Consuming one pot of smokeless or dipping tobacco per day increases the risk of developing type 2 diabetes by 70 per cent, according to a new Swedish study.
Scientists at Karolinska Institutet investigated a Swedish smokeless tobacco known as snus, and found its exposure could increase insulin resistance, a primary cause of type 2 diabetes.
The sale of snus is illegal in the European Unio, but it is legal in Sweden and prevalent in several Scandinavian countries. The Public Health Agency of Sweden reports that 19 per cent of men and four per cent of women in Sweden take snus.
The increased risk of developing type 2 diabetes among snus users was the same as previously seen for smokers who smoke one packet of cigarettes a day.
“We can confirm earlier suspicions that snus-users have a higher risk of type 2 diabetes, an effect that can seemingly not be explained by them being occasional smokers or having a lifestyle that is less healthy in other respects,” said lead author Sofia Carlsson.
To assess this risk, the researchers explored the association between snus use and the risk of type 2 diabetes using data from 54,500 men between 1990 and 2013. A total of 2,441 participants developed type 2 diabetes during this time.
Compared to non-users of snus, the risk of type 2 diabetes was heightened among those who consumed one pot a day by 70 per cent. There was also a 40 per cent increased risk among those who consumed 5-6 pots a week.
Carlsson and colleagues hypothesised that the effect of nicotine could explain these findings, with experimental studies previously linking nicotine to impaired insulin sensitivity.
“Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes,” added the study authors. “The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.”
The researchers explained that they were unable to make corresponding analyses for women because snus use is relatively uncommon among women, but stressed this should be an important aspect of future studies.
The findings appear in the Journal of Internal Medicine.

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