In case you didn’t watch 60 Minutes last night snus and other smokeless tobacco products were discussed:
http://www.cbsnews.com/video/watch/?id=6362540n&tag=api
NEW!!! Below are comments from Dr. Brian Harrison, MD, FACOEM, Affinity Health:
The media love controversy. They create it even where there is consensus. For example:
1) In the 60 Minute piece, Dr. Fagerstrom quotes "Risk Reduction" statistics for Snus (which is not swallowed).
These statistics do not apply to dissolvables (Orbs, Sticks, and Strips) which are swallowed.
We should assume that swallowing tobacco will increase the risk of cancer of the mouth, esophagus and pancreas, more than Snus does. We can't expose a whole generation to a probable carcinogen while waiting for enough cases of cancer to develop to allow conclusions.
The Precautionary Principle requires we take prudent action based on the severity of this hazard, rather than speculating about reduction of risk
2) Dissolvables and Snus both promote youth initiation of tobacco use, deliberately.
The marketing bespeaks this.
The design accomplishes this. Some deliver 3 mg nicotine in seconds. Cigarettes average 1 mg in 7-10 minutes.
These are new addiction devices, not new therapies
3) Cigarette smokers who adopt smokeless tobacco are more likely to become dual users than they are to discontinue smoking. And dual users are more likely to stop making attempts to quit smoking in the future.
4) Even if some clinicians think they can "manage" certain individual cases of nicotine addiction with smokeless tobacco, the net effect these products have on the population is to increase consumption of all forms of tobacco. That happens by youth initiation, dual-use development, and reduced future quit attempts.
5) Tobacco manufacturers argue that the smokeless tobacco products they make will help society by providing a safer alternative to cigarettes. But they also make the same cigarettes, which they admit are the worse alternative. I will listen to their argument only when tobacco manufacturers stop making cigarettes. They can't say smokeless is the lesser of two evils, when they sell both evils.
6) More than once, the claim appears in the 60 Minute piece that Snus is may be more effective than Nicotine Replacement Therapies (Nicorette Gum, Commit Lozenges, Patches, etc) because it is "cheaper and more accessible." Those are exactly the keys to addicting youth: make the substance cheap and available.
7) Manufacturers of smokeless and of the eCigarette are encouraging a confrontation between employer and employee at the worksite. Employers need to prepare for this confrontation by making their own company policy "no tobacco and no non-therapeutic nicotine on the premises, ever." The 7/5/10 smoke free workplace law isn't enough.
Brian D. Harrison MD, FACOEM
Director of Health and Productivity Management
Affinity Occupational Health
1186 Appleton Road
Menasha, WI 54952
Phone (920) 727-8729
(800) 541-0351
Fax (920) 727-8740
bharriso@affinityhealth.org
http://affinityocchealth.blogspot.com/
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