Wednesday, July 9, 2014

Dishonoring Tony Gwynn

The loss of American sports heroes is often accompanied by an outpouring of grief.  But the death of San Diego Padre star Tony Gwynn from salivary gland cancer was dishonored by a federal official (here) and other uneducated or unprincipled opportunists (here, herehere  and here) who used it to further an irresponsible campaign against smokeless tobacco.

The fact is that salivary gland cancer is extremely rare, about 23 cases per million men each year.  Epidemiologic studies have not established a definitive cause, but they show that radiation therapy, alcohol and hair dyes are possible risk factors (more information here).  Tobacco use is NOT. 

Stretching the facts to demonize smokeless products, Brian King, scientific advisor in the U.S. Center for Disease Control’s office of smoking and health, told Fox News, “…with smokeless use, it’s primarily in the oral region, [which is] why we’re seeing a lot of cancers associated with smokeless tobacco around the oral cavity.”

This is completely false.  King surely knows that the vast majority of mouth cancers are associated with smoking, alcohol abuse and/or human papillomavirus infection.  Numerous epidemiologic studies have documented that there is no mouth cancer risk associated with American moist snuff, chewing tobacco or Swedish snus.

In another attack on smokeless tied to Mr. Gwynn’s untimely death, periodontist Dr. Sanda Moldovan took to The Huffington Post with total disregard for science and fact (here).  “Nicotine is a silent killer with any number of different kinds of cancers,” she wailed.  Decades of scientific studies have established that nicotine does not cause cancer at all.  In fact, nicotine is not the cause of any disease related to smoking.

Moldovan claimed that, “As an oral health professional, I see the initial stages of oral, gum, throat and salivary gland cancers all too often,” but this is near impossible unless she defines “all too often” as twice in her entire career.  In a published study using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, I calculated that “If every oral cancer was detected by 1 of the 128,000 general dentists in the United States, then on average each dentist would make 1 diagnosis every 12 years.”

Moldovan is grossly wrong in claiming that “There are even studies that show that smokeless tobacco is more carcinogenic than smoked tobacco!”  A 2004 National Cancer Institute-funded study concluded: … “[smokeless] 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.”   
I don’t blame Tony Gwynn for desperately trying to find a cause for the cancer that took his life.  In blaming smokeless tobacco, he was wrong, but that doesn’t attenuate the sense of loss all of us feel when a legend’s life comes to a close.  However, Gwynn’s life and last struggle are dishonored when extremists torture the truth and disrespect science.                                                                                    


Anonymous said...

I fear that this excellent post regarding the facts of salivary glad cancer will be lost due to the fact that the media is looking for a reason to crusade against all tobacco products (especially smokeless). Thanks for the excellent work Dr. Rodu.

Michael J. McFadden said...

I want to second Anonymous's praise Dr. Rodu. 1 case in every 12 years of dentistry, 23 cases per million men, and no significant link.

Unfortunately, the way the antismoking (or more generally, the anti-tobacco-or-anything-with-nicotine-except-approved-NicoGummyPatchyProducts) mindset works, it's "Post hoc ergo propter hoc." and anyone who even chewed tobacco or used snus only during the final exams of their senior year college will be told by their doctor, "Well, that's probably what caused this."

I am constantly amazed by the number of internet posters out there who claim that their doctor has definitively blamed all sorts of diseases on secondhand smoke. I even quoted an extensive story in TobakkoNacht of a woman who insisted on having a breast biopsy done because she believed she had "caught" breast cancer from using a phone that was sometimes used by a co-worker after they came back from a smoke break.


Michael J. McFadden
Author of "Dissecting Antismokers' Brains" (They're about the same size as the general anti-THReductionist brain: you need a yoctoscope.)