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Smokers need the facts on alternatives

The U.S. House of Representatives already has passed and the Senate this week will debate legislation that would give the FDA regulatory authority over all tobacco products. That will be a mistake.

According to the American Association of Public Health Physicians, the bill "will do more harm than good in terms of future tobacco-related illness and death."

While the AAPHP favors "effective federal regulation of the tobacco industry &ellipses; this bill does not meet this standard." The bill is supported by medical groups that are engaged in a crusade against the tobacco industry. That's the problem: In a blind desire to kill tobacco manufacturers, the bill may end up hurting smokers.

The legislation would prohibit manufacturers from disclosing to consumers the fact that cigarettes are far deadlier than smokeless products. Consumers need to know that hundreds of thousands of American smokers have used smokeless tobacco to quit smoking. According to a panel of tobacco research experts, up to 4 million more would quit if smokeless tobacco were appropriately marketed.

Smokeless tobacco works as a cigarette substitute because it delivers satisfying doses of nicotine, a substance that is addictive but doesn't cause any smoking-related disease. Unlike cigarettes, smokeless doesn't cause lung cancer, heart disease or emphysema. The health risks from smokeless are only about 1 to 2 percent of those of smoking. Statistically, lifelong smokeless users have about the same risk of dying from that habit as automobile users have of dying in a car wreck.

Just as seat belts, airbags and anti-lock brakes are harm-reduction measures for automobile users, switching to smokeless is a form of tobacco harm reduction, a practice that has been endorsed by prestigious medical organizations like the British Royal College of Physicians and the AAPHP.

In 2007, the Royal College concluded that "smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved."

Last year, the AAPHP formally adopted a policy of "encouraging and enabling smokers to reduce their risk of tobacco-related illness and death by switching to less hazardous smokeless tobacco products."

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. As a result, they have the lowest rates of lung cancer and of all smoking-related deaths in the developed world.

Swedish women are switching, too. Modern smokeless products, available as mini-packets or dissolvable tobacco pellets, can be used invisibly, with none of the spit or stigma of old-fashioned chewing tobacco.

Alternative tobacco regulation bills containing harm-reduction provisions have been introduced in the House and the Senate.

The Senate bill, co-sponsored by Republican Richard Burr and Democrat Kay Hagan, has been attacked by anti-tobacco extremists as protective legislation for North Carolina-based RJ Reynolds. This is not only an insult to Burr and Hagan, it is a sad disservice to Carolina smokers. The Burr-Hagan legislation would require federal authorities to establish a comparative ranking of the health risks of different tobacco products. This would provide smokers with valuable information about safer smokeless alternatives.

North Carolina smokers desperately need this information. In North Carolina, 23 percent of adults smoke and 11,700 die each year from smoking-related diseases. If all of the state's smokers instead had only used smokeless tobacco, 11,400 of those lives would have been saved.

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. Congress needs to help them by passing tobacco legislation that codifies tobacco harm reduction and gives smokers the information they need to lead longer and healthier lives.

Brad Rodu is a professor in the School of Medicine at the University of Louisville.