Anti-Smokers Inch Toward Pandora's Box of Snuff

|

A recent New York Times story about new smokeless tobacco products from U.S. companies suggests the American Cancer Society's attitude toward such products is evolving. For years the ACS, like other anti-smoking groups, has deliberately obscured the fact that oral snuff is far less hazardous than cigarettes and resisted calls to promote it as a safer alternative. Now Thomas Glynn, the ACS's director of cancer science and trends, concedes that Swedish-style snuff (a.k.a. snus) "may be less harmful than other smokeless tobacco products and cigarettes," adding, "The question is, 'Why not suggest that people switch to them?' That's a very tempting argument, but it is a Pandora's box. There's a lot we don't know about. The products could encourage people to continue smoking who ordinarily would have quit."

Glynn is still not being completely forthright. First, there's no "may be" about it: Smokeless tobacco is indisputably much safer than cigarettes. Second, while Swedish methods produce oral snuff with lower levels of certain carcinogens than the old-style American process, all forms of smokeless tobacco are much less hazardous than cigarettes. The difference in risk between different kinds of oral snuff pales in comparison to the huge difference in risk between oral snuff and cigarettes. Third, studies of tobacco use in Sweden indicate that snus is a substitute for cigarettes, one of the main reasons smoking rates there, especially among men, are substantially lower than elsewhere in Europe. The main effect has been to reduce cigarette consumption, not to "encourage people to continue smoking" by giving them an alternative source of nicotine in environments where smoking is prohibited, which presumably is what Glynn has in mind. There's no reason to think the latter effect would be so dramatic in the U.S. that it would outweigh the reduction in smoking-related illnesses among smokers who switched from cigarettes to snus. In any case, the same objection could be raised against Nicorette gum or other alternative nicotine sources.

According to the "public health" logic that supposedly governs organizations like ACS, promoting snus as an alternative to cigarettes is a good idea if, on balance, it reduces morbidity and mortality. If they believe in their own professed principles, they ought to support such a "harm reduction" policy. My own view is that anti-smoking groups and (especially) government agencies should tell the truth about the relative risks of different tobacco products and let people make their own choices, regardless of what those choices might turn out to be.

ACS is at least moving closer to telling the truth. In December 2004, when I wrote a column about this issue, the group's Web page on smokeless tobacco said: "Some people believe that using smokeless tobacco is safer than smoking. This is not true." That was not true. The current version of the page says:

While some people have suggested that cigarette smokers should switch to spit tobacco, most medical experts recommend quitting use of all tobacco products. Numerous clinical studies have shown that nicotine replacement therapy (such as nicotine patches, nicotine gum, etc.) can help people to quit smoking.

While using snuff and chewing tobacco may be less lethal than smoking, there is no evidence to support claims that these products are as safe and effective as nicotine replacement in helping smokers to quit.

Smokeless tobacco is cheaper than other forms of nicotine replacement, it delivers levels of nicotine closer to those smokers are used to, and in the form of Swedish-style snus it poses negligible health risks. As for whether it is as effective as nicotine gum or patches (which are not all that effective to begin with), why not let smokers decide for themselves?

NEXT: Penn Jillette's "Greatest Hero of the Planet" (And Mine Too)

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. Jacob:
    It’s not about tobacco or the smoke, first – second – or third hand. It is people making a very comfortable living and feeling good about themselves as public health tyrants.

  2. “The products could encourage people to continue smoking who ordinarily would have quit.”

    The main effect has been to reduce cigarette consumption, not to “encourage people to continue smoking” by giving them an alternative source of nicotine in environments where smoking is prohibited, which presumably is what Glynn has in mind.

    The other possibility of what Glynn has done when he says “continue smoking” is to have bought into the “all-tobacco-is-equally-deadly” argument and says that people “continue smoking” when he means “continue using tobacco”. Because if you change “smoking” to “using tobacco,” Glynn’s statement sort of makes sense.

    “The products could encourage people to continue [using tobacco] who ordinarily would have quit.”

  3. According to the “public health” logic that supposedly governs organizations like ACS, promoting snus as an alternative to cigarettes is a good idea if, on balance, it reduces morbidity and mortality.

    Good old snus. What’s snu? Not much; what’s snu wid you?

  4. So all the stuff about malignant mouth tumors from snuff is BS?

  5. BTW: if they really gave a damn about health, they’d lobby for weed to be legalized. There has not been a single case of someone getting lung cancer from smoking marijuana.

  6. “So all the stuff about malignant mouth tumors from snuff is BS?”

