Snus Ruse

Why lie about smokeless tobacco when a misleading half-truth will do?

The European Union's highest court recently upheld the E.U.'s 12-year-old ban on oral snuff, saying it serves "the objective of health promotion." Since cigarettes, a far more hazardous form of tobacco, are still legally available in Europe, the E.U.'s policy is rather like banning bows and arrows as an intolerable threat to public safety while allowing a free trade in machine guns.

Worse, tobacco consumption patterns in Sweden, the one E.U. country where oral snuff (known there as snus) remains legal, suggest that Eurocrats are contributing to smoking-related disease and death by foreclosing a safer alternative to cigarettes. As the vice president of Swedish Match, the leading snus producer, put it, "Snus is clearly a significantly less harmful product than cigarettes and could play an important role in a much more responsible harm reduction strategy than the current cynical Quit or Die approach."

Swedish Match obviously has a strong interest in reversing the oral snuff ban. But its position has a solid enough empirical basis that prominent European health researchers and a leading British anti-smoking activist likewise have decried the "Quit or Die approach."

In the U.S., where smokeless tobacco remains legal, this approach takes the form of a misinformation campaign that encourages people to think oral snuff is just as dangerous as cigarettes. That belief, which seems to be widely accepted by smokers, is clearly wrong.

Based on the incidence of tobacco-related deaths among users, University of Alabama at Birmingham oral pathologist Brad Rodu estimates that smokeless tobacco is 98 percent safer than cigarettes. The difference is so stark that public health officials have been forced to quietly retreat from their false risk equivalence.

Last year, for instance, Surgeon General Richard Carmona told a congressional subcommittee "smokeless tobacco is not a safer substitute for cigarette smoking"—a claim that is scientifically unsupportable. But in the version of his testimony that appears on the Web site of the Centers for Disease Control and Prevention, he says "smokeless tobacco is not a safe alternative to cigarettes"—the same true but misleading warning that appears on oral snuff packages.

Similarly, a CDC Web page aimed at children asks, "Is smokeless tobacco safe?" The answer: "No way!" But the search listing for the page shows that the question used to be, "Is smokeless tobacco safer than cigarettes?" I suspect the CDC's answer was not "You bet!"

Perhaps the most telling recent change in the official line on smokeless tobacco was made to a pamphlet published by the National Institute on Aging. When I looked at the online version of the pamphlet in March, it said: "Some people think smokeless tobacco (chewing tobacco and snuff), pipes, and cigars are safer than cigarettes. They are not." The passage now reads: "Some people think smokeless tobacco (chewing tobacco and snuff), pipes, and cigars are safe. They are not."

This change came in response to a March 16 complaint from the National Legal and Policy Center arguing that the pamphlet violated the Data Quality Act by disseminating erroneous information. Among other sources, the complaint quoted a 2001 report from the National Academy of Sciences that said "the overall risk [from smokeless tobacco] is lower than for cigarette smoking, and some products such as Swedish snus may have no increased risk" (because they're especially low in carcinogens).

The fact that public health officials seem less inclined to tell outright lies about smokeless tobacco is a small victory. They are still obscuring the issue by doggedly repeating that smokeless tobacco is not risk-free when the relevant point for a cigarette smoker who is thinking about switching is that it's much less likely to kill him than his current habit.

Meanwhile, their allies in the private sector, unconstrained by the Data Quality Act, continue to explicitly promote the myth that smokeless tobacco and cigarettes are equally dangerous. "Some people believe that using smokeless tobacco is safer than smoking," the American Cancer Society says on its Web site. "This is not true."

The staffer who wrote that might want to ask Michael Thun, the society's chief epidemiologist, for a copy of the December issue of Cancer Epidemiology, Biomarkers & Prevention. That issue includes a study in which a panel of experts estimated that the mortality risk posed by Swedish-style oral snuff is at least 90 percent lower than the risk posed by cigarettes. What makes me think Thun has a copy? He was one of the experts.