A press release in the New York Sun caught ACSH off guard with its negative coverage of Swedish smokeless tobacco, also known as snus. Sweden is the only country in the European Union (EU) that is permitted to market smokeless tobacco because it joined after the EU placed a ban on the product, and was given an exemption.
Recently, the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) was asked by the European Commission to evaluate the health effects of smokeless tobacco products with specific attention to snus. The committee report confirmed that, overall, smokeless tobacco causes less harm than cigarette smoking. Snus showed dramatically less adverse health effects, with almost no pulmonary disease, the most common adverse effect of cigarettes. In addition, snus was shown not to serve as a gateway to smoking. So, why all the negative press?
Here’s what it all boils down to. Although the committee acknowledged the many positive aspects of smokeless tobacco, it did not make these points part of its overall conclusion. The reason for this is that currently the committee believes that it is not possible to extrapolate the Swedish data, which highlight the benefits of smokeless tobacco, to other European countries. Reasons for this include sociodemographic factors, possible differences in risk across country lines, and the potential success of cessation programs as well as stringent smoking restrictions, such as the ones that are now working well in California.
With all the uncertainties involved in statistically assessing the benefits of smokeless tobacco, the committee’s conclusion consisted only of the clearly-elucidated facts that have been known for some time. They chose to parrot the party line, promoted by U.S. authorities as well as anti-tobacco zealots, that "smokeless tobacco is addictive and its use is hazardous to health." That policy amounts to "quit nicotine or die" and ignores the clear and enormous public health benefits of getting addicted smokers to quit cigarettes by switching to snus. The idea of using snus to reduce smoking deaths is known as harm reduction.
Nevertheless, the media is covering the report with no real emphasis on the data showing that smokeless tobacco (despite its health risks) is a less harmful alternative to smoking.
ACSH advocates the use of smokeless tobacco as a form of harm reduction for smokers. We do not assert that it is completely harmless. The truth remains that despite using all the currently approved quitting methods, only a small minority of smokers who try to quit are successful each year. Smokeless tobacco is a very under-utilized means of reducing the overwhelming health risks of smoking. We hope that the media decide to give smokers the full story on smokeless tobacco as a form of harm reduction.
Krystal Wilson is a research associate at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).