Smokeless Tobacco During Pregnancy Linked to Risk of Cot Death

CC0 / / Mother and baby
 Mother and baby - Sputnik International, 1920, 20.02.2023
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Snus, a Nordic variant of smokeless tobacco, is commonly placed between the upper lip and gum for extended periods and contains no combustion products. Therefore it is sometimes seen as an alternative to both smoking and vaping, despite being rich in nicotine and highly addictive.
Children whose mothers used so-called 'snus', the snuff or smokeless tobacco popular in Scanvinavia, during pregnancy run a more than three times higher risk of sudden infant death syndrome, according to an extensive study from the Swedish Karolinska Institute.

"Fortunately, very few children suffer from sudden infant death syndrome, but we see that both snuff and smoking during pregnancy can be linked to increased risk," Anna Gunnerbeck, a pediatrician at Astrid Lindgren's Children's Hospital and researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institute, said in a statement.

While the risks associated with smoking during pregnancy have been known before, there is a considerable lack of knowledge over variants of smokeless tobacco, which the researchers tried to address.
For the purpose of the survey, the researchers have conducted a population study of over two million children born in 1999–2019 in Sweden. Overall, only two out of 10,000 children were affected by cot death or sudden infant death syndrome (SIDS), which occurs during sleep without an evident cause.
When enrolling in maternity care, seven percent of the Swedish mothers smoked and just over one percent used smokeless tobacco. The risks of using snuff were therefore found comparable to the those of moderate smoking (one to nine cigarettes per day).
Nordic snus contains high levels of nicotine, but unlike cigarettes, no combustion products. Therefore it is widely seen and touted as significantly less harmful, alongside vaping and other nicotine smokeless alternatives.
"In recent years, snus use has increased sharply among young women of childbearing age in Sweden. It is therefore important that women are informed about potential risks for fetuses and babies. Our study suggests that nicotine is a risk factor for sudden infant death and the conclusion is therefore that all types of nicotine products should be avoided during pregnancy," Anna Gunnerbeck concluded.
The researchers offered one final caveat that it may be difficult to distinguish between the risks that snuff and smoking pose to the fetus from exposure to cigarette smoke and nicotine in breast milk after childbirth, as some of the mothers who stopped ingesting tobacco early in pregnancy may have resumed this habit later.
No Smoking sign - Sputnik International, 1920, 24.12.2022
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In Scandinavia, snus became in popular in the early 18th-century. It is commonly placed between the upper lip and gum for extended periods. While somewhat similar to US dipping tobacco, it doesn't result in the need for spitting.
The sale of snus is most commonly banned in the EU with a few exceptions, yet it ranks among the most common tobacco products in both Sweden and Norway. Some snus variants are heavy in nicotine and may result in quick addiction.
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