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ACSH applauds a new initiative in the city of Owensboro, Kentucky, that aims to save lives by promoting the use of smokeless tobacco as a less risky alternative to smoking.

The Switch and Quit program is directed by ACSH Advisor Dr. Brad Rodu, professor of medicine at the University of Louisville, and run by the James Graham Brown Cancer Center. (Dr. Rodu also authored ACSH s most recent update on tobacco harm reduction.) It will encourage smokers through print, billboard, radio, and other media to switch from cigarettes to smokeless tobacco or to other nicotine products that do not involve smoke thereby avoiding the inhalation of carcinogenic by-products of tobacco combustion. As evidence mounts that smokeless tobacco products confer a much lower risk of disease than do cigarettes, the new program may help smokers reduce or stop smoking altogether; it could also prevent the hundreds of smoking-related deaths that occur annually in Owensboro (Kentucky has the nation s highest smoking and lung cancer rates). Furthermore, use of these products would eliminate exposure of others to second-hand smoke.

However, many national organizations governmental and nonprofit alike currently argue against promoting smokeless tobacco as a lower-risk alternative to smoking. From the National Cancer Institute to the National Institutes of Health to the Centers for Disease Control and Prevention, the prevailing message is that any tobacco use should be strongly discouraged, and smokeless tobacco is no exception. They say, correctly, there is no safe use of tobacco. While technically true, it is also true that, for addicted smokers, harm reduction can save lives.

The evidence suggests that smokeless tobacco does in fact carry a significantly lower risk than smoking cigarettes. Dr. Rodu s ACSH-supported work demonstrates in great detail the truth of that statement, revealing that the health risks of smokeless tobacco approximate one-hundreth those of smoking. It seems clear, then, that failing to inform the public about the much lower risk of using smokeless tobacco leaves smokers with an incomplete understanding of their options.

An estimated 46 million Americans smoke, and the large majority wish to quit. But with traditional smoking cessation methods, the number of people who are actually able to do so is extremely low, resulting in millions of Americans continuing to smoke and facing premature death. Dr. Donald Miller, director of the James Graham Brown Cancer Center, supports his center s new focus on the benefits of switching to smokeless tobacco. We need something that works better than what we have, he says. This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried.

ACSH s Dr. Elizabeth Whelan agrees, commenting that the popular thought about smoking is to get people off of any type of nicotine whatsoever. But all too often, this just doesn t work.

Opponents argue that there is a lack of scientific evidence supporting the decreased risk of smokeless tobacco, and that this program should not use the people of Owensboro to experiment with an untested method. But ACSH s Dr. Gilbert Ross disagrees, saying, This is not an experiment with the people of Owensboro, but with the smokers of Owensboro. We re dealing with people who have a 50 percent chance of dying as a result of tobacco use, and we need to focus on reducing this risk, above all else. No non-smokers or teenagers will be walking into this program and starting to use tobacco only those who are already smoking will be targeted.

ACSH's Dr. Josh Bloom, for his part, would like to see some of these opponents hooked up to a lie detector and asked whether they honestly believe it's possible for a smokeless product to be as unhealthy as a cigarette. He goes on to say, I would certainly like to hear the explanation from anyone who answers yes.