Tobacco prohibitionists have for many years pressed Major League Baseball (MLB) to ban player use of smokeless tobacco. Despite decades of misinformation from advocates like Joe Garagiola (example here), many ballplayers still use smokeless products. The U.S. Congress entered the fray in April, when House Health Subcommittee Chairman Henry Waxman convened a hearing to browbeat baseball executives for failing to implement a ban. Witnesses pitched a barrage of misinformation. I responded in this blog (here and here).
More misinformation flowed on November 19, when the presidents of ten organizations dedicated to tobacco prohibition called on the commissioner and the director of the MLB players’ association to ban smokeless tobacco use. Their rationale for a ban was wholly unscientific; earlier this week I wrote the commissioner and the MLB association to set the record straight. The text of my letter follows:
December 6, 2010
Mr. Allen H. (Bud) Selig
Major League Baseball
245 Park Avenue, 31st Floor
New York, NY 10167
Mr. Michael Weiner
Major League Baseball Players Association
12 East 49th Street, 24th Floor
New York, NY 10017
Dear Commissioner Selig and Mr. Weiner:
On November 19, 2010, the presidents of ten organizations dedicated to tobacco prohibition wrote you “…to urge Major League Baseball and the Major League Baseball Players Association to prohibit the use of all tobacco products, including smokeless tobacco, by players, coaches, managers, and other team personnel, at all Major League Baseball venues.” The letter (available here, hereafter referred to as Myers et al.) contains distorted and inaccurate statements about the health risks of smokeless tobacco.
I am a professor of medicine, and I hold an endowed chair in tobacco harm reduction research at the University of Louisville. I have conducted research for two decades on the health effects of smokeless tobacco use, and I believe you are entitled to know what tobacco research and policy experts consider an indisputable scientific fact: the health risks from smokeless tobacco use are so low that they are difficult or impossible to measure with modern epidemiologic methods.
Myers et al. make unsupported allegations that smokeless tobacco causes a litany of cancers. They cite no scientific evidence for their claims, because the risks are either barely measurable or completely nonexistent. In 2009, a comprehensive analysis (Reference 1) of all available epidemiologic studies documented that smokeless tobacco users do not have significantly elevated risks for ANY of the cancers listed by Myers et al.
Myers et al. also claim that “Tobacco use is the number one preventable cause of death in the United States.” This is grossly misleading, as it combines smoking’s dramatic fatality figures with the far more benign use of smokeless tobacco (2). For example, the U.S. Centers for Disease Control and Prevention estimate that over 400,000 Americans die every year from smoking-attributable diseases (3), but the comparable number attributed to smokeless tobacco use is so low that the CDC has never attempted to provide an estimate. American Cancer Society Vice President Emeritus Michael J. Thun participated in a 2004 study concluding that “…smokeless tobacco products pose a substantially lower risk to the user than do conventional cigarettes. This finding raises ethical questions concerning whether it is inappropriate and misleading for government officials or public health experts to characterize smokeless tobacco products as comparably dangerous with cigarette smoking.” (4)
The use of smokeless tobacco may be a legitimate topic of discussion between Major League Baseball and the Major League Baseball Players Association. However, the facts about smokeless tobacco vs. cigarettes should not be twisted to satisfy an anti-tobacco agenda or to influence public health policy.
Please do not hesitate to contact me if you would like more factual information on this important subject.
Professor of Medicine
Endowed Chair, Tobacco Harm Reduction Research
1. Lee PN, Hamling JS. Systematic review of the relation between smokeless tobacco and cancer in Europe and North America. BMC Medicine 7: 36, 2009. Available here.
2. Rodu B, Godshall WT, 2006. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. Harm Reduction Journal 3:37. Available here.
3. Centers for Disease Control and Prevention. Smoking-attributable mortality, morbidity, and economic costs (SAMMEC). Available here.
4. Levy DT, Mumford EA, Cummings KM, Gilpin EA, Giovino G, Hyland A, Sweanor D, Warner KE. The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts. Cancer Epidemiology Biomarkers and Prevention 13: 2035-2042, 2004.