August 30, 2011 - A prospective cohort study has shown that the discontinuation of smokeless tobacco (snus) after a myocardial infarction (MI) is associated with a 44% lower risk of subsequent mortality. The study followed 20,911 consecutive patients aged 75 years or less who had been admitted between 2005 and 2009 to coronary care units for an MI in Sweden. During a mean follow-up of 2.1 years, 812 of the participants died. Among the 1799 current snus users, 69 died (incidence rate 18.7 per 1000 person-years-at-risk); versus 14 among the 675 post MI snus quitters (incidence rate 9.7 per 1000 person-years-at-risk).  “The reduced risk in snus quitters seemed to be independent of smoking habits but may be partly related to changes in other life style behaviors, such as level of physical activity and participation in cardiac rehabilitation programs,” said Gabriel Arefalk from Uppsala University, the first author of the study. “Ideally the effects of quitting snus post-MI should be studied in a randomised clinical trial”, he added. 

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