The American Heart Association yesterday issued a strong statement against the use of smokeless tobacco as a means of harm reduction and smoking cessation. In a 26-pagepaper in Circulation: Journal of the American Heart Association, researchers argued that smokeless tobacco may increase the risk of a fatal heart attack and hasn’t been found to help smokers quit in the United States.
“The AHA’s analysis of the risks of smokeless tobacco are highly flawed,” says Dr. Ross. “First of all, the data included in the Circulation article do not support their statements that smokeless tobacco is associated with a somewhat increased risk of heart disease. Most of the studies that are cited did not find an increased risk of heart disease from smokeless tobacco.
“Further, the smokeless tobacco they analyzed is a mélange of different types of smokeless tobacco — most of which are unpurified, unprocessed, and have nothing to do with modern snus-type smokeless tobacco. They analyzed spit tobacco, dip, snuff, and chewing tobacco, along with snus, and they’re using the generic term ‘smokeless tobacco’ for that. Such an amalgam is completely unrelated to modern smokeless products, upon which the Swedish cessation data is based.”
The researchers dismissed data from Sweden showing snus did help smokers quit, says Dr. Ross. He admits that there’s scanty evidence that smokeless tobacco has helped U.S. smokers quit — but that still doesn’t justify headlines like “smokeless tobacco won’t help smokers quit.”
Adds ACSH’s Jeff Stier: “If your organization’s goal is specifically to combat heart disease, harm reduction should be your mission, not your opposition.”
Meanwhile, the American Legacy Foundation — which has taken in millions as a result of the 1998 Master Settlement Agreement between states and the tobacco industry — isapplauding the FDA’s declaration that it will regulate electronic cigarettes.
“Let’s say you had a teenage daughter who was addicted to cigarettes ... Wouldn’t you encourage her to try some alternatives to get her off those things?“ asks Dr. Whelan. “Since it’s obvious that products supplying addictive nicotine without inhaled products of combustion are safer by far, the answer has to be yes!
