Dispatch: Smokeless Tobacco Debates

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The Wall Street Journal’s “Numbers Guy” took a look at the arguments for and against smokeless tobacco as harm reduction for addicted smokers over the weekend. He mentions dangers often cited by critics of smokeless tobacco, writing, “All of these risks appear to be overblown, particularly compared with smoking, which is far more likely to kill than smokeless alternatives. But researchers who recommend these products as alternatives for smokers seeking to quit also are relying on hazy figures.”

“He’s right that cigarettes are more likely to kill than smokeless alternatives,” says ACSH’s Jeff Stier. “But if smokeless tobacco companies had made that simple and scientifically valid statement, they would be prosecuted under section 911 of the FDA tobacco legislation. He’s also correct that the data supporting harm reduction is hazier than we would like. We readily acknowledge that we would like to have even stronger data, particularly from the U.S., but the U.S. government won't fund such critical research. And if the tobacco companies fund it, journals like PLoS Medicine wouldn’t publish it, and others would find it non-credible. Furthermore, such studies might not be approved by ethics boards.”

The article quotes Dr. Greg Connolly of the Harvard School of Public Health, who opposes smokeless tobacco on the grounds that smokeless users do not always quit smoking. “If we can get everybody to switch to smokeless, great,” Connolly is quoted as saying. “That would be wonderful.” However, he’s not optimistic about that prospect.

“This shows where Dr. Connolly is coming from on this issue, since he is well aware that we cannot be sure that everyone who uses smokeless tobacco will quit smoking,” says ACSH’s Dr. Gilbert Ross. “However, we know very well that only 10% or so of smokers are able to keep off deadly cigarettes for one year with the currently approved methods. This is unacceptable. In Sweden, where snus is commonly used, the number of quitters is much higher.”

ACSH’s Dr. Elizabeth Whelan agrees: “We don’t need to get everyone to switch completely in order to see public health improvements. No one is holding nicotine patches and gum to a standard of 100% efficacy, so we shouldn’t be doing so for smokeless tobacco either.”