Monday, January 12, 2009

Dip, Don't Puff

In his on-going battle against mis-information in the News-Record's LTE section, Roch Smith can be forgiven if he misses today's letter from Ted Eaves on the health effects of smokeless tobacco compared to cigarettes. While not factually incorrect, the letter's premise is wrong. Smokeless tobacco is much safer than smoking cigarettes. A quick google search brings up this paper as one source on a study of the relative risks of dipping vs. puffing.

"There is no doubt that Western smokeless tobacco products are substantially less harmful than smoking cigarettes (notwithstanding certain recent high-profile statements by a certain high-profile official from this state). Even with the worst case scenario supported by the research, ST is in the order of 1/100 as likely to cause life-threatening disease, and the best estimates for the true value for modern moist snuff, the most popular product, are lower still. Smoking cigarettes is a well established cause of many diseases and is widely described as the largest theoretically) preventable source of premature mortality. ST, by contrast, has mostly been linked to risk for only one relatively rare life-threatening disease, oral cancer. Even that link is tenuous, based largely on a single study by Winn et al. (1981).

"The negative health implications of preventing people from realizing that smokeless tobacco is relatively safe should not be underestimated. Smokeless tobacco users are told, in effect, that they might as well switch to smoking if they find they enjoy it a bit more or it is more convenient. The much larger population of smokers is told, in effect, that they cannot use tobacco in a relatively safe way, a message that is often characterized as "quit or die." It is extremely difficult for anyone to deliver the harm reduction message in the face of the widespread misperception that is fueled by the misinformation. At this point, we can only speculate about how many smokers would take advantage of this opportunity to reduce their risk by two orders of magnitude or more."

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