Jump to content

Cigarette stand-ins: a safer addiction?

Recommended Posts

http://seattletimes.nwsource.com/html/h ... ree30.html

Cigarette stand-ins: a safer addiction?

By Valerie Reitman

Los Angeles Times

A growing number of anti-smoking researchers and public-health advocates are adopting a tack that not long ago would have been considered heresy: suggesting that hard-core smokers who can't kick the habit would be better off switching to new smokeless tobacco products.

With slogans such as "Spit-free" and "For when you can't smoke," these products differ markedly from the messy snuff and chewing-tobacco stereotypes associated with your granddaddy's spittoon or certain pro baseball players' stuffed cheeks.

They are clean, discreet, last about 30 minutes and come in mint, wintergreen and other flavors. Some go down easily, dissolving much like a breath mint, while others look like tiny tobacco-filled teabags, tucked into the side of the mouth and discarded like chewing gum.

Though no one is calling the products "safe" — any tobacco that has been cured contains some carcinogens — numerous epidemiological studies have shown that smokeless tobacco is far less likely to cause any type of cancer, including oral cancer, than cigarettes.

"If someone can't quit smoking, there is no question that smokeless is much safer. It doesn't cause heart or lung disease, and if it does cause cancer, it does so at a much lower rate," said Dr. Neal Benowitz, a professor of medicine at University of California, San Francisco, and director of its cancer center's Tobacco Control Program.

Gary Giovino, director of the Tobacco Control Research Program at the Roswell Park Cancer Institute in Buffalo, N.Y., agreed. "If everybody who smoked used these instead, there would be less disease."

Many Americans may be unaware that most scientists and researchers say that smokeless tobacco is less hazardous than cigarettes in causing deadly disease. That's not surprising. For years, some private and government medical organizations have disseminated outdated information on the subject. For instance, the Mayo Clinic in Rochester, Minn., recently acknowledged that information on its Web site was incorrect and would be revised.

Though some information on the Centers for Disease Control and Prevention's Web site was modified after one prominent researcher protested it, the agency, part of the U.S. Department of Health and Human Services, takes the position that "there is no safe form of tobacco" and that there "is no significant evidence that suggests that smokeless is a safer alternative to smoking," spokeswoman Karen Hunter said.

Some tobacco researchers contend the misinformation hinders individuals from making educated decisions about whether to switch to smokeless products. "I think it's not scientific and is a deception," said Lynn Kozlowski, who heads Pennsylvania State University's biobehavioral health department. "What the studies show is that in the U.S., smokeless causes oral cancer but that cigarettes are even more likely to cause oral cancer."

With names that include Ariva and Stonewall, both made by Star Scientific Inc., and Revel, made by the U.S. Smokeless Tobacco Co., which also makes the Copenhagen and Skoal brands, the new products have been rolled out in a few U.S. cities and are also available from their manufacturers' Web sites. They promise to deliver the nicotine fix smokers crave and take the edge off the physiological urge to light up.

Smoke worse than nicotine

Although the nicotine in cigarettes is powerfully addictive, it is the cigarette smoke — not the nicotine — that delivers the killer punch, possibly producing as many as 60 known carcinogens and about 5,000 other chemicals. Studies show that many people still believe that it is the nicotine that is the harmful element.

Brad Rodu, an oral pathologist at the University of Alabama, said nicotine should be treated more like caffeine: as an addictive drug that can be used safely. (His "tobacco harm-reduction" research is funded by a five-year grant from U.S. Smokeless.) "We would have smokers understand the nicotine addiction can be separated from the smoking."

Many public-health advocates fear that providing smokers with alternative products will keep them from quitting altogether, the healthiest option.

They also fear that some nonsmokers might start using them and, if they do, that the nicotine will encourage them to start smoking.

Some of this concern stems from the difficulty in knowing the long-term hazards of substitute products as well as the distrust of the tobacco companies based on past claims.

For example, in 1981, the U.S. Surgeon General recommended that smokers who couldn't quit would be better off switching to "low-tar" or "light" cigarettes because they were less likely to develop smoking-related illnesses. Instead, smokers were found to puff harder and inhale more deeply to compensate, thus taking in an equal amount of tar or more. Internal documents revealed that the cigarette makers knew that to be the case all along.

Kenneth Warner, director of the University of Michigan Tobacco Research Network, said he was convinced that the promise of reduced risk kept tens of thousands smoking rather than quitting — undoubtedly hastening many deaths. Nearly three years ago, the National Cancer Institute charged that light cigarettes did nothing to lower smokers' health risks.

Worries about teenagers

Among the largest fears is that teenagers will get hooked on smokeless products, then switch to smoking when they realize that cigarettes deliver a faster and more powerful hit of nicotine.

Greg Connolly, former director of the Massachusetts Tobacco Control Program, said kids who start on smokeless tobacco were three times more likely to go on to smoking cigarettes — and that some smokeless companies had deliberately targeted teenagers. He agreed that the newer products are less carcinogenic and probably safer to use but said the new products were not being aggressively pushed by their makers. Instead, the more carcinogenic, dirtier discount brands of smokeless products are growing in popularity.

"I'd be the first to say the new products are safer," Connolly said. "But I don't want them to be hurting our kids. This is an industry you can't trust."

The push for safer alternatives comes amid mounting gloom about smoking. Although cigarette smoking has declined dramatically from its peak in the 1960s, it has leveled off in the past decade. About 46 million Americans — 22 percent of adults, according to the CDC — still light up each day despite aggressive public-education campaigns, heavy cigarette taxes to make them less affordable, significant social stigma and widespread smoking bans in public places. An estimated 10 million Americans use smokeless tobacco.

It's a very tough habit to break — tobacco researcher and former smoker Giovino calls quitting "a toothache in the soul." Although 70 percent of smokers say they want to quit and 34 percent of them attempt to do so each year, only 10 percent manage to stay smoke-free for a year, according to the Institute of Medicine.

"We are not promoting tobacco use," the University of Alabama's Rodu said. "But we have a reality of 46 million smokers, and they now have only one option: to quit. It's quit or die."

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Reply to this topic...

×   Pasted as rich text.   Restore formatting

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Create New...

Important Information

By using this site, you agree to our Terms of Use.