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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jun 28, 2022; 10(3): 130-142
Published online Jun 28, 2022. doi: 10.13105/wjma.v10.i3.130
Published online Jun 28, 2022. doi: 10.13105/wjma.v10.i3.130
Review with meta-analysis relating North American, European and Japanese snus or smokeless tobacco use to major smoking-related diseases
Peter Nicholas Lee, Katharine Jane Coombs, Department of Medical Statistics and Epidemio
Janette Susan Hamling, Department of Medical Statistics and Epidemiology, RoeLee Statistics Ltd, Sutton SM2 5DA, Surrey, United Kingdom
Author contributions: Lee PN planned the study; Literature searches were carried out by Coombs KJ and checked by Lee PN; Statistical analyses were carried out by Hamling JS and checked by Lee PN; Lee PN drafted the text, which was checked by Coombs KJ and Hamling JS.
Conflict-of-interest statement: The authors have carried out consultancy work for many tobacco organizations.
PRISMA 2009 Checklist statement: The authors have read the Prisma 2009 Checklist, and the manuscript was prepared and revised according to the Checklist's requirements.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peter Nicholas Lee, MA, Senior Statistician, Department of Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd, 17 Cedar Road, Sutton SM2 5DA, Surrey, United Kingdom. peterlee@pnlee.co.uk
Received: February 10, 2022
Peer-review started: February 10, 2022
First decision: April 13, 2022
Revised: April 25, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 28, 2022
Processing time: 144 Days and 20.1 Hours
Peer-review started: February 10, 2022
First decision: April 13, 2022
Revised: April 25, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 28, 2022
Processing time: 144 Days and 20.1 Hours
Core Tip
Core Tip: United States studies show that, in never users of other products, current smokeless tobacco use associates with a significant (P < 0.05) increase in risk of the four major smoking-related diseases, with relative risks, compared to never users, of almost 1.6 for lung cancer and chronic obstructive pulmonary disease (COPD) and 1.3 for ischaemic heart disease (IHD)/acute myocardial infarction (AMI) and stroke. This increase is substantially less than for smoking. In Scandinavia, current snus use, does not significantly increase risk of IHD/AMI, stroke or lung cancer, with no data for COPD. Smokers unwilling to quit might consider these smokeless products.