Some See Smokeless Tobacco as an Alternative to Cigarettes

The Centers for Disease Control and Prevention (CDC) says there is no safe form of tobacco, but some researchers and public-health advocates say smokeless tobacco products can be a less-harmful alternative for hard-core smokers who are unable to quit, the Los Angeles Times reported June 14.

“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 the University of California at San Francisco and director of the school’s Tobacco Control Program.

Several epidemiological studies have shown that smokeless tobacco is less likely than cigarettes to cause cancer, including oral cancer. “If everybody who smoked used [smokeless tobacco] instead, there would be less disease,” said Gary Giovino, director of the Tobacco Control Research Program at the Roswell Park Cancer Institute in Buffalo, N.Y.

The CDC maintains that no tobacco is safe and “no significant evidence suggests that smokeless is a safer alternative to smoking.” But Lynn Kozlowski, head of Pennsylvania State University’s biobehavioral health department, said the CDC is preventing smokers from making educated decisions about whether to switch to smokeless products.

“I think it’s not scientific and is a deception,” she said of the CDC stance. “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.”

Smokeless-tobacco companies would like to market their products as an alternative to smoking. The harm-reduction campaign in the United States also is being fueled by statistics from Sweden. In the past 40 years, a majority of male Swedish smokers switched from smoking cigarettes to using snus, a moist-snuff product. Since then, Sweden’s cancer rates, including oral cancer, have declined to the lowest in Europe.

But many U.S. public-health advocates are concerned that pushing smokeless products would encourage teen use. Once teens become addicted to nicotine, experts say, young users may switch to smoking conventional cigarettes.

“I’d be the first to say the new products are safer,” said Greg Connolly, former director of the Massachusetts Tobacco Control Program. “But I don’t want them to be hurting our kids. This is an industry you can’t trust.”