally yet. I started with the Camel brand, solely because I stumbled across some free coupons on packs of Camels. It isn't bad, but is obviously stong with artificial sweetener. Aspartame and I don't get along well.

Can I get Swedish snus over the counter in Los Angeles?

Your best bet would be a proper tobacconist--one that sells cigars, pipes, etc. But most of them probably do not, mostly because it is still catching on, it needs to be refrigerated until use(and I even pop it back in the fridge at the end of the day), and the cans are dated, so it needs to be sold within a certain timeframe.

I've had a good experience with both of the Swedish companies I listed, though. It's priced pretty well, there is no tax at either end(and no duty if the total order is less than $200, it appears), and it usually arrives in 5-6 business days.
posted by spirit72 at 5:18 AM on March 17, 2008


Just as a closing note, this study compares levels of nitrosamines in a wide range of tobacco products and evaluates them in the context of the risks of oral cancer.
posted by spirit72 at 7:17 AM on March 17, 2008


Durn Bronzefist: "But then, I'm not a smoker.
Don't you mean you're not a snooker?
posted by davemee at 7:35 AM on March 17, 2008


I am curious spirit72, is there some benefit to snus beyond the nicotine itself? How is this different from nicotine gum or lozenges?

(I too am dubious about the health "benefits" of this stuff. I mean the study you linked sure looked all official and medical and stuff, but still I'm not so sure.)
posted by Slarty Bartfast at 8:25 AM on March 17, 2008


is there some benefit to snus beyond the nicotine itself?

I'm not sure that there is, really. For those who choose to use tobacco rather than NRT, it appears to be a less-harmful way to do so, and pretty much eliminates the effect on others as far as secondhand smoke and spitting are concerned.

The one thing that can certainly be termed a 'benefit' for those who use it as smoking cessation is that they are no longer getting all the crap that is produced by combustion and all of the weird-ass chemicals that are used in cigarettes and even some other smokeless types. I've definitely noticed the difference there.

How is this different from nicotine gum or lozenges

It ends up costing less financially, at least in my experience. And speaking solely for myself, I ultimately didn't care for either form of NRT. Gum isn't my thing, the lozenges use artificial sweetener which makes me feel weird, and at the end of the day, it just isn't the same. I enjoy the stuff, like people have for hundreds of years or more, and I think the addiction to nicotine is only part of that.
posted by spirit72 at 9:18 AM on March 17, 2008


I was part of the test-market for Camel's snus here in the US. I'd previously signed up for free cigarettes at a club (despite not smoking) because, hey, most of my friends smoke, and I could trade my roommate cigarettes for doing my dishes.

So, they sent me the snus and I figured I'd try it. It is a stimulant, yeah, and it does feel pretty good, but it left a dry, numb spot in my cheek, and the couple of times that it got wet with spit were absolutely vile. I ended up with, like, four or five of these tins, unable to even give it away. I just dumped the snus and made pinhole cameras out of the boxes.
posted by klangklangston at 10:28 AM on March 17, 2008


Snuff is a fine powdered tobacco and has a much more interesting history as well as certain strict etiquette rules on how to properly use it.

So if I whap it out on a mirror, chop it up with a credit card and hoover the stuff up a rolled £20 note, the other snuff-heads are likely to look down on me?

in 1820 the double barrelled snuff pistol was invented; it was capable of packing a day's worth of snuff into the nose using an explosive charge.

That's me, that is. If I took snuff, I'd want one of those pistols.
posted by PeterMcDermott at 11:41 AM on March 17, 2008



The data on Snus and health are actually compelling [pdf]-- what people are forgetting here is prevalence. Lung cancer-- very common, very deadly. Cardiovascular disease-- likewise. Oral cancer-- which this study says isn't even increased by snus-- is relatively rare.

So, if you have a product like snus that reduces all-cause mortality (ie, by eliminating lung cancer risk and reducing cardiovascular disease risk even if it increases the risk of the relatively rare oral cancer), you're winning.
posted by Maias at 1:37 PM on March 17, 2008


LA? Yeah.

First time I tried snus was on a transatlantic flight with a Swede who offered a couple of portions to stop me getting twitchy.

