Anti-tobacco extremists have a big problem with smokeless tobacco. There is virtually no scientific evidence that long-term smokeless tobacco use is associated with ANY disease. So extremists have engaged in a media campaign to vilify these products in exceptionally creative ways.
I previously discussed the specious claim that smokeless tobacco products contained dangerous levels of wintergreen flavor (available here). Now a diatribe from Gregory Connolly, a Harvard University tobacco prohibitionist, has created the illusion that smokeless tobacco products are a major cause of poisoning among American children. The study was published in the journal Pediatrics (see the abstract here). It was tailored to produce a media frenzy, and it did. Here is a typical headline from MSNBC: “Tobacco mints tied to kids’ poisoning: smokeless products 2nd most common source of accidents.”
Most Americans will think that children all over the U.S. are dropping dead from accidental exposure to smokeless products. Connolly and his colleagues at Harvard, the CDC and an Ohio poison control center collected information on 13,705 incidents from the National Poison Data System from three years (2006-2008). Out of context, that appears to be an alarmingly high number.
I can’t provide context on the three-year data they accessed, but I was able to review the 2008 annual report of the American Association of Poison Control Centers (read it here). I think you will find the report informative.
It turns out that tobacco products accounted for only about 1% of the over 684,000 cases of exposure to non-pharmaceutical agents of all kinds in children less than 6 years of age in 2008. That’s 7,310 cases. Here’s a table of the top 20 exposures:
Non-pharmaceutical Exposure Cases Among Children Under 6 Years of Age, 2008
|Product Category||Number of Exposures|
|Cosmetics and personal care products||170,210|
|Arts, crafts, office supplies||28,331|
|Paint, paint strippers||9,593|
|Building, construction products||4,683|
The MSNBC subheadline (“smokeless products 2nd most common source of accidents”) reflects another omission in Connolly’s abstract. He listed smokeless as the second most common TOBACCO source in the abstract, without revealing that it was a distant second. Cigarettes were responsible for 77% of 2006-08 tobacco exposures. In comparison, smokeless tobacco was only responsible for 13% of tobacco exposures.
The 2008 report shows that smokeless tobacco products were responsible for 1,105 of the 7,310 tobacco exposures, or about 15%.
So let’s do the math: in 2008 smokeless tobacco exposures were 0.16% of the 684,000 total exposures among children less than 6 years of age.
There is one more flagrant omission in Connolly’s journal article: he didn’t report the number of exposures involving nicotine medicines. That information is available from poison control reports; in 2008, 589 children under 6 years were exposed to nicotine medicines, slightly more than half of those exposed to smokeless tobacco. It’s another example of Connolly’s extreme selectivity.
Connolly used the results of his study to comment that tobacco manufacturers were “recklessly playing with the health of children.” When put into proper perspective, (exposures like household cleaners, solvents and oils, paint and paint strippers, fertilizers), Connolly’s selective reporting of poison control information is recklessly playing with the tolerance of the American public for honest discussion of important public health issues.
[Originally created on April 19, this entry was updated on April 20.]