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Cancer centre urges smokers to switch to smoke-free tobacco

Wed 2nd November, 2011

The National Cancer Institute at the National Institutes of Health in the USA is urging smokers to swap their cigarettes for smokeless tobacco. 

Supporters of the “Switch and Quit” campaign say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do.

“We need something that works better than what we have,” said Dr Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which supports the effort along with the University of Louisville. “This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried.”

Brad Rodu, a professor of medicine at the University of Louisville, analyzed the 2000 National Health Interview Survey and found that male smokers who switched to smokeless tobacco were more likely to quit smoking than those who used nicotine patches or gum.

“Americans are largely misinformed about the relative risks. ... They think smokeless tobacco is just as dangerous,” Rodu said. “This level of misinformation is an enormous barrier to actually accomplishing tobacco-harm reduction because if people believe that the products have equal risk, there’s not a real incentive.”

The 'Switch and Quit' campaign is funded through Rodu’s research money, which includes grants from the tobacco industry. “There’s absolutely no influence whatsoever,” Rodu said. “I decide, along with my colleagues, how we use the money, for what projects, and this is entirely the case. I would not have a situation where there was some control over the kind of projects I undertake.”

Tobacco companies are barred by federal law from explicitly marketing them as less risky than cigarettes. That means the “Switch and Quit” programme can do something the tobacco industry itself cannot: claim that smokeless tobacco has a health benefit when compared to smoking.

The programme has raised concerns among some in the public health community who say organizers are claiming smokeless tobacco is a healthier alternative to smoking without approval from the Food and Drug Administration.

A 2009 law gives the FDA authority to evaluate health risks of tobacco products and approve those that could be marketed as safer than what’s currently for sale. None have been given the OK yet. The FDA also plans to regulate electronic cigarettes, battery-powered plastic and metal devices that heat a liquid nicotine solution in a disposable cartridge, creating vapor that users inhale.

The campaign runs counter to the prevailing opinion of the public health community, which holds that there is no safe way to use tobacco. 

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the program “a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine.”

Myers said more research is needed before anyone should suggest that the nation’s 46 million smokers would be better off using smokeless tobacco. In the meantime, he said, there are a host of FDA-approved products that can help people give up smoking.

“There’s a right way and a wrong way to determine whether smokeless tobacco can and should be marketed as a way to help people quit,” Myers said.

The tobacco industry sees smokeless tobacco as its future, said Matthew J. Carpenter, a psychology professor at the Medical University of South Carolina who is conducting a nationwide 1,250-person study to look at whether being given a snus product changes the habits of smokers who are not motivated to quit.

Carpenter said the snus study will examine what smokers do when given smokeless tobacco. He won’t look at the health effects, or advise smokers to use the snus to quit.

“They are probably safer than conventional cigarettes, if for no other reason than you’re not burning anything, you’re not smoking anything, you’re not inhaling any smoke,” he said.

“If you compare it to conventional cigarettes, they’re probably a little bit better. If you compare it to quitting, they’re absolutely worse.”

Source: Owensboro Messenger-Inquirer (29 October 2011)

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