    No, some forms of oral tobacco do increase the risk of oral cancer, albeit to a level much less than smoked tobacco. Snus, on the other hand, which is a specially prepared form of oral tobacco that is very low in the tobacco-speciifc nitrosamines which are thought to cause oral cancer, does not appear to increase the risk of oral cancer.

  7. “BTW: if they really gave a damn about health, they’d lobby for weed to be legalized. There has not been a single case of someone getting lung cancer from smoking marijuana.”

    I don’t see your point. Cannabis doesn’t cause lung cancer, but why would legalzing it improve public health? Its not like tobacco smokers will substitute cannabis for tobacco. . .

  8. why not let smokers decide for themselves?

    You sure know how to ruin all the fun, Jacob.

  9. Uh, I have used smokeless tobacco ever since some evil loggers bent me over a stump and made me do it. I assure you it is in no way safer than any other form of tobacco ingestion. I’m lucky to be alive. I can assurre you that it is harder to quit than smoking is.

    Try me. I’ll quit if you stay in the same room with me for the several weeks it takes for me to stop being crazy.

  10. Patrick: my point is that by their implications they should endorse cannabis as a substitute. They don’t because their problem with smoking is cultural — “I don’t like it, so don’t do it”. They can’t say that and expect anyone to listen to them, so they claim health is the reason.

  11. BTW: if they really gave a damn about health, they’d lobby for weed to be legalized. There has not been a single case of someone getting lung cancer from smoking marijuana.

    More accurately, there haven’t been any documented cases. However, there’ve been no systematic medical studies on this point either, ie. no opportunity for any existing cases to be documented, so we don’t really know one way or the other whether pot smoking causes lung cancer (or other diseases, for that matter). That said, it’s difficult to look at the thick, oily residue that appears on the inside of any given bong and imagine that a similiar accumulation inside your lungs is going to have an entirely positive impact on your respiratory health.

  12. “Patrick: my point is that by their implications they should endorse cannabis as a substitute. They don’t because their problem with smoking is cultural — “I don’t like it, so don’t do it.”

    Like I said though, cannabis is simply not a substitute for tobacco, for many reasons but mainly for the obvious reason that it does not contain nicotine.

  13. “Anti-Smokers Inch Toward Pandora’s Box of Snuff”

    When I came back recently from vacation up near Traverse City, MI, I had already contracted swimmers’ itch.
    (It has something to do with the complex cycle of the guano of Diving Merganzer ducks and periwinkles. Humans are somehow caught in the squiddle.)

    There is probably no connection to “anti-smokers inch,” eh?
    Are we sure?

    Snuff said.

  14. More accurately, there haven’t been any documented cases. However, there’ve been no systematic medical studies on this point either, ie. no opportunity for any existing cases to be documented, so we don’t really know one way or the other whether pot smoking causes lung cancer (or other diseases, for that matter).

    Borovan,

    That was true maybe 10-15 years ago, but is emphatically not true today. There is now a sizable and growing body of “systematic medical studies”, of several different varieites, examining the impact of cannabis smoking on lung/respiratory cancer risk, as well as respiratory diseases like COPD. And the evidence to date does in fact support the view that cannabis smoking, even heavy and long term cannabis smoking, does not increase risk of lung cancer. See, for instance, the recent large case-control epidemiological study conducted by Tashking and colleagues:

    http://msnbc.msn.com/id/12943013/

    For other examples, see:

    Rodenblatt et al, 2004. Marijuana Use and Risk of Oral Squamous Cell Carcinoma. Cancer Research 64, 4049-4054.

    Sidney et al, 1997. Marijuana use and mortality. American Journal of Public Health 87, 585-590.

    Sidney et al, 1997. Marijuana use and cancer incidence (California, United States). Cancer Causes and Control 8(5), 722-728.

    Taylor et al, 2002. A longitudinal study of the effects of tobacco and cannabis exposure on lung function in young adults. Addiction 97, 1055?1061.

    Tashkin et al, 1997a. Heavy habitual marijuana smoking does not cause an accelerated decline in FEV1 with age. American Journal of Respiratory Critical Care Medicine 155(1), 141-1488.

  15. “snuff” is a funny word

  16. Does this mean restaurants and bars will have to buy spitoons for their patrons who chew tobacco?

  17. Pablo,
    I’m so old, I remember when the local US Post office had cuspidors.

  18. Does this mean restaurants and bars will have to buy spitoons for their patrons who chew tobacco?

    No. Spitting’s what empty pop-top soda cans are for.

  19. Why to ask so much when you are in love?

    ??The mature never ask the past, the wise never ask the present and the open-minded never ask the future.

Please to post comments

Comments are closed.