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Sweden sticks to its guns in pushing snus on an unwilling Europe.

YOU have to hand it to the Swedes--they never let up in their determination to squash the European Union (EU) ban on the sale of snus, the Swedish oral smoke-free tobacco product, in spite of repeated brush-offs from Brussels over the years.

A year ago it looked as if the ban, which was imposed in 1992 and from which Sweden itself was exempt, might be reconsidered in the light of a largely inconclusive report from the EU Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) on cancer and other dangers. Rightly or wrongly, it never happened. Now the Swedes are trying again, focusing on the trade restriction aspects of the ban. Whatever happens this time, Sweden has put the matter back on the EU agenda where it will surely remain so long as cigarette smoking is perceived as a health threat. Stockholm is in a good place to push its agenda this year in particular, given it holds the EU's rotating presidency from July to December.

According to Sweden's trade minister Dr Ewa Bjorling, snus is now the only commodity that is lawfully produced, sold and consumed in one member state and exported all over the world but which cannot be sold in the rest of the EU. "The principle of the free movement of goods, services, people and capital on the EU's internal market is a cornerstone of the Union that we should continue to develop--not restrict," Bjorling wrote in an article in the European Voice magazine in April. Bjorling said that in its role as guardian of the principle of free trade which is supposed to grant every member state equal right of access to the internal market, the European Commission "has failed to prove a clear answer as to why the ban on snus is reasonable." The ban "has not been sufficiently discussed from the point of view of free movement of goods in the EU," she said.

Bjorling was told flatly by the EU's health commissioner Androulla Vassiliou last year however that after the SCENHIR report there was no intention of lifting the ban. Undeterred, the trade minister has taken the snus case to two other more business-minded EU commissioners, Charlie McCreevy, in charge of internal market affairs, and Gunter Verheugen, who is responsible for enterprise and industry. Neither has summarily rejected her plea.

"McCreevy showed great understanding and promised to look at the issue from an internal market perspective," Bjorling wrote on her blog recently. Ton van Lierop, Commission spokesman for enterprise and industry, said that Verheugen received a communication from Bjorling last month and "is considering" the Swedish position. But whatever the merits of the free trade argument, the snus case cannot be separated from health issues and Brussels is hugely vigilant in this area.

In considering the health arguments for and against snus, a lot depends on a factor known as "the Swedish experience." On the face of it there is a paradox in that although Swedish males consume much the same amount of tobacco as those of other European countries, the risk for men of dying from a tobacco-related disease is far less in Sweden than elsewhere. It's also far less than it is for Swedish women, who smoke about as much as European women generally. The explanation is simply that Swedish men consume snus far more than they smoke cigarettes. According to a 2007 survey by Swedish Match, the major snus manufacturer, 19% of Swedish males consumed snus in 2007 while only 12% smoked on a daily basis. Among Swedish women, 16% smoked and 4% used snus. Overall, 14% of adult Swedes smoked compared to rates of between 21% and 44% in other EU countries (the Swedish adult smoking rate was barely half of that in the neighbouring Scandinavian countries of Denmark and Norway.) The Swedish Board of Health and Welfare said surveys showed that "for each person who switched from snus to smoking, approximately four persons switched from smoking to snus." The board concluded that "many have used snus as a method for quitting smoking." However, it may also be relevant that snus are much cheaper than cigarettes.

Snus are not inhaled and therefore do not lead to lung cancer or other respiratory diseases, though they do contain more nicotine than cigarettes and are habit-forming. The SCENIHR report concluded that smokeless tobacco products (STPs) contain carcinogenic tobacco-specific nitrosamines, albeit at differing levels. "A high risk for development of oral cancer has been shown for various STP" said the scientists, but added that "the evidence for oral cancer in users of Swedish moist snuff (snus) is less clear." This is hardly a green light for snus but nor is it an outright health warning.

"The report actually said a lot of positive things about Swedish snus including that there was no evidence that it caused oral cancer," said Henrik Brehmer, senior vice president corporate communications for Swedish Match. He told World Tobacco that the industry had never sought to deny that snus contained nicotine nor that it was addictive, noting that nicotine was also contained in other smoke-less tobacco products like chewing gym, patches and snuff. Brehmer further noted that in a report released last September the Royal College of Physicians (RCP) in the UK recommended that snus should be made available "as a healthier alternative to smoking." The RCP noted that snus "is widely recognised to have contributed to the low prevalence of smoking in Swedish men and consequent low rates of lung cancer."

For health experts, the medical profession and Brussels consumer safety officials, there is a real challenge here. Why should a product that is far less hazardous than many on the market, and which may actually serve to divert consumers from more dangerous things, be the subject of a ban--especially when that ban flouts the EU's free trade rules ? Brehmer said the company was calling for the EU ban to be replaced with a scientific based product regulation to control the content of the product and how it was marketed. "We don't advocate this as a health product but we ask why the commission should restrict European smokers from having access to it," he said. Brehmer said it would be good for public health if European smokers had access to snus as an alternative to cigarette smoking, adding that this approach was favoured by many prominent medical associations.

"There is a lot of movement in this issue now. There is still a ban but we have more and more people, both scientists and politicians, that acknowledge the success Sweden has had," he said. "We have the lowest cigarette consumption in the western world and the lowest rate of tobacco-related diseases and this is now being looked at by many other countries." These are cogent arguments and there is little doubt the major tobacco groups are picking up on developments. The most striking example so far is the agreement announced in February between Swedish Match and Philip Morris International (PMI) on a global joint venture to commercialise STPs. Both companies will own 50% of the new company which will combine Swedish Match's STP development and manufacturing expertise with PMI's extensive sales and distribution infrastructure. Brehmer said the venture had only just begun and was long-term in concept with a remit to develop all markets outside Scandinavia and the US (where STPs are legal but very much a minority taste).
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Author:Osborn, Alan
Publication:International News
Geographic Code:4EUSW
Date:Apr 1, 2009
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