STOCKHOLM - Few things get Swedish snus users more riled up than the European Union's ban on oral snuff, and Trade Minister Ewa Bjorling is no exception.
As Stockholm prepares to host the rotating EU presidency in July, Bjorling is spearheading a campaign to lift the bloc's prohibition on snus, a moist tobacco product as steeped in Swedish tradition as pickled herring or crispbread.
"I get upset when I think about how unfair this is," the former dental surgeon told The Associated Press in a recent interview, noting that the snus pouches she slips under her upper lip helped her quit smoking about three years ago.
For years Sweden fought a lonely battle against the directive that bars sales of snus -- pronounced snoos -- in all EU countries except Sweden. But the government's renewed snuff crusade comes amid growing debate internationally about smokeless tobacco's potential as a less harmful alternative for smokers who fail to shake the nicotine habit.
Pragmatists say snus should be allowed to compete with nicotine replacement products in the effort to snub out the much bigger threat of cigarettes. Anti-snus campaigners counter that snus is a highly addictive product whose health effects are unclear. Embracing it, they say, would only serve tobacco companies looking for new ways to deliver nicotine as smoking rates decline in the developed world.
"It's not a harmless product," said Dr. Gunilla Bolinder, chief physician at Karolinska Hospital in Stockholm and a veteran snus researcher.
Documented ill-effects range from stained teeth to increased risk of diabetes and fatal heart attacks. One study found a slightly higher risk of pancreatic cancer. Still, most research has failed to identify a clear link between snus and cancer, a fact that hasn't escaped Sweden's one million snus users.
"They still haven't found proof saying snus is really harmful," said Linda Persson, a 34-year-old bartender in Stockholm, as she squeezed a licorice-flavoured snus pouch under her lip. "As a substitute to cigarettes, which are really dangerous, it is really good."
According to a study published in 2007 in the medical journal, Lancet, smokers are 10 times more likely to get lung cancer than snus users. Some public health officials argue that legalizing snus would lower global cancer rates.
Snus is sold in kiosks or supermarkets and vending machines in bars all over the country. It comes in cans in its original loose form or packed in thin paper sachets. It's legal in the U.S., where big tobacco companies like Altria Group Inc. and Reynolds American Inc. are marketing smokeless tobacco products aggressively, mindful of falling demand for cigarettes.
The EU, however, banned oral snuff in 1992 in a directive primarily aimed at U.S.-made snuff products that researchers found caused mouth cancer. Sweden got an exemption when it joined the union three years later, but the ban remained elsewhere, even though snus makers insisted they use a different manufacturing process that reduces the level of carcinogens.
Bjorling has sent letters to the EU commission asking it to consider legalizing snus. Health Commissioner Androulla Vassiliou replied that no changes were planned, citing a 2004 decision by the European Court of Justice to uphold the ban, and a report by an EU committee on new health threats, which said smokeless tobacco products are addictive and can cause cancer.
Undeterred, Bjorling raised the issue again in Brussels last month in meetings with EU commissioners Charlie McCreevy, who oversees the 27-nation bloc's internal market, and Guenter Verheugen, responsible for enterprise and industry.
"McCreevy showed great understanding and promised to look at the issue from an internal market perspective," Bjorling wrote on her blog.
She's tackling the issue from a fair trade perspective: How can snus be outlawed when cigarettes are not?
But the health issues always lurk underneath when you compare any product to smoking.
What got health experts talking about snus in the first place was Sweden's exceptional health statistics. The country of nine million has one of the lowest rates of smoking and lung cancer in the industrial world, and snus is widely recognized as part of the reason.
The Swedish National Institute of Public Health last month said that only 11 per cent of Swedish men and 14 per cent of women smoke on a daily basis. Meanwhile, 19 per cent of men and four per cent of women are daily snus users, the institute said.
The country's biggest snus maker, Swedish Match, has absorbed the health arguments into its marketing strategy.
"I want to sell as much snus as possible to adults in Sweden -- that's nothing we try to hide -- but the more successful we are in converting smokers to snus, the more money Swedish Match makes, but in addition it has very positive effects on Sweden's public health," chief executive Lars Dahlgren said. Last year the company sold snus for 3.8 billion kronor (about C$56 million).
Skeptics warn that snus is highly addictive. Studies show that the average snus user consumes nicotine corresponding to as many as 30 cigarettes a day.
According to Alexander Macara, president of Britain's National Heart Forum, 60 per cent of people who use snus to quit smoking become chronic snus users instead.
Britain's Royal College of Physicians last year called for more research on how effective snus is as a smoking substitute. It stressed it wasn't lobbying for lifting the European ban, but added that if snus proves more effective than nicotine replacement products, "we can see grounds for legalization."
Across the globe, tobacco researcher Coral Gartner, at the University of Queensland, has called for lifting Australia's 1991 ban on snus. "I think Australia should look at its regulation of all tobacco products and consider making less harmful non-smoked products available in a very restricted way," she said in an email.
Even if the EU ban were lifted, it's doubtful that millions of Europeans would rush to stuff their faces with a tobacco product that takes some getting used to. Even in Sweden, the bulging upper lips are not considered very attractive outside the snus community.
The biggest effect would probably be along neighbouring Finland's west coast and the Aland islands, where snus has made inroads among the ethnic Swedish minority.
Patrick Wingren openly defied the EU ban last December by selling snus at a rally in Jakobstad, 470 kilometres northwest of the Finnish capital, Helsinki. Wingren, who is running for a seat in the European Parliament, said EU citizens don't need to be protected from snus.
"I can understand the argument about protecting kids from it, but the majority that use it are grown-ups," he said. "If we continue like this we'll end up having bicycle helmets nailed to our heads."
