One advantage of spending so much of my time “on the road” is that I’ve had the opportunity to observe first-hand how many nations have opted for tobacco control policies that reduce the harm for smokers who either can’t or won’t stop.
For example, one of the safest alternatives to smoking for those who must use tobacco is snus, the sale of which is illegal throughout the EU. The basis for this policy was enunciated in 2005 when the EU Commissioner of Health and Consumer Affairs, Markos Kyprianou, stated there was no scientific evidence to justify harm reduction since all tobacco products were harmful.
Apparently, this is a position held by the UK government because, according to its new tobacco strategy, the “ongoing concerns about the health impacts of using snus … the UK continues to support the current European prohibition on the sale of this type of tobacco.” The document provides no evidence in support of its position. There is, however, a wealth of epidemiological evidence that shows that the use of Snus causes a trivial mortality risk when compared with cigarettes.
This is evident from the fact that the three major risks for smokers – lung cancer, cardiovascular disease, and COPD – are either absent or sharply diminished with snus. With snus, there is little evidence of an increased risk for lung cancer or COPD. Roth et al found that of studies looking specifically at Swedish snus, three of four studies found lower cardiovascular disease risks than for smoking (Roth et al. Health risks of smoking compared to Swedish Snus. Inhalation Toxicology 2005 (17): 741-738). As for oral cancer, as the RCP report on the scientific literature noted, “the risk of oral cancer associated with use of low-TSNA tobacco products such as Swedish snus is small, and possibly non-existent” (Royal College of Physicians. Harm Reduction in Nicotine Addiction. London, 2007). All of which led the RCP to conclude that “in relation to cigarette smoking, the hazard profile of the lower risk smokeless products is very favourable.”
The UK government’s claim that there are “on-going concerns about the health impacts” of snus is scientifically questionable, at best. Moreover, even if there were concerns, this misses the point. No one claims that snus is a completely risk-free tobacco product. The point is that when compared to smoking cigarettes, snus is enormously safer.
Patrick Basham is author of “Butt Out! How Philip Morris Burned Ted Kennedy, the FDA & the Anti-Tobacco Movement” and is coauthor of the bestselling “Diet Nation.” He has taught tobacco regulation and other health policy courses at Johns Hopkins University and has spoken on tobacco policy at universities and conferences around the world. Dr Basham is founding director of the Democracy Institute and is a Cato Institute adjunct scholar. He has no competing interests with any of the snus manufacturers.