A document in the University of California San Francisco
tobacco industry archives describes the hostile reaction in 1995 to my
smokeless tobacco harm reduction strategy for smokers (here). Opponents used messaging they would later redeploy
against e-cigarettes: (1) all tobacco is dangerous, (2) medicines work, so
substitutes aren’t needed, and (3) the children.
In a CNN “Your Health” segment on October 21, 1995,
correspondent Loretta Lepore “met a doctor who actually prescribes tobacco
pouches as a way to satisfy the craving for nicotine without lighting up.”
Lepore: “One, two, the count climbs to forty-six million
U.S. smokers. Charles Mayfield, a
genetic cancer researcher was one, until his toddler demonstrated the error of
his way.”
Mayfield: “He used to walk around with a piece of paper
rolled up like a cigarette…And, I mean, that had a devastating effect on me and
my conscience.”
Lepore: “Mayfield quit smoking, but he hasn’t overcome his
nicotine addiction. Now he gets his fix
from smokeless tobacco.”
Dr. Brad Rodu: “It’s a discreet, paper pouch that fits
invisibly between the cheek and gum.”
Lepore: “Oral pathologist Brad Rodu recommends all smokers
make the switch. He says it’s the smoke
that causes fatal lung and heart disease.”
Mayfield: “I’m using smokeless tobacco right now, and no one
can even tell.”
Lepore: “While the use of smokeless tobacco socially
acceptable to some, many view Rodu’s approach as medically unacceptable.”
Dr. Scott Tomar (CDC): “To recommend to smokers that they
switch to smokeless tobacco is simply maintaining their addiction.”
Lepore: “Instead, Tomar recommends an already approved
nicotine replacement therapy.”
Tomar: “Nicotine patch and gum, both have been found to be
effective in treating nicotine addiction.”
Rodu: “Nicotine patch and gum don’t provide nearly the same
level, or nearly the same spike that smokers crave, and so are not effective
for many smokers [Note: “ineffective” is more accurate, here
and here]
Lepore: “And there’s another concern.”
Dr. Clark Heath (American Cancer Society): “Smokeless
tobacco carries with it a sharply increased risk of cancer.” [Totally wrong with respect to dip and chew here]
Lepore: “A four to five fold increase over non-smokers. Aside from health concerns, Dr. Rodu’s
critics are also raising ethical questions about his approach. Mainly, should doctors be advising patients
to choose another addiction? And if a
patient gets sick from smokeless tobacco, is the doctor legally responsible?”
Rodu: “Since when is it unethical to reduce the smoker’s
risk for all tobacco-related diseases, including oral cancer?”
Lepore: “A 1981 study published in the New England Journal of
Medicine says 26 out of 100,000 smokeless tobacco users contract oral cancer
each year. The five-year survival rate
for oral cancer is 50 percent. In part,
because it’s easier to detect than lung and other forms of cancer. So according to Dr. Rodu’s theory, if all
smokers switch to smokeless tobacco, the United States would see 6,000 cancer
deaths each year [Note: this was a gross overestimate, based on falsified
research, here
and here],
versus 420,000 smoking-related deaths reported annually.”
Lepore: “Dr. Donald Miller, an oncologist and Rodu colleague
at the University of Alabama at Birmingham.”
Miller: “I have wondered many times why I didn’t think of
this. It is an outstanding idea that
really has the opportunity to change the way society thinks about cancer risk.”
Lepore: “Critics say there’s also the risk non-smokers,
especially teenagers, will start using smokeless tobacco, perceiving it to be
safe. But Dr. Rodu stresses his approach
is for smokers only.”
This transcript was circulated by Vincent Gierer, Chairman
of the Board and CEO of US Tobacco, to employees of the world’s largest
smokeless tobacco company in 1995. Gierer
challenged the baseless claims that my research was an industry ploy:
“Obviously, Dr. Rodu’s thesis may cause considerable
controversy, since some people may view his advice as favorable to our Company
and our products. Whatever your personal
opinion of his thesis may be, I want to make clear the Company’s position
regarding Dr. Rodu’s [book] publication.
The Company’s longstanding policy is not to make health claims about its
products, nor to comment on health claims regarding other tobacco products.”
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