Wednesday, February 1, 2017

Experts to FDA: End the Smokeless Tobacco Misinformation Campaign

Two internationally renowned tobacco policy experts are urging “the FDA and like campaigns and health information websites” to “follow established ethical principles and accepted communication methods to inform the public of less-harmful tobacco/nicotine products as well as the greater harms of smoking.”

Lynn Kozlowski, professor at the University of Buffalo School of Public Health and Health Professions, and David Sweanor, adjunct professor of law at the University of Ottawa, published their commentary online in Addictive Behaviors (open access, here).  Their focus is a $36 million FDA campaign against smokeless tobacco “that fails to directly warn about the much greater harms from smoked tobacco (predominantly cigarettes).” 

Shortly after the campaign’s launch in April 2016, I produced a detailed analysis showing that it was based “on population cancer estimates derived from unreliable and inappropriate relative risks” (here).  I insisted that “the FDA should publish an honest estimate of the risks and consequences of smoking and smokeless use, and issue public messages that inform rather than mislead.  The current campaign wastes taxpayer resources, obfuscates the truth about smokeless tobacco and, ultimately, denies smokers information that could save their lives.”

Kozlowski and Sweanor echo my criticism of the FDA’s war on smokeless, noting that “consumers and potential consumers have a fundamental right (based on the principles of autonomy, health communication, and health literacy) to be well aware of the dramatic differential harms from the various products they are already or might consider using (reference here).”  Consumers don’t have that information, and the authors blame “…health authorities [that] have failed to provide accurate differential risk information on tobacco products” for decades.  They highlight misinformation from the Mayo Clinic, which I have criticized for 12 years (here), and former U.S. Surgeon General Richard Carmona’s congressional testimony of  2003, which, as I noted at the time (here), ignored decades of published research and the findings of Britain’s esteemed Royal College of Physicians.

Kozlowski and Sweanor offer clear policy prescriptions:

  • “The public and especially users of multiple tobacco/nicotine products need to be provided accurate and actionable information on major differential tobacco/nicotine product risk.
  • “This recommendation applies equally to youth who are using prohibited products and adults who are using legal products.
  • “Deception or evasion about major differences in product risks is not supported by public health ethics, health communication or consumer practices.
  • “Public health agencies have an obligation to correct the current dramatic level of consumer misinformation on relative risks that they have fostered.”

The Kozlowski/Sweanor commentary mirrors my 23-year science-based argument that government and other health authorities must stop lying about vastly safer tobacco products.  “Health-focused agencies,” they write, “need to regain some credibility in communicating about tobacco/nicotine product risks and work to place it responsibly in the context of comprehensive public health activities.”


Unknown said...

Dr rodu ive been dipping for over 3 years I started in the marine corps my question if u use proper hygiene willyou get mouth cancer from dipping also I've heard pouches are worse for you then long cut is this true I really love dipping it helps with my nerves I really don't want to quit.

Brad Rodu said...

I am unable to answer individual questions about risks in this venue. However, according to numerous epidemiologic studies, the risk of mouth cancer among dippers and chewers is not significantly higher than that among non-users of tobacco. For example, see my blog post about this study from federal government researchers:

Brad Rodu