La Suède est le pays au monde où l’on compte le moins de cancers. C’est le pays occidental aussi où les hommes fument le moins : à peine plus de 10 % de la population en âge de fumer. Ce modèle d’excellence mériterait d’inspirer nos dealers d’opinion actifs dans la lutte contre le tabagisme.
Peine perdue ! Les suédois ont inventé il y a fort longtemps un tabac à sucer nommé Snus° commercialisé par Swedish Match. Sur 44 % des hommes qui consomment du tabac, seuls 14 % le fument encore, 30 % utilisent désormais le snus selon le Pr Molimard. L’Union Européenne - bien inspirée par des agents d’influence sans doute – a interdit la vente de Snus, au profit de la cigarette. Le snus est aussi un concurrent redoutable de la nicotine pharmaceutique doté d'un statut de "médicament".
Le Pr Molimard dont nous avons déjà mentionné les travaux et publications (voir ci-dessous) a osé mettre en cause le dogme de l’usage de nicotine pharmaceutique dans son dernier ouvrage Petit manuel de défume (Ed. Sides, 2007). Sa position est confortée aujourd’hui par la publication d’un dossier dans le Lancet, journal médical de référence dans le monde entier [1].
Bien sûr que le tabac sucé n’est pas sans danger, mais le risque est considérablement inférieur à celui du tabac fumé. De nombreux spécialistes médicaux anglo-saxons prônent avec insistance la disponibilité et la libre commercialisation du snus en alternative et à la cigarette et aux présentations pharmaceutiques de la nicotine. Ce serait avantageux pour la santé publique comme le montrent les statistiques suédoises : encore un exemple que la santé des fumeurs passe APRÈS certains intérêts financiers.
Référence
- Snus — What should the public-health response be?, The Lancet; DOI:10.1016/S0140-6736(07)60679-5
(voir résumé en anglais de Associated Press ci-après).
Nos principaux billets citant le Pr Molimard
- Juin 2006 : Tabac et aides médica-menteuses
- Novembre 2006 : L'effet des substituts nicotiniques est montré dans les quinze premiers jours d'arrêt, mais il n'y a plus d'effets à long terme
- Janvier 2007 : Tabacocologues : enseignement biaisé par les conflits d'intérêts
- Février 2007 : Conflits d'intérêt dans la recherche sur le tabagisme
- Mars 2007 : Champix : un avis du Pr Molimard
= O =
Voici le texte du communiqué de Associated Press reprenant les principales conclusions du dossier du Lancet :
Doctors: Sweden Offers Safer Tobacco Alternative
(AP) LONDON Smokers looking for a less harmful way to get their nicotine fix should switch to Swedish snus — a smokeless tobacco that puts them at a significantly lower risk of cancer than cigarettes, doctors say in an article posted online Thursday in The Lancet.
Smokers are at least 10 times more likely to get lung cancer than people who use snus, studies showed — a finding that could challenge bans on snus, particularly in the European Union.
All EU nations now prohibit snus, except for Sweden, which was granted an exemption because of the widespread use of the powder tobacco among Swedes. In the United States, smokeless tobacco is legal, and Swedish snus is being test-marketed in at least two U.S. cities.
"We should not delay in allowing snus to compete with cigarettes for market share," Drs. Jonathan Foulds and Lynn Kozlowski of the University of Medicine and Dentistry of New Jersey said in analyzing two studies published in The Lancet. "The banning or exaggerated opposition to snus in cigarette-rife environments is not sound public health policy," they wrote.
One study tracked the incidence of cancer over among nearly 280 000 Swedish men — some of them snus users, some smokers and some who never used tobacco — over a 20-year period. The other projected the effect on health if snus were introduced in Australia, where it currently is banned. Swedish snus makers say the production process there is different from similar products in the U.S., adding that they work hard to remove carcinogens during manufacturing.
But snus is far from harmless; about 30 carcinogens have been found in the smokeless tobacco. In 2004, the Luxembourg-based European Court of Justice upheld a ban on the substance, ruling that the dangers of snus merited its being outlawed. However, the two studies show snus may not be as harmful as previously thought, and far less harmful than cigarettes.
International researchers followed 279,897 male Swedish construction workers from 1978 to 1992. About 26 percent were snus users, 37 percent were smokers and the rest never used tobacco.
For smokers, the incidence rate of pancreatic cancer was 13 cases per 100 000. That rate dropped to 8.8 cases per 100 000 for snus users. Among those who did not use tobacco, the rate was 3.9 cases per 100 000.
However, snus users were twice as likely to develop pancreatic cancer than those who had never smoked or used snus. The study also showed that using snus did not increase the risk of oral cancer, though users might develop mouth lesions where the substance is placed since it generally is tucked inside the upper lip. In addition, using snus can complicate pregnancies and may raise the risk for heart disease.
In the modeling study, Australian researchers found that lifting current restrictions on snus would probably benefit public health if the smokeless tobacco is adopted by people who would otherwise continue smoking. In Sweden, many smokers have switched to snus, and the country now has one of the lowest smoking rates in the world: less than 20 percent of the population.
Some experts worry that legalizing snus could still have harmful effects. "As with all tobacco products, snus is not completely risk-free," said Jean King, director of tobacco control at Cancer Research UK. King, who was not connected to either study, said that while snus could help smokers quit, it would be important to prevent snus from being adopted by new users.
Smoking is the top risk factor for cancer, and approximately 1 billion people worldwide are addicted to the nicotine in cigarettes. Tobacco kills one in ten people globally, and causes four million deaths every year.
"For a smoker, quitting all tobacco use is best, but failing that, switching to snus is a good idea," said Dr. Peter Hajek, professor of clinical psychology at Queen Mary University Hospital in London. Hajek was not involved in either study. "If a sufficient proportion of smokers switched to snus, lifting the ban could be in the public interest," Hajek said.
(© 2007 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. )
La
politique de prohibition totale du tabagisme a les faveurs des
autorités de santé. L'option d'une réduction du risque sanitaire avec
une consommation moins dangereuse est sacrifiée sur l'autel de l'arrêt
total, pour le monde entier. Malheureusement cet objectif est un voeu pieux, d'une part pour les jeunes avant que le tabagisme ait accompli ses premiers dégâts, et d'autre part pour le noyau dur des 'hard core smokers'
pour lesquels il n'existe pas de solution de remplacement au tabac, ou
du moins à la nicotine. L'exemple de la Californie montre qu'il ne
semble pas possible de descendre en dessous d'un seuil de 10 % de la population fumeuse...
Ce serait une alternative au dérivés nicotiniques des firmes pharmaceutiques : elles ne le permettront pas. Nous sommes prêt à parier une tournée de Beaujolais nouveau que la conférence de l'OMS en novembre prochain posera des conditions d'homologation impossibles à satisfaire, sous le bel halibit de la santé des populations, ben voyons ! 
