Experts fear Swedish snus sales in the U.S. could thwart anti-tobacco measures.

A new product on the market in a handful of U.S. cities has stirred up mixed feelings in the public-health community. Known as snus (rhymes with " goose "), it is a smokeless tobacco product that has been used in Sweden for nearly a century. Because it has lower levels of cancer-causing tox-ins than cigarettes or other smokeless tobacco products that are currently sold in the U.S. (such as chewing or dipping tobacco) some public-health experts are wondering whether snus could be a less dangerous substitute for smoking. Within the public-health community, there are two camps on this issue. Most believe that no tobacco product should ever be promoted because even a " safer " product is still not safe. But the other side, an outspoken minority, thinks it is better to be realistic about tobacco use and provide consumers with honest information about less harmful alternatives to cigarettes. This debate, which includes other harm-reduction strategies like long-term nicotine replacement, might have remained in the realm of the theoretical. But two tobacco companies, Philip Morris and R.J. Reynolds, have been test-marketing their own snus products (named after their best-selling cigarettes Marlboro and Camel, respectively) in cities around the country. The new snus products come in small teabag-like pouches that are about the size of a paperclip. While Swedish snus has nicotine levels comparable to those of cigarettes , these new snus products deliver much less nicotine. That's the tradeoff for creating a more socially acceptable, spit-free product, said Gregory Connolly, D.M.D., director of the tobacco control research program at Harvard School of Public Health. There is no debate that snus is less harmful than cigarettes. The tobacco in snus is steam pasteurized, not fermented like other spit tobacco products, including chewing tobacco. This process, developed in Sweden, kills the microbes that create some of the cancer-causing toxins found in other smokeless tobacco products. Snus also doesn't have the dangerous combustion products that cigarettes do, and there is little to no risk of lung cancer. But this is not to say that snus is completely safe. The most common health effects of snus are white patches in the mouth, called leuko-plakia, and gum recession. There are cancer risks as well. A recent study in The Lancet showed that long-term snus users in Sweden had twice the risk of pancreatic cancer of people who never used any tobacco product (smokers had the …