Tobacco Documents Online

COMMENTARY' Sunday~ January 12~ 2003 Anti-tobacco group opposes lifesaving data By BRAD RODU and PHIUP COLE When the history of tobacco public policy is written, Dec.. 10, 2002, will stand as a land- mark. On that date, Britain's Royal College of" Physicians, one of the world's most prestigious medical so- cieties, issued the report "Protecting Smokers, Saving Lives," which was fo- cused primarily on tobacco regulatory policy in the United Kingdom. But the British report has enorinous impllca- lions for American tobacco policy, because it represents the first ac- knowledgment by a health organiza- tion that products such as smokeless tobacco are safer than cigarettes. The report states: "As a way of.us- ing nicotine, the consumption of noncombustible (smokeless) tobacco is on the order of 10-1,000 times tess hazardous than smoking, de'pending on the product." The report continues with an even bolder statement, acknowledging that some smokeless tobacco manufactur- ers may want to market their prod- ucts "as a 'harm reduction' option for • nicotine users, and they may find support for that in the public health • .But some tobacco-control .adve- catos in the United States wish to deny srnoke~s this lifesaving infarma- lion. They asked Dr. Richard Car- mona, the newly appointed U.S. sur- geon general, to join them in opposing any such marketing strat- egy, urging him instead to "reinforce the health benefits of not using any form of tobacco." They are prohibitionists, obsessed with tobacco abstinence and with a public health strategy:. Quit smoking or die. Inveterate smokers are irre- versibly addicted to nicotine and.can- not quit. So, according to the federal Centers for Disease Control and Pre- vention, 440,000 Americans die each year from diseases caused, by smok- ing, The toll in Alab .arua is.more than 7,200. Prohibitionists control the Ameri- can anti-smoking campaign, and they are not inclined to help inveterate smokers. They effectively stifle Juno- ration by transforming every dis- cussion of tobacco control into a children's issue, a tactic carried to tteme lengths by the Campaign for Tobacco-Free Kids. Eliminating child- ren's access to tobacco ".~ important, but the I0 million Americans who will die from their habit over the next two det~___es are not now chikiren. They • re adults. Prohibitionists offer these inveter- ate smokers only "behavior therapy" and the temporary use of expensive replacement products (gum and patches) that provide an insufficient dose of nicotine to allow smokers to quit permanently. This tired qnit-or- die tactic has a long record of over- whelming failure. Prohibitionists daim success by pointing to slowly declining smoking rates. But smoking rates are only derreporting ~as smokers are demo- ~ and fluctuation (as smokers try and fail to quit). They do not provide an adequate picture of smoking in so- ciety, or of the impact of smoking- control efforts. Lung cancer is a far better measure of long-term smoking because it is an index of how many ~ die. Our research shows that, by this measure, the campaign has made little progress in helping the nation's 20 million in- veterate smokers to quit. in North Carolina, lung cancer d~adas actually rose about .4 percent during the 1990s, remaifiing 9 percent above the national average. Prohibitionists emphasize that nic- otine is powerfully addictive, but they will not acknowledge the reality that it causes none of the diseases that kill ing smokers about other.effective sources of nicotine delivery such as smokeless tobacco, which is 98 per- ~nt safer than smoking. They ignore the evidence fro~ Sweden where, over the past centmT, men have smoked le~ and used more smokele~ tobacco than in any other Western country. The r~uR: ~ men have the lowest rates of lung cancer -- indeed,.of all smoking-re- lated deaths -- in the developed woflcL Smoking carries twice the risk for mouth cancer as smokeless use, so Swedish men even have low rates of • this disease as~welL The Swedes have adopted the pub- lic health practice of "harm reduc-~ tion," in this case substituting rela- tively safe smokeless tobacco ~or" cigarettes. Our research indicates that if all American smokers had instead used smokeless tobacco,, the annual tobacco-related mortality in this" country would be only 2 percent of. the current figure. That's saving about 430,000 lives per year across the country and 7,000 in Alabama, . This ieformation should bring joy to American anti-smoking advocates." But no -- many remain hostile to harm reduction and obiect vehe-" menti¥ to allowing smokeless tobacco.,. manufacturers to tell smokers the troth: That while their products may not be perfectly "safe," they are vastly. less harmful than cigarettes. Prohibit " tionists insist that the only acceptable " approach to tobacco use is no use~' whatsoever. With stable smoking" rates, this" is an approach cigarette.: manufacturers can live with. For..- more than half of inveterate smokers.,.•, it's m approach they ~ die with. - -~. Last stmunar, the American Coun--~. cil on Science and Health spofis0red ac- symposium on tobacco harm' redu~,-.'., tion~ Prohibitidnists arrogantly com- plained to ACSH that the. topic was'.. unacceptable and that only person," .funded by the tobacco industty would-. advocate substituting smokeless hacco for cigarettes. ACSH President .. Elizabeth Whelan was even threat-" ened with "excommunication" fronf. the public health' ao. ti-smoking com~ munity ffACSH ~vent forward with the" ~=debate (which it did) ..... ' The tobacco industry has been un-. " der scrutiny for 50 years -- and right-.'. fully so. Now moderate ~md tea-' sortable persons in the anti-smoking campaign, and the public at large;.' must scrutinize the anti-tobacco in-" dustry and its failed policies and." practices. It is time that those policies and practices change. -. Brad Rodu, D.D.$.; is a professor the Department Of Patholo~, at thi . University of Alabdma at Birmingham. School of Medicine. Philip Cole, M.D., b professor emefitut in the Debot- ofPub/~: H~th. .

