Anti-Harm Reduction Tactics By The American Dental Association

On June 24 the American Dental Association (ADA) continued its long assault on tobacco harm reduction in a news article on FDA cigarette warning labels (here). The dental group repeated its 2009 statement about smokeless tobacco substitution: “As a matter of public health, we have become increasingly alarmed by recent attempts to market smokeless tobacco as a healthier (or less harmful) alternative to cigarettes. Smokeless tobacco is not a healthy alternative to cigarette smoking; both products pose health risks.”

Under the guise of “public health,” the ADA continues to deny smokers information that smokeless tobacco is a satisfying and vastly safer substitute.

The ADA has a long history of undermining this lifesaving strategy. In 1994 I published the first two articles in the medical and scientific literature proposing that smokers switch to smokeless tobacco (here and here). At the time I was chairman of the oral pathology department at the University of Alabama at Birmingham School of Dentistry, and I was a member of the ADA. Nevertheless, the organization aggressively worked to destroy my reputation and my career.

On August 17, 1994 the president of the ADA wrote to the dean that my proposal was “naïve at best and irresponsible at worst,…a disservice to the faculty and the public at large. He called the “notion that smokeless tobacco is a safe alternative to smoking tobacco” a “deception,” and he urged the dean to “repudiate the advice being promulgated by Dr. Rodu in the strongest possible manner.”

The ADA letter was a thinly veiled request to silence me. I do not know if the dean responded, but I know that the ADA expanded its destructive campaign by trying to convince the local dental society to condemn me. However, in November 1994 Dr. Alvin Stevens, the local society’s president, published a letter supporting me in the nationally distributed ADA News. Dr. Stevens wrote that “Dr. Rodu’s message is simple and is backed up by published medical and dental data…statistically, the morbidity of smokeless tobacco use is dramatically and significantly less than the use of cigarettes…Dr. Rodu’s proposal is a viable and realistic option.”

Dr. Stevens concluded that “we think that it is a disservice to call a fellow dentist ‘irresponsible’ without acknowledging, recognizing or listening to his total message…”

The ADA encouraged my professional organization, the American Academy of Oral and Maxillofacial Pathology, to condemn me and my proposal. The president replied that “…it is not the role of the AAOMP to make public statements in support of or disagreement with any individual research that has been appropriately reviewed…”

The ADA also collaborated with the American Association of Oral and Maxillofacial Surgeons, which contacted all of their members, suggesting that they send a form letter under their signature to the local newspaper. The letter contained the false punchline: “Suggesting this switch is like telling someone to use a rifle instead of an Uzi.” In retrospect, we know now that the analogy would have been more accurate if the substitute was a water gun.

In the seventeen years since 1994, approximately 6.8 million Americans have died from diseases attributable to smoking. Yet, there is no evidence that officials at the ADA, or at other national health organizations, have even considered the hundreds of scientific and medical studies documenting the benefits of tobacco harm reduction.

One of the most frequently asked questions about tobacco harm reduction is: “Why don’t all health professionals recommend that smokers switch to smoke-free alternatives?” In addition to the widespread misperception about risks (documented here), health professionals are reluctant to draw the wrath of powerful national organizations that believe that the destruction of the tobacco industry is more important than the health of America’s smokers.