Skoal! Chewing tobacco instead of smoking saves lives

Posted By News On February 19, 2012 - 3:44pm

VANCOUVER, British Columbia – Substituting smokeless tobacco products can save smokers' lives, and there is a scientific foundation that proves it.

That is the message Brad Rodu, D.D.S., professor of medicine at the University of Louisville (UofL) School of Medicine and the Endowed Chair in Tobacco Harm Reduction at UofL's James Graham Brown Cancer Center, delivered at the Annual Meeting of the American Association for the Advancement of Science Feb. 18. Rodu spoke at the session, "Harm Reduction: Policy Change to Reduce the Global Toll of Smoking-Related Disease."

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year, according to statistics from the Centers for Disease Control and Prevention," Rodu said. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's presentation, "Transforming Tobacco Use: The Potential of Tobacco Harm Reduction," was based on his almost 20 years of research. His work shows that smokers can greatly reduce their risk of disease and death by replacing smoking products with e-cigarettes or modern, spit-free smokeless tobacco. These products provide a much safer alternative for those smokers who are unable or unwilling to quit smoking because they continue to deliver nicotine without the harmful effect of smoking.

"Nicotine is addictive, but it is not the cause of any smoking-related disease. Like caffeine, nicotine can be used safely by consumers," Rodu said.

Decades of epidemiologic research bear out Rodu's findings. While no tobacco product is completely safe, smokeless products have been shown to be 98 percent safer than cigarettes. In the United Kingdom, the Royal College of Physicians reported in 2002 that smokeless tobacco is up to 1,000 times less hazardous than smoking, and in 2007, further urged world governments to seriously consider instituting tobacco harm reduction strategies as a means to save lives.

To see the proof of what tobacco harm reduction can do, look to Sweden, Rodu said. "Over the past 50 years, Swedish men have had Europe's highest per capita consumption of smokeless tobacco as well as Europe's lowest cigarette use. During the same time, they also have the lowest rate of lung cancer than men in any other European country."

In the United States., steps have been made to document the value of tobacco harm reduction. In 2006, a National Cancer Institute-funded study estimated that if tobacco harm reduction was "responsibly communicated" to smokers, 4 million would switch to smokeless tobacco. The American Council on Science and Health – which organized Rodu's session at the AAAS Annual Meeting – concluded in the same year that tobacco harm reduction "shows great potential as a public health strategy to help millions of smokers."

Rodu is well aware of the controversy his research findings generate. Opponents of any use of nicotine delivery products maintain that smokeless tobacco puts the user at great risk for oral cancer, a position not supported by research.

"The risk of mouth cancer among smokeless tobacco users is extremely low – certainly lower than the risk of smoking-related diseases among smokers," he said. "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to a 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 every year"

"The data clearly show that smokeless tobacco users have, at most, about the same risk of dying from mouth cancer as automobile users have of dying in a car wreck."

Do you really mean to lump pipe smokers into the category with cigarette smokers? It is almost impossible to inhale a pipe. Pipe smokers have been around for hundreds of years before the major smoking related diseases came into being, which was after the invention of machines that could mass-produce cigarettes.

Interesting article. What about the propylene glycol which is
a filler in e-cigarettes? Is this a dangerous substance?

Perhaps the e-cigs might be a reasonable path for nicotine replacement when we have some idea what the cartridges made in China actually have in them, and how good their manufacturing and purity controls are. That is something we do not know today.

As to Rodu, he has been (before the snus which is likely less harmful that smoking), gotten all of his funding for his research from big tobacco companies that have a vested interest in it all, and before snus an advocate for conventional spit tobacco, that does indeed cause mouth cancers. Ask Tony Gwynn about this if you don't think so. In my opinion that makes his findings suspect. I mean the big tobacco companies have never lied to us before right? They have never falsified data before either, right? They never market to our youth right? And we should trust them today?

I vote for the FDA to take a look at e-acigarettes, and if they find them safe that they be added to the armamentarium of tobacco cessation products. Snus while certainly safer than burning plant material, does not free you up from really ugly gum disease and other issues. Something that Rpdu with his dental background should talk about in his presentations (along with where his funding comes from). Is that better than getting lung cancer? You Bet. But less harmful, is not harmless.

It's too bad they are marketing dissolvable and other smokeless to kids. But early addiction is a good business model. And Rodu and his "paid for by big tobacco" chair in harm reduction, starts to look like a shill more than a researcher.

You make some great pionts with your comments,and some could be true.One comment made me upset though because i hear it so much and that is they advertise to children. I have been alive for 36 years now and through out my life i have never seen a tobacco advertisment directed towards kids.I and alot of my friends, also people have have asked say they started using because of friends, parents, siblings, or other family members but not once have they ever said they seen a comercial or advertisement thats made them try it.'besides (Joe Camel) I can,t think of any other advertisement they could be seen as kid friendly but even that cartoon for camel had adult themes like alchol and women in it. I didn't see any with toys or anything associated with kids so i cant see where even that can be said to be directed towards kids.Also since the ban of comercials that advertise tobacco, the snus or dissolvable tobacco just came out so i can't see were they can target kids with that. If Im wrong in this give me some exaples that are lagit to change my mind

The nicotine delivery system of cigarettes is what made them so dangerous.

E-cigs can really work, but you need to find a reliable product: my husband pays extra for vegetable glycerine based nic juice from England, where harm reduction is more common, so such products are more carefully regulated.

The vaporizer is technically not a cigarette and the juice is not actually a tobacco product per se.

My very addicted husband has left cigarettes behind for good thanks to the vaporizer. However these products need to be disassociated with the stigma of cigarettes and also need to be more fully appreciated by nonsmokers as something that is relatively safe (certainly safer than alcohol or prescription drugs...which are both consumed and are dangerous) both to the user and those around him.

The damning of nicotine generally is a distraction and far too many people think that nicotine causes the lung cancer.

In a similar vein, holding a BB gun to your head and pulling the trigger would give you a much better chance of survival than doing the same with a .38 Special, but is that what you would advise a person who is thinking about putting a gun to his head? Rodu will have many more dental patients if he convinces smokers to start jamming tobacco into their mouths instead of abstaining from tobacco; this is an obvious conflict of interest for a dentist. His remark that "tobacco abstinence is unattainable and unnecessary for many smokers" is bogus, too; people who think that have not figured the situation out for themselves and have not received the right counseling. If he means insane people who smoke, then I would be more likely to agree with him; they shouldn't have matches or lighters anyway.

E-cigarette instead of cigarettes....Is it like choosing the lesser evil?

Brilliant article. If people were to open their eyes they could see how much better smokeless tobacco is. Unfortunately, we're brought up in a black/white society where it must be all or nothing. P.S. If you're not addicted to nicotine or have ever been addicted to nicotine, then your opinion has no place in this article.

What idiot wrote this article!!! My broter in law had mouth cancer and is feeding himself with a tube in his stomach!!! Can't eat regular food!! Only liquids!! Tell it like it really is!!DUMB ASS!! What some pictures to show!!! E Cigarettes are only making some JERK RICH just like the cigarette companies got rich!! Try eating fruits or nuts when cravings call!! Stop making these Jerks rich!!!

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