Indications from Indy That Snus is a Viable Cigarette Substitute

Indianapolis is the quintessential Midwest American city, and it has served as a test market of Swedish-style snus by the two largest American cigarette manufacturers. In 2006 Philip Morris launched a test market for Taboka snus in Indy (in 2008 it was discontinued when Marlboro snus was launched). In 2007 Indy was one of several expansion markets for RJ Reynolds’ Camel Snus; that product went on to national distribution earlier this year.

Lois Biener and Karen Bogen, from the University of Massachusetts Center for Survey Research, analyzed data from the 2006-7 Indiana Adult Tobacco Survey, and their recently published study provides some valuable information.

Biener and Bogen reported that almost 20% of survey respondents throughout Indiana were aware of snus. Awareness among smokers statewide was 44%, which was 4.5 times higher than awareness among non-smokers.

Awareness among respondents in central Indiana (i.e. around Indianapolis) was 29%. More importantly, about 64% of male smokers in central Indiana had heard about snus, and 20% had tried it. This is evidence that Philip Morris and Reynolds were targeting adult male smokers in their test-market campaigns, and that the manufacturers were fairly successful.

Biener and Bogen also reported that risk perception played an important role in getting people to try snus. Respondents who correctly believed that smokeless tobacco is less harmful than cigarettes were almost 4 times as likely to try snus as those who had been misinformed about the differential risks. Unfortunately, this study revealed that 88% of all respondents had been misinformed, so they incorrectly believed that smokeless tobacco was just as dangerous as cigarettes.

Biener and Bogen offer some perceptive comments on the sad state of smoker misinformation:

“Both marketing and health education messages should include the information that all tobacco products are harmful and that abstinence from all tobacco products is the most healthful choice. At the same time, simply saying that smokeless tobacco is ‘not safe’ is not a sufficient stance for public health communications. There is a recognized continuum of risk along which various tobacco products can be placed, with low-nitrosamine smokeless tobacco products much lower on the risk continuum than combustible tobacco, although it is not harmless. Devising an effective way to inform the public about the continuum should be an important research priority, as currently consumers are woefully incorrect in their assessments of relative risk of various tobacco products. This state of affairs could result in people deciding not to give up smoking in favor of a product lower on the risk continuum because they assume that all tobacco products are equally harmful.”

Biener and Bogen mention that information about differential risks of smokeless and smoking have appeared in the media, and they cite a 2006 article by Kevin Helliker in the Wall Street Journal. That article remains the most well researched and best written description of tobacco harm reduction, and it can be found here.

Wisdom From the Wall Street Journal

I have been engaged in tobacco harm reduction research for over 15 years; during this time I have discussed the subject with numerous journalists. Most of the subsequent news stories have been of marginal quality or even grossly inaccurate, because journalists rarely challenge spokesmen from the American Cancer Society or government health agencies who misrepresent smokeless tobacco as just as dangerous and just as evil as cigarettes.

The Wall Street Journal is the rare exception to the above. In 2006 and 2007, the Journal’s Pulitzer prize winning Kevin Helliker wrote a series of articles on tobacco harm reduction as a critical public health issue. Helliker challenged everyone he interviewed to fully substantiate their positions. The resulting articles remain quite simply the best media treatment on the subject. Two of his articles can be read here and here.

On August 31, R.J. Reynolds Tobacco Company and Lorillard, Inc. filed suit in U.S. district court in Bowling Green, Kentucky to block some of the provisions of legislation giving the FDA regulatory authority over tobacco products. On September 13, the Wall Street Journal editorialized on why the FDA legislation is flawed. One of the major points of the editorial, available here is that the legislation prohibits manufacturers from telling consumers that smokeless tobacco is safer than cigarettes:

“And there's also not much doubt that the new law hinders the ability of tobacco companies to communicate information to consumers, even when that information could lead to less harmful choices. Smokeless tobacco products aren't as dangerous as cigarettes because they contain fewer carcinogens and don't enter the lungs. Yet the law effectively prohibits companies from describing the relative health risks of different products. So a law that backers call a victory for public health actually prevents tobacco companies from informing consumers that switching to smoke-free nicotine products will reduce their health risks. Smokeless tobacco is not risk-free, but a public policy that pretends it is just as dangerous as lighting up is misleading and constitutionally suspect.”

The editorial concludes: “We sympathize with sincere efforts to reduce smoking. But imposing overly broad commercial speech restrictions that impede competition from safer alternatives is the wrong way to advance public health.”