Safe Substitute for Cigarettes? Go Smokeless

Reprinted with Permission from The Pittsburgh Tribune-Review, May 1, 1998

As President Clinton and Congress prepare to impose their version of a national tobacco settlement on American tobacco users, one very relevant fact has been overlooked: All tobacco is not created equal with regard to health risks. Smokers burn tobacco and inhale the smoke in order to get nicotine. The smoke -- not the nicotine -- is the problem, as it contains 3,000 other chemicals that deliver substantial risks for cancer, heart disease and emphysema. In contrast, smokeless tobacco users get the same nicotine kick, but research shows that smokeless use is 98% safer than smoking.

Just how safe is smokeless tobacco? On average, after five or six decades of continuous use, thirteen smokeless users in 100,000 will die of mouth cancer. This research was published in 1981 in no less than the prestigious New England Journal of Medicine.

There is reason to believe that this is a high estimate of smokeless tobacco's risk. In the seventeen years since the mouth cancer risk was published, carcinogen levels in American smokeless products have dropped a whopping 70% according to independent research published by the American Health Foundation.

There's even better news, according to new epidemiologic research appearing last week in Cancer, published by the American Cancer Society. The medical journal reported that there is no association of smokeless use with mouth cancer in Sweden, despite its widespread use by 15% of Swedish men. In fact, smoking-related deaths in Swedish men are the lowest of any developed country, primarily because smokeless tobacco has been substituted for cigarette smoking in Sweden through most of this century.

Unfortunately, this news will not be good enough for strident anti-tobacco activists, who insist that tobacco can never be made absolutely safe. However, it is unreasonable to impose a higher level of safety from tobacco use than would be expected from other common activities.

Consider, for example, automobile travel. The National Safety Council reported 43,300 deaths resulting from motor vehicle accidents in 1996. With virtually every one of the 260 million Americans "exposed" to the risks of auto travel, the death rate due to accidents is about 17 per 100,000 people each year. In other words, smokeless tobacco use (at 13 deaths per 100,000 users per year) is safer than car travel (17 deaths per 100,000 users per year).

Smokeless tobacco is not only demonstrably safe; newer products can be used invisibly. This is a pleasant surprise to most Americans, for whom the "spitting" image has characterized smokeless use for decades. But the image is changing: the Centers for Disease Control and Prevention reports that as many as 2 million Americans have quit smoking successfully by switching to smokeless tobacco.

There are 46 million smokers in the U.S., and many of them are unable to quit, despite a strong desire to do so. Consequently, more than 400,000 Americans each year continue to smoke...well, until they die. Effective and safe alternative sources of nicotine such as smokeless tobacco mean that smokers can no longer be portrayed as manipulated, enslaved or otherwise helplessly victimized by the tobacco industry. Smokeless tobacco, just like seatbelts, airbags and antilock brakes for automobile users, can be a life-saving alternative for today's inveterate smokers.