Smokeless Tobacco – Harm Reduction

There’s real progress to be had for harm reduction in getting this news out to the general public.

There are advantages in harm reduction by smokers migrating to smokeless products. However, it would also be helpful if the relative harm for the various type of smokeless tobacco were made public. They are not all equal – but it seems quite clear that snus is the least harmful. If this is correct – we should say so.

11 comments ↓

#1 Moist Guy on 05.22.08 at 3:31 PM

Now this is what I think folks need to know – The anti – tobacco folks are just totally irrational as the T word just makes them go stupid. Moist tobacco is so less harmful than cigarette smoking. Folks I have heard that “it’s the smoke” that is what causes harm. We do noeed to let folks know that there are tobacco products that are less harmful.

#2 Johnie Jay on 05.23.08 at 12:46 AM

I was thinking about this last week and I’m wondering if I as a retailer could put up news articles to communicate that smokeless is a good alternative to smoking.

A good buddy of mine actually quit smoking as his doctor recommended he use pouches of Skoal. He liked the idea especially since he was able to switch up on flavors. He mentioned a very interesting benefit in that when we play hoops he doesn’t get out of breathe as quick as he did when smoking.

#3 Copenhagen Charlie on 05.31.08 at 9:59 AM

I’ve been a dipper of the fine Copenhagen brand for over 40 years now and I’m glad to see that folks are trying to get the word out. I find enjoyment in the product and I think that there are more serious issues in our country that health agencies should focus on. Good to see folks get the real truth out!

#4 TAZ on 06.20.08 at 1:58 PM

A VERY INTERESTING ARTICLE ON THE TOPIC WAS SENT TO ME THIS PAST WEEK!

Industry and public health should partner

Bill Godshall, Executive Director of Smokefree Pennsylvania, discusses the
postive health aspects of swapping cigarettes for smokeless tobacco
products

World Tobacco
Smokeless Special: Harm Reduction
May 2008

As commonly used, different tobacco/nicotine products confer vastly
different health and safety risks for users and others. Truthfully
informing tobacco consumers about the relative and comparable health risks
of various tobacco products can reduce the morbidity and mortality risks of
tobacco use, which should be a common goal for public health and the
tobacco industry.

Unfortunately for consumer and public health, the overwhelming majority
(about 85%) of smokers (and nonsmokers) inaccurately believe that smokefree
tobacco products are just as, if not more, hazardous than cigarettes.

Although reduced ignition propensity (RIP) cigarettes reduce fire and burn
risks (compared to other cigarettes), there is no evidence that any type of
combustible cigarette (including filtered) poses fewer health risks than
any other type of cigarette. Additionally, many (perhaps most) smokers
inaccurately believe that nicotine in tobacco/nicotine products causes
cancer.

Is nicotine a health risk?

Nicotine is what makes cigarettes and most smokeless tobacco products
highly addictive, whereas cigars are less addictive because most cigar
smokers don’t directly inhale the smoke (as occurs with cigarettes). But
cigar smokers who inhale similar to cigarette smokers face similar health
risks, which is why cigars are not less hazardous alternatives for
cigarette smokers.

On a mortality risk scale from one to 10, on which nicotine products sold
as smoking cessation aids are a one and cigarettes are a 10, smokefree
tobacco products commonly used in the U.S. and Sweden are a two or less.

In essence, combustible tobacco products, smokefree tobacco products,
nicotine products sold as smoking cessation aids, and other nicotine
delivery devices all compete against each other in the nicotine products
market, and all of these products rely upon the tobacco plant for their
nicotine.

Smokefree tobacco products account for about half of all nicotine
consumption in Sweden, where more men use snus than cigarettes. In the
rest of the E.U., Australia and New Zealand, where most smokefree tobacco
products are banned, cigarettes account for virtually all nicotine
consumption. In the U.S., smokefree tobacco products account for about 10%
of nicotine consumption, while cigarettes account for the most of the rest.
Meanwhile, nicotine products sold for smoking cessation account for less
than 1% of nicotine consumption in all countries.

Even if overall nicotine consumption remains the same, the health of
tobacco users and the public can improve as the percentage of nicotine
consumed from smokefree tobacco/nicotine products increases.

