Call It Whatever You Want -- Tobacco Harm Reduction Saves Smokers’ Lives

 

The U.S. desperately needs tobacco harm reduction, starting with reducing the harm from the pronouncements of federal officials.  Case in point: FDA Commissioner Robert Califf’s April 11 tobacco testimony before the House Oversight Committee.

Dr. Califf made so many false statements that I penned a response for Real Clear Health. Following are some additional observations related to his testimony.

Readers know that I don’t tolerate doctors who claim they saw many people die from the ravages of tobacco, when those patients actually died from the smoke!  Similarly, I can’t let the federal official in charge of regulating tobacco get away with mislabeling it in the same fashion as the World Health Organization and the National Cancer Institute.

Dr. Califf wrongly claimed that harm reduction is an industry term.  My late colleague Dr. Philip Cole and I used that term in an article published by the American Council on Science and Health in 1995.  The Institute of Medicine, hardly a tobacco industry tool, titled a 2001 report, “Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction (here).”

For 30 years, I’ve been saying, without challenge, “Nicotine, when consumed without the harmful constituents of cigarette smoke, is no more harmful than caffeine.”

Fifteen years ago Britain’s Royal College of Physicians, one of the world’s oldest and most prestigious medical societies, agreed with me, finding, “…that smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

Dr. Califf should stop supporting the cigarette industry by trashing vastly safer cigarette substitutes.  That's called tobacco harm escalation.

 

 

Swedish Tax Proposal Threatens Successful Tobacco Harm Reduction

Sweden, which represents the world’s best example of the population effect of tobacco harm reduction, is considering increasing its snus tax by 22%, according to the Swedish national newspaper Aftonbladet.  An April 2 article claims “it would be the first time ever that a can of snus would cost more than a pack of cigarettes.”  Swedes are reportedly outraged by the proposal.  Public health experts should be outraged as well, given such a tax hike’s threat to the developed world’s lowest smoking and lung cancer rates.

As expected, the Karolinska Institute’s tobacco expert Hans Giljam expressed support for a higher snus tax.  However, even he admitted, “There is a risk that many will quit snus and move to cigarettes.  And if many start smoking instead of using snus, we will get sicker. That is a certainty.”

That is unquestionably the strangest endorsement of tobacco harm reduction ever heard.  Giljam couched his comment in dire, unfounded or exaggerated warnings about links between snus and a host of diseases, but he waffled on how much snus use triggers health effects.  “It takes decades of study to reach such conclusions.  It is one of the pedagogic problems we face; we don’t really know what the health effects of long-term snus usage are.”

In fact, decades of study have defined the long-term health effects snus use – nearly zero.  And even Giljam acknowledges that smoking is at least ten times more dangerous than using snus.  His support for equalizing taxes on snus and cigarettes is unfathomable.

This article is available only in Swedish (here), so the English translation I have could account for Giljam’s bizarre logic.  But I sincerely doubt it.  Like anti-tobacco extremists everywhere, those in Sweden not only completely ignore the phenomenal Swedish tobacco experience, they enthusiastically endorse policies that would destroy it.