STIER/RODU: To stop going up in smoke

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By Jeff Stier and Brad Rodu

COMMENTARY:

"Quit smoking" should be the No. 1 New Year's resolution for 45 million Americans. What a shame if Congress stands in their way.

Most smokers know setting tobacco on fire puts their lives in jeopardy, but for them, the risk of dying can't compete with the immediate dread of living without nicotine, a powerfully addictive substance.

Over the last 15 years, 6 million American inveterate smokers - those who couldn't quit - died from lung and other cancers, emphysema, heart disease and stroke. Conventional, abstinence-oriented, quit-smoking tactics don't help inveterate smokers. Pharmaceutical nicotine - in the form of pills, patches and gum - is advertised as a proven and effective cessation aid, but research shows it helps only about 7 percent of smokers. If any other medicine had a success rate that low, it would be labeled a failure.

Early this year, if anti-tobacco activists get their way, Congress will pass a tobacco regulation bill that codifies and perpetuates failed tobacco policies. The pending Kennedy/Waxman bill conceals the fact that cigarettes are vastly deadlier than smokeless products and it prohibits manufacturers from truthfully disclosing this marked difference to consumers. The bill ignores science-based tobacco harm reduction involving substituting safer smokeless tobacco products for cigarettes.

Tobacco harm reduction has been enthusiastically endorsed by prestigious medical organizations like the British Royal College of Physicians and the American Association of Public Health Physicians. These societies recognize that smokers who switch to smokeless can achieve almost all the health benefits of tobacco abstinence while obtaining almost all the satisfaction of smoking.

Smokeless tobacco products are at least 98 percent safer than smoking. While no tobacco product is completely safe, the majority of cigarette smokers are routinely misinformed - by government agencies and by anti-tobacco extremists - about the relative safety of smokeless products. Unlike cigarettes, smokeless doesn't cause lung cancer, heart disease or emphysema. And what about mouth cancer - a deadly disease commonly linked to smoking? Statistically, users of smokeless tobacco have about the same small risk of dying from mouth cancer as automobile users have of dying in a car wreck.

Tobacco harm reduction has worked in Sweden. For 50 years, smokeless use has been directly associated with low smoking rates there; Swedish men smoke less than those in any other developed country. The result is that Swedish men have the lowest rates of lung cancer and of all smoking-related deaths in the developed world.

And Swedish women are switching too. The reason: Modern smokeless products, available as minipackets or dissolvable pellets of tobacco, can be placed invisibly inside the upper lip, with none of the spit or stigma of old-fashioned chewing tobacco.

This month, Congress will have an added incentive to produce legislation to help American smokers: President-elect Barack Obama wants to quit smoking. He is in a position to demand that the bill contain scientifically sound provisions for tobacco harm reduction. As president, he should direct federal agencies to make and keep a New Year's resolution to end the campaign of misinformation that irresponsibly misrepresents scientific information about the use of smokeless products. The Surgeon General, the Centers for Disease Control and Prevention and the National Institutes of Health have been conducting a war against tobacco manufacturers, rather than focusing on proven and practical measures to reduce smokers' risks.

If any other consumer product was as dangerous as cigarettes, society would demand safer alternatives, and it would be scandalous if consumers were denied them. American smokers are literally dying for ways to step away from the fire, and they deserve information about effective, safer smokeless substitutes. Let's give them the facts, and a healthier New Year.

Jeff Stier is associate director of the American Council on Science and Health. Brad Rodu is professor in the University of Louisville Department of Medicine and holds the university's endowed chair for tobacco harm reduction research.