Education, not legislation

Survey data indicate that about two million male ex-smokers in the U.S.,
and several hundred thousand ex-smokers in Sweden, have already quit
smoking by switching to smokefree tobacco products. This appears to be a
recently growing trend in the U.S., as consumption of moist snuff has
increased to an estimated 1.2 bn cans this year.

Public health agencies have an ethical duty to provide accurate health risk
information, and tobacco users have a human right to be provided accurate
health risk information. But instead of educating tobacco users about the
comparable health risks of different tobacco products, government health
agencies and many health organisations have been misleading tobacco users
(and the public) into believing that all tobacco products pose similar
health risks.

A 1986 law requires all smokeless tobacco products sold in the U.S. to
include a misleading warning that states ‘this product is not a safe
alternative to cigarettes,’
and ‘this product may cause mouth cancer,’ which has been widely adopted by
many health agencies and organisations as a talking point against smokeless
tobacco products.

Despite the overwhelming evidence that cigarettes are more hazardous than
commonly used smokefree tobacco products in the U.S. and Sweden, this
author is unaware of any government health agency websites or educational
materials that inform cigarette smokers (or the public) that smokefree
tobacco/nicotine products are less hazardous alternatives to cigarettes.

But a growing number of public health advocates are challenging the
abstinence-only anti-tobacco goal and mindset of those who oppose tobacco
harm reduction. Educating smokers about the comparable health risks of
smokefree tobacco/nicotine products can and should be embraced by the
public health community and the tobacco industry.

#5 Walter Raleigh on 06.23.08 at 9:59 PM

Would seem to this simple farm boy that it has to do with the smoke! The burning of the product is what produces the smoke. Read an interesting article on artificial sweetners that seems to present a more serious risk than “dipping” but I don’t see the health advocates attacking the sweetner industry like they do the moist tobacco industry. I think it is time that folks begin to realize the inconsistencies out there.

#6 DEERHUNTER on 08.12.08 at 2:31 PM

Pretty interesting blog going on here. A friend of mine told me to take a look at it so here I am. I have a question for someone who may be in the know. When you make the claim that smokeless tobacco is 98% safer than smoking cigarettes is that because more folks smoke. I guess what I’m saying is if 1000 folks smoke and a 1000 folks dip are you saying that less folks by dipping will experience harm by 98%? Always wondered if this was the case. Can someone answer this?

#7 Bill Godshall on 11.11.08 at 3:10 PM

Smokeless tobacco becomes a target

By Richard Craver
Winston-Salem Journal
November 10, 2008
http://www2.journalnow.com/content/2008/nov/10/smokeless-tobacco-becomes-a-target/

In bars and restaurants, theaters and stadiums, malls and offices, tobacco manufacturers are trying to reassert their presence in the market with innovative smokeless products such as snus and dissolvable products.

“We’re meeting the adult tobacco consumer where they are in society today,” said Maura Payne, a spokeswoman for R.J. Reynolds Tobacco Co.

But health-advocacy groups, having won the day with bans on smoking in most public venues after a 16-year fight, are gearing up their efforts and rhetoric to try to prevent those products from taking root.

“These smokeless products are likely to discourage smokers from quitting by sustaining their nicotine addiction in the growing number of places where smoking is not allowed,” said Matthew Myers, the executive director of the Campaign for Tobacco-Free Kids.

The evolution of the health-advocacy groups from anti-smoking to anti-tobacco is ratcheting up the moralistic aspect of buying and consuming a legal product.

It also is pitting more health-care and anti-smoking officials on both sides of the smokeless debate since it’s unclear whether smokeless tobacco equals reduced risk, particularly involving cancer.

There have been mixed findings from the few studies that have been conducted on snus.

What is clear is that the major U.S. tobacco manufacturers are putting more emphasis on smokeless products, such as snuff and snus, to gain market share and sales as the smoking rate among adults declines.

Government figures show that fewer than 44 million Americans smoke, down from a peak of 53.5 million in 1983.

On the front lines of the migration to smokeless products: Innovations from Reynolds, such as Camel Snus, a spitless product, and dissolvable Camel products that feature a pellet, a twisted stick and a film strip for the tongue.

Reynolds is taking Camel Snus nationwide by late January, and the other products will enter test markets in 2009.

“Consumer research has found that adult tobacco consumers have wanted another option for using tobacco where it wasn’t comfortable or they weren’t permitted to smoke,” Payne said.

