Q. In your column about switching to smokeless tobacco from smoking, you missed the most important piece of information. Current studies show that switching from smoking to smokeless tobacco is almost as good as quitting. So argue against smokeless if you want to, but if you convince that person to give it up, and he ends up going back to smoking, you have just helped him increase his risks of disease dramatically.
This question made me re-examine everything I had researched about smokeless (chewing tobacco, snuff or lozenges). I learned a lesson worth sharing: even the most reliable sources are capable of misleading you. Some of the subterfuge is unconscious and often well-intentioned, but, in any case, the truth is not served.
First, here's some of what I reported in my earlier column:
The chances of getting a variety of cancers increases with the use of smokeless tobacco. These cancers can grow in your mouth, throat, esophagus, kidneys and pancreas.
Smokeless tobacco puts more nicotine in your blood than cigarettes. The nicotine makes smokeless tobacco addictive.
In 1986, the U.S. Surgeon General concluded that the use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous conditions and can lead to nicotine addiction and dependence.”
Since 1991, the National Cancer Institute, a part of the National Institutes of Health, has officially recommended that the public discontinue the use of all tobacco products.
Nowhere in the column did I compare the risks of smokeless tobacco to smoking. Why? Because I fell into the “quit-or-die” trap of political correctness that almost all the health authorities seem to set for you. There's a reluctance to say what is obvious when you look closely at the facts:
Smoking is horrendous for your health. Smokeless tobacco has health risks, but they are dwarfed by the risks of smoking. If you can't quit smoking any other way, it is in your self interest to switch to smokeless tobacco. It could save your life. To be reluctant to provide this information is wrong.
Britain's Royal College of Physicians, one of the world's most prestigious medical societies, issued a report on tobacco regulation in the United Kingdom called "Protecting Smokers, Saving Lives." This report marked the first time a major health organization acknowledged that products like smokeless tobacco are safer than cigarettes. Here's what the report said:
“As a way of using nicotine, the consumption of non-combustible tobacco is of the order of 10–1,000 times less hazardous than smoking, depending on the product. Some manufacturers want to market smokeless tobacco as a 'harm reduction' option for nicotine users, and they may find support for that in the public health community.”
Snus, a Swedish version of snuff that comes in teabag-like pouches, is especially attractive to smokers because it produces nicotine levels comparable to smoking. Snus does not require spitting.
The health benefits of snus are impressive. Forty percent of Swedish men use tobacco products, yet Sweden has the lowest rate of lung cancer by far. Why? Largely because of snus, which represents half of all the tobacco that Swedish men use. (The other half smoke.) Snus has not caught on with women.
I want to emphasize that smokeless tobacco is harmful and, frankly, disgusting. No one should start the habit if they don't have a nicotine addiction. But, it's a possible alternative to smoking if nothing else works. That's the whole truth.