Willful blindness of our public health officials on tobacco is still killing hundreds of thousands of Americans each year.
Here are the facts:
i) There are approximately 46 million tobacco smokers in the United States.
ii) While three-quarters say they want to quit smoking, and about one-third try to quit each year, fewer than 10% succeed.
iii) The FDA-approved smoking cessation aids simply do not work: They improve quit rates only minimally, if at all, therefore …
iv) About 450,000 American tobacco nicotine addicts die prematurely each year from smoking-related causes.
The means to reduce this public health catastrophe exists: tobacco harm reduction.
The process and benefits of harm reduction are well known: reduce the adverse health consequences of a substance or behavior without demanding complete abstinence (condoms for risky sexual activity, sterile needles for heroin addicts).
By contrast, “abstinence only” demands that users renounce their substance or activity of abuse — or else.
In a perversion of science-based public health policy, the truth about effective methods to help many more smokers quit has been ignored or even suppressed by our public health authorities.
Tobacco harm reduction involves the substitution of reduced-risk nicotine-delivery products for cigarettes, allowing addicted smokers to quit smoking without forcing them to quit nicotine.
While addiction to nicotine is every bit as strong as that for heroin and cocaine, smoking-related diseases are not caused by nicotine, but by the products of tobacco combustion — the smoke — inhaled many times a day.
Just stop the smoke.
Our CDC, FDA, and associations such as the American Cancer Society ignore sound science and epidemiological evidence from Sweden about the documented benefits for smokers of a product called snus.
This type of smokeless tobacco has been shown to increase cessation rates for Swedish men and accounts for the lowest rates of smoking and smoking-related diseases in Europe.
Snus is neither chewed nor spit: it comes in small teabag-like sachets placed between teeth and gum, then discarded after some minutes.
Contrary to official mythologies, snus is not associated with increased risks of cancer: neither oral nor any other type. It does not cause heart disease, and obviously does not contribute to COPD or second-hand smoke.
Another, newer technology which is rapidly attracting desperate smokers is the electronic cigarette (e-cigarette), which delivers nicotine-containing vapor from a cigarette look-alike when puffed.
But again, our guardians of public health have recoiled from the method and attempted to ban them without any conceivable rationale, in another flight from science.
Despite the demonstrated benefits of harm reduction, and the lack of efficacy of the approved pharmaceutical products (such as patches, gum, and medications), public health spokespersons, governmental and private, adhere to the mantra, “there is no safe tobacco product.”
While inexcusable, their rationales for such unscientific policies understandably derive from deep-seated mistrust of tobacco companies and their phony promotion of ostensibly “reduced risk” products like “light” or filter-tip cigarettes.
But this “won’t be fooled again” policy — ignoring the fate of the millions of addicted smokers — enforces an abstinence only, “quit or die” approach.
This fundamentalism helps no one.
The real victims are the millions of addicted smokers, who deserve to hear the truth about reduced-risk smokeless tobacco. It is time to help addicted smokers get the help they need to quit the death-dealing cigarette.
George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association. Gilbert Ross is the Executive Director and Medical Director of the American Council on Science and Health (ACSH). Elizabeth Whelan founded the American Council on Science and Health in 1978 and serves as President.
