A commentary on “the
political, social, genetic, and neuroscientific challenges in continuing an
abstinence-only approach to nicotine use” was recently published by University
of Ottawa Faculty of Law Adjunct Professor David Sweanor and student Adam
Houston.
In their Ottawa Law Review article
(here),
Sweanor and Houston observe that the “health catastrophe” of smoking “results
not from the nicotine that smokers seek, but from the inhalation of smoke in
order to obtain it” They note that “non-combustion
tobacco products — medicinal nicotine, various types of smokeless tobacco
products, and now vapour products …effectively deliver nicotine without the
inhalation of smoke,” and they believe that “shifting the market to non-combustion
alternatives not only has the potential to achieve a public health breakthrough
of truly historic significance, but is also a rather simple idea.”
According to Sweanor and
Houston, “tobacco control policies hostage to an abstinence-only agenda” is so
destructive “that even major US governmental health bodies avoid telling the
public of the huge differential in risk between smokeless tobacco and
cigarettes.” I have repeatedly described
the how the CDC doesn’t acknowledge the minimal risks of smokeless tobacco (here
and here).
My decades-long effort to educate
American tobacco consumers has been met with relentless opposition from
anti-tobacco forces. Sweanor and Houston
show that wrong-headed opposition by health professionals is not unique to
tobacco harm reduction.
Vaccines have been challenged for over 200 years. “Dr. Edward
Jenner is rightly honoured for the simple idea that cowpox [vaccination] could
protect against smallpox, but his breakthrough in understanding the importance
of vaccinations faced opposition…from those who saw such things as interfering
with the will of God… As a result,
widespread immunization took many decades to achieve.”
Physicians rejected hand-washing. “The
ground-breaking work of Dr. Ignác Semmelweis, on the simple idea of doctors
washing their hands between conducting autopsies and attending to childbirth,
was not merely ignored for decades, but his sanitary procedures were actually
abandoned on the orders of his superiors, who did so after his measures had proven exceedingly effective at preventing an
epidemic of unnecessary maternal and child deaths.” (emphasis in original)
Sweanor and Houston call for
“intelligent regulatory oversight,” but it’s an oxymoron in the U.S. today, as
evidenced by recent FDA actions on smokeless tobacco. The FDA has conducted a misinformation
campaign on cancer risks (here) that
includes the conflation of “tobacco” with “smoking” (here). Now, according to a report in The Hill (here), the
FDA wants to lower the level of one or more tobacco-specific nitrosamines
(TSNAs) in smokeless products.
As I documented six years ago
(here), TSNAs
“are present [in tobacco products] in vanishingly small concentrations – mainly
in the single-digit parts-per-million range… Despite decades of epidemiologic research, long-term use of Swedish or
American smokeless tobacco products (other than dry powdered snuff) has not
been associated in a significant way with ANY disease.”
I predicted that “anti-tobacco
extremists will call for reductions. However, since there is virtually no
evidence that current TSNA levels are associated with ANY measurable cancer
risks, it is inconceivable that a reduction in levels will produce any
measurable benefit.”
The Hill reports that the
Campaign for Tobacco-Free Kids is taking credit for the FDA proposal. CTFK’s Denis Henigan said, “We wrote to the agency
and said well look if these products have such lower levels than clearly it's
feasible to manufacture products with lower levels of carcinogens and you
should draft a product standard. It
appears FDA has proposed to do something like that, something we asked for or
close to it.”
It is wrong for CTFK to drive
FDA action in the absence of any scientific rationale related to risk reduction,
when current risks are near zero.
