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Information embargoed until midnight on Sunday 25 June 2006
CALL TO LIFT BAN ON SMOKELESS TOBACCO
Today (26th June 2006), speaking at the UK National Smoking Cessation Conference, Jonathan Foulds, Associate Professor at the University of Medicine and Dentistry in New Jersey advocates lifting the ban on certain forms of smokeless tobacco in the European Union.
Despite being around 90 per cent (1) less harmful to health than cigarettes, most forms of smokeless tobacco are illegal in Europe and are presented by public health authorities around the world as having a similar health risk to cigarettes.
The strongest evidence for smokeless tobacco playing a potentially useful role in reducing smoking and reducing associated health problems, comes from Sweden. There, a form of smokeless tobacco - snus – is available, that is low in many toxins, but not nicotine. Snus, a moist, ground oral tobacco product, is typically placed behind the upper lip, either as loose tobacco or contained in sachets like very small teabags. It is generally held in the mouth without chewing for approximately 30 minutes before being discarded.
Whilst snus tobacco is not really any less addictive a form of nicotine product than cigarettes, it appears to have no association with cancer, or respiratory disease and to have a lower cardiovascular risk than cigarettes.(2) In addition, it can help smoking cessation and results show that smoking prevalence amongst males in Sweden has dropped from 40 per cent in 1976 to 15 per cent in 2002, following more widespread use of snus.(2)
Dr Foulds agrees that the benefits seen in Sweden would not automatically transfer to other countries, but he points out that in Sweden we have a concrete example in which availability of a less harmful tobacco product has worked to produce a reduction in smoking and a net improvement in the health of that country.
Key players amongst cigarette manufacturers have now started to take an apparently serious interest in smokeless tobacco, against the background of smokefree legislation, and companies are test marketing using their established brand names (eg Lucky Strike snus and Camel snus).
Many public health advocates have concerns about moves to smokeless tobacco, particularly as some products are still carcinogenic and all forms of tobacco cause some harm to health, especially in pregnant women. Many believe that policies that aim to reduce smoking prevalence should be the main focus of effort, without transferring smokers to smokeless tobacco. Furthermore there are concerns that the tobacco industry could market these smokeless products to people who wouldn’t otherwise use tobacco.
Dr Foulds stated that he would recommend nicotine replacement therapy rather than smokeless tobacco as an aid to smoking cessation, but he believes it’s an issue of letting much less harmful tobacco products compete with the most deadly form of tobacco - cigarettes, rather than being banned.
“For me it’s all about numbers of lung cancer, emphysema and heart attacks prevented. I’m not concerned if the rate of tobacco use remains high, any more than I am about high rates of coffee drinking, so long as the morbidity, mortality and misery are clearly going down, as has been seen with the use of snus in Sweden,” says Dr Foulds.
In accepting that we now have smokeless tobacco products available that are less harmful than cigarettes, European public health professionals and policymakers need to decide whether to focus efforts on restricting access to cigarettes, or to improving access to less harmful products, that under some circumstances produce a net public health benefit.
-ends-
Editors notes:
- The UK National Smoking Cessation Conference (UKNSCC) is the world’s largest annual gathering of smoking cessation practitioners. Held at the Sage Gateshead conference centre, this year, it runs over two days – Monday 26 June and Tuesday 27 June. Every year the conference attracts speakers from Europe, the US and New Zealand.
For more information visit www.uknscc.org
- (1) Levy DT, Mumford EA, Cummings MK, Gilpin EA, Giovino G, Hyland A, Sweanor D and Warner KE. The Relative Risks of a Low-Nitrosamine Smokeless Tobacco Product Compared with Smoking Cigarettes: Estimates of a Panel of Experts Cancer Epidemiology Biomarkers & Prevention Vol 13, 2035-2042, December 2004.
- (2) Effect of smokeless tobacco (snus) on smoking and public health in Sweden, Foulds J, Ramstrom L, Burke M, Fagerstrom K Tobacco Control 2003: 12:349-359
- Snus is manufactured and stored in a manner that causes it to deliver lower concentrations of some harmful chemicals than tobacco products, although it can deliver high doses of nicotine. Snus is manufactured by Swedish Match.
- Speakers are available for interviews and filming.
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