As Dale Pendell says, tobacco's a drug that grips you tight. NRT is there, of course, but those $60 boxes of Commit are sending a nice big margin to Big Pharma, and they're really not that pleasant for many people. Nor is Nicorette jaw. And if those things are standing between the morning rush for a lighter and somewhere to hock out that chest full of crap, then it's an alternative that's less likely to have you hooked up to a chemotherapy line.
posted by holgate at 10:04 PM on March 17, 2008


When comparing health costs between tobacco users and the elderly, shouldn't the comparison be based on a ratio of average lifetime health costs per capita vs. average lifetime tax collected per capita for the given demographic? There's probably some peak economic good produced by individuals who work at full capacity for 65 years and die promptly after retirement. Also, if that kind of analysis is important to you, it's probably best to factor in social security payouts to the elderly, and reduced economic output from smokers due to increased sick days.

However, as has been pointed out, snus is currently probably targetted mostly at smokers who want healthier lungs, and/or people who want to consume tobacco more furtively. Although I have heard that a lot of people who didn't formerly use tobacco products started using chew when some major league ball players popularized it. Still less objectionable than the faux status symbol that cigar smoking has become as far as I'm concerned.

Ikkyu2, are there ever circumstances in which you'd consider nicotine patches or SNUS for therapeutic use? What's the status on therapeutic use for Alzheimer's and Parkinson's disease sufferers?
posted by BrotherCaine at 11:19 PM on March 17, 2008


I give the nicotine patch to hospitalized smoker patients to prevent withdrawals, after they've expressed that they don't plan to use this hospital stay to quit smoking. I view that as compassionate use, not therapeutic. I'm not aware of anyone using nicotine for any therapeutic purpose, including treatment of AD or PD.

I think the idea of administering nicotine to someone in order to have them quit using nicotine is a stupid idea. Quitting self-administration of nicotine is a behavioral modification. It is accomplished by not self-administering nicotine. Quitting self-administration of nicotine is not accomplished by self-administering nicotine. I am aware that I am in the minority with this opinion; many and vocal are the proponents, who state loudly and vehemently that self-adminstration of nicotine leads efficaciously to cessation of self-administration of nicotine, without ever being able to comprehend the fallacy.
posted by ikkyu2 at 1:55 AM on March 18, 2008 [2 favorites]


I think the idea of administering nicotine to someone in order to have them quit using nicotine is a stupid idea.

You're the doctor, of course, but the patch worked like a goddamn charm for me.
posted by middleclasstool at 6:19 AM on March 18, 2008


I am aware that I am in the minority with this opinion

Actually, I agree totally with you here. Ultimately, if one is going to get off nicotine and stay off, they have to take the pain at some point. From what I've read, only about 5% or so actually manage to do that for a full year, even with NRT.

NRT can be useful in helping break the psychological habit first, but eventually the physical addiction has to be confronted as well. And, even NRT has a tendency to simply replace the psychological habit, speaking just from my experience with it.

On the other hand though, even if they remain addicted to nicotine to whatever extent, they have at least rid themselves of all the other really lethal garbage they get from smoked tobacco, which in my opinion is a victory by any standard.
posted by spirit72 at 7:15 AM on March 18, 2008


NRT can be useful in helping break the psychological habit first, but eventually the physical addiction has to be confronted as well.

Well, that's the point of NRT, as I understand it. There's more than just the physical addiction to overcome, and dealing with the psychological addiction and the physical addiction at the same time is IME much harder than breaking the habit before you face the withdrawal. Not to mention that slowly stepping down the dosage was much less uncomfortable and stressful for me than going cold turkey. Baby-stepping my way through a couple of small wins on the way to success added a level of encouragement and a feeling of progress as well.

I agree with you and ikkyu2 to a degree -- I don't like the lozenges or gum and studiously avoided them, because I think it's kind of stupid to put a junkie in control of his dosage when he's trying to quit. I know people who "quit" but have been chewing gum steadily for years.

