This week’s Morbidity and Mortality Weekly Report, a publication by the CDC, found that the proportion of cigarette smokers who also use smokeless tobacco products — such as snuff and chew tobacco — ranged from 0.9 to 13.7 percent on a state-by-state analysis, according to data from the 2009 Behavioral Risk Factor Surveillance System.
Puerto Rico and California had the lowest rates while Wyoming had the highest. According to American Heart Association CEO Nancy Brown, “No tobacco product is safe to consume. The health hazards associated with tobacco use are well-documented and a recent American Heart Association policy statement indicates smokeless tobacco products increase the risk of fatal heart attack, fatal stroke and certain cancers.”
ACSH's Dr. Gilbert Ross counters that the AHA policy statement that Dr. Brown is referring to was “horrendous, and these illnesses are not related to smokeless use, and such assertions were not supported by data cited in their own accompanying research article, with very few exceptions.”
Though ACSH agrees that the dual use of cigarettes and smokeless tobacco should not be encouraged on a long-term basis, there can be a period of dual use that occurs when smokers start using smokeless tobacco products while attempting to quit using regular cigarettes. “Many smokers use smokeless tobacco with the intent to quit cigarette smoking, and we encourage this. According to epidemiological data from Sweden, the use of snus is one of the most effective means to quit smoking,” says Dr. Ross.