Snus products make up less than 1 percent of all smokeless tobacco sales, said Bill Godshall, the executive director of SmokeFree Pennsylvania. Godshall supports smokeless products as a tool for reducing smoking, but acknowledges they are not a risk-free alternative.

Payne said that Reynolds does not promote the new smokeless products as a means to cessation.

“These new products pose serious threats to the nation’s health,” Myers said. “They are likely to appeal to children because they are flavored and packaged like candy, are easy to conceal even in a classroom and carry the Camel brand that is already so popular with underage smokers.”

There is potential for a long battle over smokeless tobacco’s place in the market and society, said Stephen Pope, the chief global-market strategist with Cantor Fitzgerald Europe.

“Snus is fighting for a very specific sector, and it takes time for people to accept the concept,” Pope said. “I do see the customer base being hard to please. There is an interaction, an activity with a cigarette that one just does not attain with a small pouch of tobacco.”

Smokeless has long history

Smokeless tobacco has been around since there’s been tobacco.

For many people, smokeless tobacco carries images of rural America, of bulging jaws or a pinch between the cheek and gum, and spit cups. Of the top 10 states for moist snuff use in the third quarter of 2007, Pennsylvania (No. 2), Ohio (No. 3) and California (No. 10) were the only non-Southern states. Texas was first, and North Carolina was seventh.

But in recent years, smokeless products have become more much subtle by use and by design — to the better for tobacco users to consume without breaking the law or facing scornful looks.

“Will all adult tobacco smokers switch to these smokeless products? We don’t know,” said David Howard, a spokesman for Reynolds. “We believe they should be educated to their tobacco options.”

But Susan Ivey, the chairwoman and chief executive of Reynolds American Inc., said that the company has to be at the forefront of innovative smokeless products as a “total tobacco company.”

“As leaders in tobacco-industry innovation, our companies are particularly well-suited to identify and create new opportunities for long-term growth,” Ivey said.

According to some anti-smoking officials, it’s vital that their message goes beyond smoking.

“Just like there is no safe cigarette, there is no safe tobacco product,” said Melva Fager Okun, the senior manager for N.C. Prevention Partners. Okun said that limited resources have compelled the groups to put more of their focus on secondhand smoke until recently.

“From a public-health viewpoint, I encourage all N.C. employers to support and reward all employees that quit the use of any tobacco products,” Okun said.

“Spit tobacco and other smokeless products are harmful to your health and can cause cancer in the mouth and jaw and other illnesses. These diseases are painful, disfiguring and very expensive to treat.”

Godshall said that the anti-tobacco groups “are trying to deny people the opportunity to use a legal product, a product with less risk than cigarettes, a product in which there is no one else can be harmed by its use. They want tobacco-free laws rather than no-smoking laws.”

Regulation of industry

The simmering debate comes while there is growing expectation that the Food and Drug Administration will eventually regulate the tobacco industry as early as next year. President-elect Barack Obama is a co-sponsor of the U.S. Senate’s legislation.

The regulation was crafted in large part through an alliance between Philip Morris USA and the Campaign for Tobacco-Free Kids.

Philip Morris is testing Marlboro Snus, but remains well behind Reynolds in terms of next-generation smokeless products. Analysts have said that tobacco manufacturers are moving quickly to introduce new smokeless products out of expectation that FDA regulation would make that more challenging, if not prohibitive.

“While it is likely that a bill may be taken up again in the new Congress, we have no way to predict timing of that,” Payne said. “So we have pursued product development and testing on these tobacco products independent of that issue.”

U.S. Sen. Richard Burr, R-N.C., is among the tobacco industry’s biggest political backers. He supports the inclusion of smokeless products as a less-hazardous alternative to cigarettes in any FDA regulation.

“I don’t know what the process will look like in 2009,” Burr said. “Some are hoping to jam the tobacco industry with the regulation rather than show interest in less-hazardous products than cigarettes.”

Brad Rodu, the chairman of the Tobacco Harm Reduction Research University at the University of Louisville, has been advocating implementation of tobacco harm-reduction products for 15 years. His research is supported by unrestricted grants from smokeless tobacco manufacturers UST and Swedish Match to the University of Louisville, and by the Kentucky Research Challenge Trust Fund.

“All smokeless products in the United States, including the new line from Reynolds, confer only about 1 percent to 2 percent of the health risks of smoking,” Rodu said.

