Blowing Smokeless
Smokeless tobacco is 98% less likely to cause cancer than the smokeable kind, writes Jacob Sullum, in Reason, but that's not what the liars at the CDC will tell you:
In the U.S., where smokeless tobacco remains legal, this approach takes the form of a misinformation campaign that encourages people to think oral snuff is just as dangerous as cigarettes. That belief, which seems to be widely accepted by smokers, is clearly wrong.Based on the incidence of tobacco-related deaths among users, University of Alabama at Birmingham oral pathologist Brad Rodu estimates that smokeless tobacco is 98 percent safer than cigarettes. The difference is so stark that public health officials have been forced to quietly retreat from their false risk equivalence.
Last year, for instance, Surgeon General Richard Carmona told a congressional subcommittee "smokeless tobacco is not a safer substitute for cigarette smoking"—a claim that is scientifically unsupportable. But in the version of his testimony that appears on the Web site of the Centers for Disease Control and Prevention, he says "smokeless tobacco is not a safe alternative to cigarettes"—the same true but misleading warning that appears on oral snuff packages.
Similarly, a CDC Web page aimed at children asks, "Is smokeless tobacco safe?" The answer: "No way!" But the search listing for the page shows that the question used to be, "Is smokeless tobacco safer than cigarettes?" I suspect the CDC's answer was not "You bet!"
Perhaps the most telling recent change in the official line on smokeless tobacco was made to a pamphlet published by the National Institute on Aging. When I looked at the online version of the pamphlet in March, it said: "Some people think smokeless tobacco (chewing tobacco and snuff), pipes, and cigars are safer than cigarettes. They are not." The passage now reads: "Some people think smokeless tobacco (chewing tobacco and snuff), pipes, and cigars are safe. They are not."
This change came in response to a March 16 complaint from the National Legal and Policy Center arguing that the pamphlet violated the Data Quality Act by disseminating erroneous information. Among other sources, the complaint quoted a 2001 report from the National Academy of Sciences that said "the overall risk [from smokeless tobacco] is lower than for cigarette smoking, and some products such as Swedish snus may have no increased risk" (because they're especially low in carcinogens).
The fact that public health officials seem less inclined to tell outright lies about smokeless tobacco is a small victory. They are still obscuring the issue by doggedly repeating that smokeless tobacco is not risk-free when the relevant point for a cigarette smoker who is thinking about switching is that it's much less likely to kill him than his current habit.
Why let the truth get in the way of perfectly good propaganda?!
Does it cause heart disease?
PS- In Indiana, smokeless tobacco, when consumed by others, makes you want to move to California.
Cridland at December 27, 2004 4:44 PM
Dunno, but I would imagine it doesn't, since, isn't smoking, not tobacco, that's the problem? Still, oral cancer is a risk, and getting half one's face amputated isn't going to improve one's looks -- in most cases.
Amy Alkon at December 27, 2004 6:07 PM
Back in the early '90s, just before the big cigar craze really peaked, I did a story about cigar smoking for a weekly in San Diego. I interviewed the local spokeswoman for the American Cancer Society. She had absolutely no concern about moderate cigar or pipe smoking. She faxed me, on ACS letterhead, information on studies that showed moderate pipe and cigar smoking -- the kind of smoking true aficionados engage in -- poses no serious cancer risk.
Within a year, the American Cancer Society began to campaign against cigars, and the same source was quoted about the horrors of cigars.
Why the change? Well, you can't raise money if you don't have something to scare people with.
Howard Owens at December 27, 2004 7:20 PM
Good to have you back. Yeah, when they say it's the principle, it's always the money. Think of people who might be more likely to get cancer because the don't know the truth. Disgusting.
Amy Alkon at December 27, 2004 8:08 PM
> getting half one's face amputated isn't going
> to improve one's looks -- in most cases.
Again, Amy, in southern Indiana....
Cridland at December 27, 2004 9:42 PM
hmmm...point taken!