COMMENTARY' Sunday~ January 12~ 2003 Anti-tobacco group opposes lifesaving data By BRAD RODU and PHIUP COLE When the history of tobacco public policy is written, Dec.. 10, 2002, will stand as a land- mark. On that date, Britain's Royal College of" Physicians, one of the world's most prestigious medical so- cieties, issued the report "Protecting Smokers, Saving Lives," which was fo- cused primarily on tobacco regulatory policy in the United Kingdom. But the British report has enorinous impllca- lions for American tobacco policy, because it represents the first ac- knowledgment by a health organiza- tion that products such as smokeless tobacco are safer than cigarettes. The report states: "As a way of.us- ing nicotine, the consumption of noncombustible (smokeless) tobacco is on the order of 10-1,000 times tess hazardous than smoking, de'pending on the product." The report continues with an even bolder statement, acknowledging that some smokeless tobacco manufactur- ers may want to market their prod- ucts "as a 'harm reduction' option for • nicotine users, and they may find support for that in the public health • .But some tobacco-control .adve- catos in the United States wish to deny srnoke~s this lifesaving infarma- lion. They asked Dr. Richard Car- mona, the newly appointed U.S. sur- geon general, to join them in opposing any such marketing strat- egy, urging him instead to "reinforce the health benefits of not using any form of tobacco." They are prohibitionists, obsessed with tobacco abstinence and with a public health strategy:. Quit smoking or die. Inveterate smokers are irre- versibly addicted to nicotine and.can- not quit. So, according to the federal Centers for Disease Control and Pre- vention, 440,000 Americans die each year from diseases caused, by smok- ing, The toll in Alab .arua is.more than 7,200. Prohibitionists control the Ameri- can anti-smoking campaign, and they are not inclined to help inveterate smokers. They effectively stifle Juno- ration by transforming every dis- cussion of tobacco control into a children's issue, a tactic carried to tteme lengths by the Campaign for Tobacco-Free Kids. Eliminating child- ren's access to tobacco ".~ important, but the I0 million Americans who will die from their habit over the next two det~___es are not now chikiren. They • re adults. Prohibitionists offer these inveter- ate smokers only "behavior therapy" and the temporary use of expensive replacement products (gum and patches) that provide an insufficient dose of nicotine to allow smokers to quit permanently. This tired qnit-or- die tactic has a long record of over- whelming failure. Prohibitionists daim success by pointing to slowly declining smoking rates. But smoking rates are only derreporting ~as smokers are demo- ~ and fluctuation (as smokers try and fail to quit). They do not provide an adequate picture of smoking in so- ciety, or of the impact of smoking- control efforts. Lung cancer is a far better measure of long-term smoking because it is an index of how many ~ die. Our research shows that, by this measure, the campaign has made little progress in helping the nation's 20 million in- veterate smokers to quit. in North Carolina, lung cancer d~adas actually rose about .4 percent during the 1990s, remaifiing 9 percent above the national average. Prohibitionists emphasize that nic- otine is powerfully addictive, but they will not acknowledge the reality that it causes none of the diseases that kill ing smokers about other.effective sources of nicotine delivery such as smokeless tobacco, which is 98 per- ~nt safer than smoking. They ignore the evidence fro~ Sweden where, over the past centmT, men have smoked le~ and used more smokele~ tobacco than in any other Western country. The r~uR: ~ men have the lowest rates of lung cancer -- indeed,.of all smoking-re- lated deaths -- in the developed woflcL Smoking carries twice the risk for mouth cancer as smokeless use, so Swedish men even have low rates of • this disease as~welL The Swedes have adopted the pub- lic health practice of "harm reduc-~ tion," in this case substituting rela- tively safe smokeless tobacco ~or" cigarettes. Our research indicates that if all American smokers had instead used smokeless tobacco,, the annual tobacco-related mortality in this" country would be only 2 percent of. the current figure. That's saving about 430,000 lives per year across the country and 7,000 in Alabama, . This ieformation should bring joy to American anti-smoking advocates." But no -- many remain hostile to harm reduction and obiect vehe-" menti¥ to allowing smokeless tobacco.,. manufacturers to tell smokers the troth: That while their products may not be perfectly "safe," they are vastly. less harmful than cigarettes. Prohibit " tionists insist that the only acceptable " approach to tobacco use is no use~' whatsoever. With stable smoking" rates, this" is an approach cigarette.: manufacturers can live with. For..- more than half of inveterate smokers.,.•, it's m approach they ~ die with. - -~. Last stmunar, the American Coun--~. cil on Science and Health spofis0red ac- symposium on tobacco harm' redu~,-.'., tion~ Prohibitidnists arrogantly com- plained to ACSH that the. topic was'.. unacceptable and that only person," .funded by the tobacco industty would-. advocate substituting smokeless hacco for cigarettes. ACSH President .. Elizabeth Whelan was even threat-" ened with "excommunication" fronf. the public health' ao. ti-smoking com~ munity ffACSH ~vent forward with the" ~=debate (which it did) ..... ' The tobacco industry has been un-. " der scrutiny for 50 years -- and right-.'. fully so. Now moderate ~md tea-' sortable persons in the anti-smoking campaign, and the public at large;.' must scrutinize the anti-tobacco in-" dustry and its failed policies and." practices. It is time that those policies and practices change. -. Brad Rodu, D.D.$.; is a professor the Department Of Patholo~, at thi . University of Alabdma at Birmingham. School of Medicine. Philip Cole, M.D., b professor emefitut in the Debot- ofPub/~: H~th. .