Smoking is one habit whose adverse effects have been documented often. But compare it to the effects of smokeless tobacco? Not many reports have been published. Published in Circulation, a study from Sweden, shows that after a heart attack, quitting smokeless tobacco is as beneficial as quitting smoking. The common view that smokeless tobacco is a safe alternative to smoking is not supported by these results.

The effect of quitting snus, a Swedish smokeless tobacco powder, was analyzed by researchers. Snus is kept under the upper lip and it does not need to be spit out. The researchers identified 2,474 snus users who were heart attack survivors below the age of 75 in Sweden between the years 2005 and 2009.

Investigators analysed risk of death in myocardial infarction patients in Sweden of which 675 had quit using oral snuff after myordial infarction and 1,799 who continued to use it. After 25 months, the mortality rate reduced by half for those who quit than for those who continues, from 18.7 to 9.7 for every 1,000 persons a year.

Gabriel Aregfalk, lead author, said in an AHA press release, "We didn't expect to see such a strong association among those people who stopped using (smokeless tobacco). After a heart attack, no doubt smoking cessation reduces the risk of death approximately one third and is really a cornerstone of cardiac rehabilitation worldwide. For smokeless tobacco, we did not know."

Researchers said, "After considering factors like age, gender, other tobacco use, occupation and participation in a cardiac rehabilitation program, those who stopped using snus had nearly half the mortality risk, similar to the benefit observed with smoking cessation."

The use of snuff is increasing day-by-day. In the United States, which is the largest market of snuff, every year, around 1.7 billion cans are consumed. The most concentration of population of users of snuff is in Sweden. Daily, twenty per cent of men and three percent of women use snus.