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The greater increase compared to smoking, as well as the protective associations for those who ceased use in the three months before their first visit (adjusted odds ratio 0.71 (0.441.14) for snus use and 0.88 (0.731.05) for smoking) make it difficult to interpret these results as causal

This situation is creating long-term budget concerns for programs that depend on the money

Although analyses were adjusted for many confounders, the potential for residual confounding can never be excluded in observational studies

in fact smoking seems to cause an increase in oxidative stress and reduces the levels of -tocopherol in plasma