Commentary: Smoke-free tobacco can save lives By Dr. Brad Rodu University of Louisville James Graham Brown Cancer Center

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While our federal government dreams of a tobacco-free society, 42 million Americans continue to smoke cigarettes and nearly half a million die each year. That’s 1,300 smoker deaths.
Every. Single. Day.

Tobacco policy in the U.S. is driven by prohibitionists who insist that smokers quit nicotine and tobacco altogether. They ignore the fact that nicotine, although addictive, is not the major cause of any disease associated with smoking. Nicotine is similar to caffeine, which is addictive but safely consumed by millions daily in coffee, tea and cola drinks. Science shows that it’s the smoke that kills, yet the government refuses to tell smokers about far safer alternative products like smokeless tobacco and e-cigarettes.

It doesn’t have to be that way. Over the past century in Sweden, men have smoked less and used more smokeless tobacco (a spit-free product called snus) than in any other Western country. The result: Swedish men have the developed world’s lowest rates of lung cancer and smoking-related deaths.

Numerous research studies document that the health risks of smokeless tobacco use are so low as to be barely measurable, even for mouth cancer. (The European Union removed warning labels for that disease from Swedish snus packages in 2001.) Statistically, smokeless users have about the same risk of dying from their habit as automobile users have of dying in a car accident.

Swedes have a history of embracing harm reduction. They invented the modern seat belt, and they’ve eagerly substituted relatively safe snus for cigarettes. Snus is now widely available in the U.S., as are e-cigarettes, another safer-than-cigarettes option. E-cigarettes deliver nicotine in a vapor of water and propylene glycol, which is used in hundreds of medicines and personal-care products. E-cigarettes satisfy cigarette smokers because they provide the “throat hit” that mimics smoking.

Research shows that smokeless tobacco and e-cigarettes have helped many smokers quit deadly cigarettes.

Tobacco prohibitionists inaccurately portray smoke-free products as causing teen smoking, but there is no evidence for these claims. National surveys show that teen smoking has declined to record lows. Tobacco initiation by young people should be stopped in its tracks. But the 8 million Americans who will die from smoking-related illness in the next 20 years are not children today; they are adults, 35 years and older. Children shouldn’t be used as a smokescreen to condemn their smoking parents and grandparents to premature death.

I have conducted research on tobacco use and health risks for over 20 years at two major cancer centers. In 2011, I created “Switch and Quit,” the first-of-its-kind, community-based quit-smoking program in Owensboro, Kentucky. That campaign, aimed at smokers who were unable or unwilling to quit using total tobacco abstinence, included print, radio, billboard, social-media and cinema public-service messages.

The switch-and-quit concept has been endorsed by the British Royal College of Physicians (among others), which found “…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.”

Switching from cigarettes to smoke-free tobacco products yields almost all of the health benefits of quitting altogether. That’s the life-saving truth.

Rodu is a professor of medicine and holds an endowed chair in tobacco harm reduction research at the University of Louisville James Graham Brown Cancer Center. He is the author of For Smokers Only: How Smokeless Tobacco Can Save Your Life.