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The Heartland Institute forwarded your inquiry about nasal snuff. I am happy to respond.
First, I have discussed a relative risk of four for mouth cancer among American dry powdered snuff users, but this is not relevant to the dry snuffs used nasally in the U.K., Germany and other countries. There is virtually no nasal use of tobacco in the U.S. American powdered dry snuff is a traditional product dating back to the American Civil War. It is primarily used by some women in the Southern U.S. (they use it in the mouth, not the nose), and until recently almost nothing was known about the chemistry and toxicity of the product. In 2004 I co-authored a study with a scientist from the Swedish National Food Administration. We found that the level of tobacco-specific nitrosamines (a toxic contaminant) was very high in these products, which perhaps contributed to the moderate risk for mouth cancer among some women in the Southern U.S.
I specifically characterize the relative risk of four for mouth cancer as moderate, because it has been grossly exaggerated by American health authorities. The original author of that report estimated that a relative risk of four would result in 26 cases of mouth cancer per year among 100,000 long term users of American powdered dry snuff. Oral cancer has a mortality rate of just under 50%, so there would be 12 deaths per year. In 2015 the U.S. National Highway Traffic Safety Administration estimated that there were 11 deaths from motor vehicle accidents per 100,000.
As you probably know, the prevalence of nasal snuff use, even in the U.K. and Europe, is very low. This means that very few studies have been done. I found one German study of nasal cancer. Nasal snuff users who did not smoke did not have an elevated risk. Of course, lack of evidence doesn