Take Swedish snus (pronounced ‘snoose’ or ‘snooze’), a moist smokeless tobacco that users place underneath the upper lip. (It is sometimes used loosely as well.) In June 2014, the Stockholm-based company Swedish Match AB submitted a Modified Risk Tobacco Product (MRTP) application to the FDA for 10 of its General snus sub-brands. The company proposed that the FDA change the warning label from: “WARNING: This product is not a safe alternative to cigarettes” to “WARNING: No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.” In April 2015, the 8-member Tobacco Products Scientific Advisory Committee (TPSAC) panel concluded that “the applications do not provide adequate data to support a lack of association for use of these products with the other disease endpoints explored (i.e., esophageal, stomach, and pancreatic cancers, CVD, stroke, and all-cause mortality).” The panel members voted unanimously not to change the warning on snus products because the company’s proposed language does not adequately describe the health risks, including cancer, heart disease, gum diseases, tooth loss and pregnancy complications such as early delivery and stillbirth. The products also deliver nicotine — an addictive drug. In addition, the committee felt that the company’s proposed language oversimplifies the risk, since some snus users also smoke, exposing themselves to negative health effects from both combustible and smokeless products. The FDA is due to issue its final decision on the Swedish snus modified risk application by August 2015. The agency is not obligated to follow the committee’s decision, but it usually does. In the meantime, Swedish Match cannot alter the current warning label or market its products as a safer nicotine alternative to traditional cigarettes. But US consumers can still buy snus in shops and from internet snus stores. American tobacco companies, like Altria and R.J. Reynolds, have also promoted smokeless tobacco products (Skoal and Copenhagen) like snus. According to Snus Central.org, 50 million cans of snus are sold in the US each year.