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From Science to Practice

Statistics from the CDC indicate that more than 1.5 million smokers have used smokeless tobacco to quit smoking. The transition is possible because the spike of nicotine that addicted smokers seek is effectively delivered by smokeless tobacco. Furthermore, newer smokeless tobacco products are essentially invisible in use, as they occupy no more space than a breath mint or a piece of chewing gum. A small pre-packaged pouch of tobacco is tucked discreetly between the cheek and gum, where it delivers nicotine across the lining of the mouth. Spitting, once the stigma of outmoded and bulky "chewing" tobacco, is minimal or nonexistent. We recently published the first profiles of a group of "switchers." They came from all walks of life and switched to smokeless tobacco after smoking many years (25 years on average) Some switched to smokeless after months or years of abstinence and continuous craving. The transition proved stable in this group, as the average duration of smokeless tobacco use after quitting smoking was 9 years.

What do switchers accomplish? Our research shows that they will live on average as long as those smokers who quit nicotine altogether. They reduce their risks for smoking-related illness and death, which is the goal of all existing smoking cessation efforts. There is, of course, no debate about the ideal way to achieve this goal: complete tobacco abstinence. But that ideal is not always attainable, since many smokers are unable to give up nicotine. Switching to smokeless tobacco is a small compromise with the ideal which reaps large individual and public health gains.

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