“The development and marketing of vastly safer smokeless-tobacco products that appeal to adult cigarette smokers has the potential to transform tobacco use from a highly risky behavior to one that is as safe as consuming coffee.”

Dr. John Spangler, the director of the Tobacco Intervention program at Wake Forest University School of Medicine, sharply disagrees. His studies show that “smokeless tobacco acts as a gateway to smoking.”

“With safe and effective smoking-cessation products on the market — except Chantix, which has shown increased adverse events — there is absolutely no reason to propose snus or smokeless tobacco as a means of smoking cessation,” Spangler said.

“In fact, the data actually suggest that smokeless tobacco — at best — partially substitutes for cigarettes and does not help with cessation, but does induce initiation.”

Dr. Michael Thun, the vice president of epidemiology and surveillance research, said that the debate about smokeless tobacco products “has been complicated by the fact that some credible independent scientists have accepted the idea that because smokeless products are less lethal than smoking, they must therefore be useful in reducing the disease burden from smoking.”

“This idea is simplistic,” Thun said. “We are at risk of repeating the mistakes that contributed to the fiasco of light’ and low yield’ cigarettes.”

Pat Shehan, the owner of Tarheel Tobacco in Winston-Salem, said he believes that there is potential for smokeless if Reynolds and other manufacturers can get the word out to tobacco consumers.

“The anti-smoking groups have won the battle on secondhand smoke, and that is a good thing for society,” Shehan said. “But I don’t think it’s any of their business if people use smokeless-tobacco products, particularly if it helps to reduce the amount of secondhand smoke.

“This is one issue where I believe those groups need to butt out and let people use a legal product if they want to.”

Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.

——————————————————————————–

Switching impact

Data from the American Cancer Society show that switching from smoking can be safer for tobacco users. The figures represent the higher risk compared with a nontobacco user:

Disease – Smokers – Switched to smokeless – Quit tobacco

Lung cancer – 21.3 times risk – 5.6 times – 3.8 times

Chronic obstruction – 10.8 times – 3.2 times – 2.5 times

pulmonary disease –

Chronic heart disease – 1.8 times – 1.3 times – 1.1 times

Stroke – 1.7 times – 1.3 times – 1.1 times

Source: The American Cancer Society, R.J. Reynolds Tobacco Co.

#8 Moist Guy on 11.13.08 at 8:47 AM

Will be interesting to see how Philip Morris moves forward as they spent a lot on money on the acquisition of UST? What I find of interest in the numbers presented by Bill’s blogging is the definitive reduction in harm and the very minute difference if one were to quit totally. Has any body ever used this logic with fast food? Those who eat a Big Mac & Fries but give it up for a Southern Chicken Sandwich and a side of apples versus not eating at Mickey D’s? Or why doesn’t Matt Meyers get a life and go after the Alcohol industry like he attacks tobacco and get off his hobby horse. Is he not away of how the alcohol industry leads to disease & get this broken homes and even innocent peoples deaths by drunk drivers? If I don’t want to be in the presence of a smoker I do have a choice to ask that individual to honor my space but what about my friend’s dad who several weeks ago was traveling and was killed by a drunk driver? And get this has his research ever found that alcohol consumption leads to folks smoking? Let’s get real and stop misleading folks! Moist tobacco is an alternative and the truth must prevail not some fanatical Matt Meyer tirades!

#9 TAZ on 11.19.08 at 9:10 PM

Informational:

RJ Reynolds spokesman David Howard disputed a West Virginia University study, which found that the company’s smokeless, spit-free tobacco product Camel Snus that is currently being sold in the State has twice the nicotine content of an earlier test-market version sold elsewhere in the US and more nicotine than most other smokeless tobacco products available in the country, saying RJR can produce independent research findings that show that Camel Snus’ nicotine content has not only declined over the past two years, but is also below the average content of more than 40 other smokeless tobacco products.(Charleston Gazette 11/18)

#10 SKOAL MAN on 02.11.09 at 10:59 PM

ive been rubbn copenhagen and skoal 4 a good while now and i love it but ima country boy and if u dont like us dippers then get the hell out of here

#11 Montgomery on 08.02.09 at 8:06 PM

So question: if smokeless tobacco really is less harmful than cigarette smoking, why does it say on the tin that it is not a safe alternative to cigarettes?

Not trying to put down dippers, just trying to solve this paradox…

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