Asplund Kjell
Medicinkliniken, Norrlands Universitetssjukhus, Umeå.
Lakartidningen. 2003 Jun 19;100(25):2206-10.
Oral snuff, a form of smokeless tobacco, causes an immediate rise in heart rate and blood pressure, but snuff users do not show permanent changes in heart rate or blood pressure when not exposed to tobacco. Cardiac output during workload and maximal work capacity are unaffected. Snuff users usually do not show the biochemical stigmata that regular smokers do with the exception of a possible excess risk of type 2 diabetes. Two studies have found that snuff users, as opposed to smokers, do not show increased intima-media thickness or atherosclerotic lesions when investigated by ultrasonography. Results on the risk of myocardial infarction have provided conflicting evidence, two case-control studies showing the same risk as in non-tobacco users and one cohort study showing an increased risk of cardiovascular death. A nested case-control study failed to show an excess risk of stroke in snuff users. It is concluded that the use of smokeless tobacco (with snuff being the most studied variant) entails a lower risk of adverse cardiovascular effects than does smoking.
口含烟是无烟烟草的一种形式，它会使心率和血压立即升高，但口含烟使用者在不接触烟草时，心率或血压不会出现永久性变化。工作量和最大工作能力期间的心输出量不受影响。口含烟使用者通常不会像经常吸烟的人那样出现生化特征，只是可能有患2型糖尿病的额外风险。两项研究发现，与吸烟者相比，口含烟使用者在接受超声检查时，内膜中层厚度或动脉粥样硬化病变没有增加。关于心肌梗死风险的研究结果提供了相互矛盾的证据，两项病例对照研究显示其风险与非烟草使用者相同，而一项队列研究显示心血管死亡风险增加。一项巢式病例对照研究未能显示口含烟使用者有中风的额外风险。得出的结论是，使用无烟烟草（口含烟是研究最多的变体）比吸烟带来的心血管不良影响风险更低。
