In a recent study, Bolinder et al. reported that Swedish construction workers aged 35 through 54 who use smokeless
tobacco have higher mortality from cardiovascular diseases and from all causes than do workers who use no form of tobacco.
Excess deaths from all causes (n = 50) in these smokeless tobacco users are only partly attributable to excess cardiovascular
disease deaths (n = 23) and other specific causes. In addition, no excess mortality from any cause was seen in older (aged 55 through 64) smokeless tobacco users. The broad spectrum of fatal "effects"
and the striking age specificity do not seem explicable to us in biological terms.
Comment On: American Journal of Public Health. 1994 Mar;84(3):399-404