Evidence That Dissolvable Tobacco Works for American Smokers

Researchers from the Department of Psychiatry at the Medical University of South Carolina have published a small, but persuasive, study documenting that dissolvable tobacco products “led to a significant reduction (40%) in cigarettes per day, no significant increases in total tobacco use, and significant increases in two measures of readiness to quit, either in the next month or within the next 6 months.”

The study was funded by the National Institute on Drug Abuse, a U.S. government agency, and it was published by Matthew Carpenter and Kevin Gray in the online edition of Nicotine and Tobacco Research.

Carpenter and Gray randomly assigned 31 smokers who were uninterested in quitting to receive Ariva or Stonewall, dissolvable smokeless products from Star Tobacco (that I have recommended to smokers for many years here and here), or to continue smoking cigarettes. Smokers were given “minimal instructions on how to use” these products and were “told that there is no safe tobacco product and that the best thing they can do for their health is to quit entirely.”

Carpenter and Gray wrote that their findings suggest “that Ariva and Stonewall are effective products to curb withdrawal and craving.” In other words, these products satisfy smokers.

Perhaps the researchers’ most important conclusion was that there is “no evidence that smokeless tobacco (Ariva or Stonewall) undermines quitting. To the contrary, readiness to quit (in the next 1 month and within the next 6 months) significantly increased among smokers who used a smokeless tobacco product relative to those who continued to smoke conventional cigarettes.”

This is important because tobacco prohibitionists have complained that telling smokers about vastly safer smokeless substitutes will “undermine quitting.” Never mind that this puts their dream for a tobacco-free society ahead of the health of people who smoke. The new research shows that tobacco harm reduction is completely consistent with both the health of smokers and broader public health goals.

Had Carpenter-Gray successfully completed a lung cancer vaccine trial, it would have made international headlines. Instead, their monumental study on smokeless tobacco, with major implications for immunizing smokers against lung cancer, has gone unnoticed. With the lives of millions of smokers at stake, their work deserves greater attention.