Dr. Whelan urges Kansas to consider tobacco harm reduction study

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To: The Kansas House of Representatives
Committee on Federal and State Affairs

From: The American Council on Science and Health
Elizabeth M. Whelan, President

Re: Support for Resolution No. 6026, to direct the KDHE to investigate a study of tobacco harm reduction

The American Council on Science and Health (ACSH), a consumer education and advocacy nonprofit devoted throughout our 34 year history to the promotion of sound science in public health policy, urges the Kansas House of Representatives to pass Res. 6026, directing the Kansas Department of Health and the Environment (KDHE) to undertake a one-year analysis of Tobacco Harm Reduction (THR).

Our own studies of this subject (1, 2), published in a peer-reviewed academic journal, as well as many others, have proven to our satisfaction that the methodologies comprising THR have significant potential benefits in terms of reducing the tragic toll of cigarette smoking by supplying addicted smokers with the substance they crave--nicotine--but at a much reduced cost in terms of adverse health effects.

While we are in full agreement that no form of tobacco use is entirely "safe"--i.e. without an increased risk of adverse health effects--and that therefore all tobacco use should be discouraged, it is still necessary to acknowledge the fact that there are 46 million addicted adult smokers in our nation, about 20% of the total population. Further, while almost three-quarters wish to quit, and almost one-half do indeed attempt to quit each year, well under one-tenth succeed. One reason for this abysmal "success" rate is that the methods approved by the FDA (including the nicotine patch (NRT), gum, inhalers, and pharmaceuticals such as Zyban and Chantix) and promoted by the official public health authorities and the large nonprofits, simply fail to help smokers quit.

The established authorities' positions on using reduced risk products to deliver adequate nicotine levels to requite smokers' cravings and help them get off deadly cigarettes is based on long-held, formerly legitimate but now obsolete hatred and mistrust of tobacco companies. Given the current stringent regulatory oversight and the clear downward-trending cigarette sales along with the irrefutable evidence of "the Swedish Experience," which illustrates how Swedish men have shifted their tobacco use pattern from lethal cigarettes towards much safer "snus" (smokeless tobacco in small teabags), it is in tobacco companies' interests as well as public health's for them to market reduced risk products. They couldn't get away with the nefarious behaviors of the 20th century, even if they had such an inclination.

Those who support Resolution 6026, including ACSH, merely ask the Kansas legislature to initiate a science-based study of the subject. We would not expect a commitment based upon our say-so, even based on our scientific investigations, and we merely encourage your health department to conduct your own studies. This should include not only snus-type smokeless tobacco aimed at helping addicted smokers quit cigarettes, but also the newer products such as dissolvable tobacco and electronic-cigarettes (e-cigarettes). We firmly believe that the more comprehensive the investigation, the more reasonable people will come to understand that the official policies of adhering to "there is no safe tobacco product, so abstinence is the only answer" amounts to a "quit or die" position, the status quo, with the ongoing toll of over 400,000 smoking-related deaths each year. This is no longer an acceptable position from a public health perspective, and we hope you will agree that such a study is desperately needed, indeed long overdue.

Thank you for your consideration.

Elizabeth M. Whelan, Sc.D., M.P.H.
The American Council on Science and Health

1. Rodu, Brad and Godshall, William T.
Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

2. Rodu, Brad
The scientific foundation for tobacco harm reduction, 2006-2011