The good thing about the patch is that that's taken care of for you. You slap one on and you're good for the day. You step down dosage when the calendar tells you it's time. Then one day you just go without, and it's not as hard as you thought it was.
posted by middleclasstool at 7:25 AM on March 18, 2008


Attempting to distinguish psychology from physiology or psychologic addiction from physical or physiologic addiction is a ridiculous, 18th century endeavor. That people are still using this kind of language to try to discuss real phenomena in the 21st century dismays me greatly.

There is one brain per human. It functions in a certain way.
posted by ikkyu2 at 11:09 PM on March 18, 2008


There is one brain per human. It functions in a certain way.

My understanding is that that brain has many regions that perform different tasks, that there's a substantive difference between overcoming the physical craving for a chemical one's addicted to and breaking a habitual activity so ingrained that it's pretty much unconscious. Saying that there's no difference at all between the chemical addiction and the ingrained habitual action (if you prefer that term to "psychological addiction") is to me like saying there's no difference at all between contemplating quantum mechanics and processing signals from nerves in a burned hand. Or, closer to the point, no difference between overcoming alcoholism and quitting compulsive nail-chewing. But again, you do know more about this than I do.
posted by middleclasstool at 6:46 AM on March 19, 2008


Well, it's a definitional question, middleclasstool. You have chosen to distinguish addiction from habit on the grounds that one is chemical and the other is ingrained. Do you really believe that no chemicals are involved in habitual behaviors that are not addictive? I would argue otherwise: specifically, that neurotransmitters are involved in both addiction and other habitual behaviors, as well as other behaviors.

In fact I would argue otherwise to any thesis that tried to somehow distinguish free will from pathological behaviors. Such theses are morally dangerous.
posted by ikkyu2 at 12:53 AM on March 20, 2008


Moral danger? That's where I'm a viking!

My personal experience with Nicotine Replacement Therapy, using Nicorette inhalers, which not only delivered some sweet drug but also gave me a simulacrum of the habitual action of smoking, hand to mouth, particular when in a social situation, having a few drinks with friends or whatever, was entirely successful. But that's merely anecdotal, and so not worth much, I know. Made it a breeze to quit, though, for me at least.
posted by stavrosthewonderchicken at 1:36 AM on March 20, 2008


Do you really believe that no chemicals are involved in habitual behaviors that are not addictive?

No, certainly not, and I'm certainly not goofy enough to be arguing for some sort of Cartesian dualist nonsense. Absolutely, neurotransmitters are involved. The reason I distinguish between the chemical addiction and the habit is probably for a couple of (arguably unscientific) reasons:

For one, I experience them as separate phenomena with different qualia. The former was a physical hunger that caused me pain to deny it, the latter was just a behavior that I never gave thought to until I tried stopping it, sort of an "oh, I don't need to automatically crack the window when I get in the car anymore" thing I had to keep reminding myself of.

For another, I regard the latter as a learned behavior that is corrected by repeatedly un-learning it, while the former is something that you really can't un-learn. I still get nicotine cravings to this day, over 25,000 unsmoked cigarettes later. When I walk through a cloud of second hand smoke, there's a brief clash in my brain between lust and revulsion. It's gotten better, but the addiction never goes away. The habit, absolutely. It's been years since I reached into my pocket after a meal.

Also -- and again, I'm in danger of getting out of my depth here, as my scientific understanding of the mind is limited to courses in analytic philosophy -- I'm acknowledging that there is more than one neurological process going on here.

Now again, these (and other minor related points I won't bore you with) are surely unscientific in that they appear to distinguish between the psychological "mind" and physical processes in the brain. I know that's not true, in the same way I can talk about the "sunset" without realizing there's no actual setting of the sun, it's just the earth spinning. But as with the sunset, my experience matches the term for it more closely than it does the scientific reality -- the sun does not set, but it sure looks like it does. Likewise, it may be medically incorrect for me to separate the the experience and methodology of my addiction recovery into "physical" and "psychological" spheres, but it very much felt like there were those two separate spheres, and tackling them independently using different techniques is for many of us an extremely useful way of overcoming the addiction.
posted by middleclasstool at 6:55 AM on March 20, 2008 [1 favorite]


Grr s/b "talk about the sunset while realizing..." I previewed that like fourteen goddamn times and didn't catch it until after hitting the post button.
posted by middleclasstool at 7:27 AM on March 20, 2008


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