Amy Alkon at December 27, 2004 11:35 PM
Just a few quick comments from what little I know:
First, cigarette smoking is much worse than smokeless tobacco products because of the chemical milieu (high temperature, low oxygen content) that leads to incomplete oxidation of organic compounds. Without delving too much into organic chemistry, it makes compounds that have unstable bonds that are apt to attack cell structures (including DNA), therefore potentially leading to cancer. Smokeless products deliver the nicotine without giving you a bulk of the carcinogens that go along with it.
However…
A drug via the lungs is the most effective way to deliver a dose, hitting the brain in seconds (why smoking crack is so much more addictive than injection). In order to get that ‘hit’ of nicotine, smokeless products include ‘irritants’ in their formulations (fiberglass use to be used in small amounts, although I don’t know if it still is). Regardless, by roughing-up the oral mucousa you get better transbuccal delivery, therefore, a higher level of blood nicotine at a faster rate (and a better ‘hit’). Nonetheless, tobacco contains lots of organic compounds that are carcinogens without the high temperature conversion to something more potent. The combination of rapid cell turnover (from the irritants) and carcinogens that cause DNA bloopers you get a greatly increased incidence of oral cancer. But no, not as high as you would get with smoking.
Doc Jensen at December 28, 2004 3:40 AM
Thanks, Doc. Much appreciate the scientific explanation. And I do have a writerfriend who uses Nicorette as his Ritalin, so it must have at least some kick.
Amy Alkon at December 28, 2004 4:38 AM
Hi, regarding your friend who uses Nicorette as a stimulant instead of Ritalin... is that prevalent in LA and the entertainment industry? Is it like pharmaceutically safe, mild cocaine? Not that there's anything wrong with that.
Jessica at December 28, 2004 10:50 PM
That friend is a fellow sufferer at the keyboard, in the journalistic end of things. I'm not a doctor -- you'll have to ask Doc Jensen to be sure, if he comes back to this item -- but I don't recall nicotene being the problem so much as the smoke. I believe that's kind of what the Doc says above, actually.
Amy Alkon at December 28, 2004 11:38 PM
As for nicotine as a pharmaceutical, the studies I remember indicate that it not only acts stimulant but also enhances memory for a short time thereafter. Overall, it kind of takes a shotgun approach to the receptors it activates (because of where and how it activates them): activation of the sympathetic system (fight-or-flight) increase heart rate and blood pressure, cause release of adrenaline; parasympathetic system (relax and digest) speeding up the function of the bowels and increasing secretions; as well as a bunch of unrelated and boring effects. As for all the hand-waving regarding nicotine as addictive as heroin (one I have heard often) what I have seen and read makes me think more a habituation to the act of smoking along with a pharmacological response than a true dependency (i.e. cocaine, valium-like drugs, barbiturates, heavy use of alcohol = ones that change your physiology that create dependence on it for said semi-normal physiologic function). Nicotine does not do that. It is for the most part a stimulant (but packs more of a punch than caffeine). However, nicotine is a toxic compound in high enough doses. So is caffeine. And water.
As for my personal experience with pure nicotine: before medical school I use to work as a chemist in a pharmaceutical lab, where I worked on the delivery of drugs across the mucousa of the mouth (hence the last post). The only thing a 2 mg dose (the usual amount in a single cigarette) did was to give me a bad case of the hiccups for the next hour. One of my supervisors (also a non-smoker) tried the 16 mg dose and said he spent the next half hour retching in the garbage can (nicotine also can directly activate the part of the brain that says “throw-up now!”). Ah, those were the days!
Doc Jensen at December 29, 2004 2:13 AM
Actually, for information on addiction, there's a link in the Carlin entry of December 28...to Stanton Peele's work...which I believe confirms your contention above, Doc J. Good to have you back. Especially since you're especially qualified to weigh in on this. I'm a Ritalin girl myself. Concentration vitamins, I call them. Luckily, I've been diagnosed as a scattered mess -- uh, ADHD -- so I don't have to buy them on the street corner or anything. I'm still not organized. I'm just more focused in my disorganization!
Amy Alkon at December 29, 2004 2:24 AM