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The study is nested among 9,582 men with incident prostate cancer within a prospective cohort of 336,381 Swedish construction workers. Information on tobacco use was collected at study entry between 1971 and 1992, and categorized into (<jats:italic>i<\/jats:italic>) never users of any tobacco, (<jats:italic>ii<\/jats:italic>) exclusive snus: ever users of snus only, (<jats:italic>iii<\/jats:italic>) exclusive smokers: ever smokers (cigarette, cigar and\/or pipe) only and (<jats:italic>iv<\/jats:italic>) ever users of both snus and smoking. Hazard ratios for prostate cancer\u2010specific and total mortality for smoking and snus use based on Cox proportional hazards models adjusted for age, calendar period at diagnosis and body mass index at baseline. During 36 years of follow\u2010up, 4,758 patients died\u20142,489 due to prostate cancer. Compared to never users of tobacco, exclusive smokers were at increased risk of prostate cancer mortality (HR 1.15, 95% CI: 1.05\u20131.27) and total mortality (HR 1.17, 95% CI: 1.09\u20131.26). Exclusive snus users also had increased risks for prostate cancer mortality (HR 1.24, 95% CI: 1.03\u20131.49) and total mortality (HR 1.19, 95% CI: 1.04\u20131.37). Among men diagnosed with nonmetastatic disease, the HR for prostate cancer death among exclusive snus users was 3.17 (95% CI: 1.66\u20136.06). The study is limited by a single assessment of tobacco use prior to diagnosis. Snus use was associated with increased risks of prostate cancer and total mortality among prostate cancer patients. This suggests that tobacco\u2010related components such as nicotine or tobacco\u2010specific carcinogens may promote cancer progression independent of tobacco's combustion products.<\/jats:p>","DOI":"10.1002\/ijc.30411","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T11:13:24Z","timestamp":1472728404000},"page":"2753-2759","source":"Crossref","is-referenced-by-count":27,"title":["Snus use, smoking and survival among prostate cancer patients"],"prefix":"10.1002","volume":"139","author":[{"given":"Kathryn M.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA"},{"name":"Channing Division of Network Medicine Brigham &amp; Women's Hospital, Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Markt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. 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