Can the Use of WTAs Ever Be Safe?

Yes. Swedish Snus probably contains all the WTAs possible (plus measurable quantities of carcinogens), and as the health outcomes for Snus users in Sweden are virtually identical to those who have totally quit, it seems that ad lib consumption of nicotine and WTAs has no identifiable risk at population level. A Snus user in Sweden has about the same risk as a non-smoker, and this is shown by the national health statistics (which are unique); the very large volume of epidemiologic data; the population-level data; more than 150 clinical trials over almost 30 years, with very large sample trials of around 100,000 subjects followed for multiple decades in some cases; and by large-scale meta-analyses of the studies [4]. In fact the volume of facts and data is so great that certain aspects of non-combusted tobacco consumption are regarded as proven, since the facts are indisputable:

- No harm can be demonstrated from chronic nicotine consumption;

- No significant difference can be detected between health outcomes in smokers in Sweden who switch to noncombusted tobacco and those who totally quit;

- Sweden has the lowest male lung cancer and oral cancer rates in the EU (as more Swedes use Snus than smoke, and more Swedish men than women are Snusers).

Smoking prevalence was reduced by 64% in Sweden compared to for example UK male smoking prevalence, and smoking mortality is falling in parallel, leaving Sweden with the lowest smoking-related death rate of any developed country by a wide margin. It appears that neither the WTAs nor not-insignificant quantities of carcinogens have much effect from a statistical perspective - when considering a product that is 'sucked' not inhaled, at any rate. Individuals however might need to consider their current medical issues or prescriptions.

It is debatable which would have the least risk: Snus or e-liquid with added WTAs. Neither could compare in any way with the risk of smoking. Swedish Snus however is proven to have a risk so low that it is statistically insignificant. We need to recognise that the consumption of WTAs within Snus and within e-liquid are not the same thing: we know that the steam processing of Snus removes enough of the carcinogens that cancer is no longer a significant issue, but we know nothing about the processing of WTA e-liquid. Of course, any kind of e-liquid would need to be highly toxic before the risk was even measurable, never mind approaching that of smoking: inhalation of a flavoured water-based mist has no health implications as it has been used since time immemorial without implication; and the principle ingredients of e-liquid (such as PG) have been inhaled in asthma inhalers for decades without incident.


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