A smokeless history lesson for vaping advocates
E-cigarettes are under siege by federal health authorities and NGOs, aided and abetted by countless university researchers funded generously by the National Institutes of Health. Many of their tactics were introduced 35 years ago. Here, in brief, is the story of smokeless.
The American anti-smokeless campaign started March 26, 1981, when Deborah Winn reported in the New England Journal of Medicine that the relative risk for oral cancer among powdered dry snuff users was 4, a risk she described as “exceptionally high.” In reality, that risk translated to a mere 12 deaths per year among 100,000 long-term users (For perspective, compare this with the contemporary annual U.S. death rate of 10 per 100,000 users of automobiles).
Winn studied only the use of powdered dry snuff, not the moist snuff and chewing tobacco that the vast majority of American smokeless tobacco consumers prefer. She later acknowledged in two obscure scientific publications – a 1983 International Agency for Research on Cancer report and the 1986 Banbury Report 23 from Cold Spring Harbor Laboratory – that her study involved only dry powdered snuff. Her omission of that critical detail in the initial article set the stage for condemnation of all smokeless products as health hazards (discussed in detail here).
Winn also falsely inflated the moderate relative risk of 4 to a startling and unsubstantiated 50 (explained in detail here). The 50 fabrication was adopted by public-health agencies and associations worldwide, and continues to pollute the websites of the American Cancer Society and the Commonwealth of Kentucky, among many others.
The Office of the Surgeon General of the United States has been tarnished by the campaign to demonize smokeless products. Surgeon General Richard Carmona grossly distorted the facts when he testified before Congress in 2003, saying “there is no significant evidence that suggests smokeless tobacco is a safer alternative to cigarettes.” I also testified at that hearing and published in the Washington Times the following week an op-ed dismantling Dr. Carmona’s testimony.
It was another surgeon general, Antonia Novello, whose 1994 false claim that the “majority of our experts predict an oral cancer epidemic if the current trends in spit tobacco use continue,” prompted me to enter the field of tobacco harm reduction. There was never any basis for that prediction, and it was never realized.
Major medical institutions have damaged their credibility by spreading misinformation about smokeless tobacco. These include the Mayo Clinic, the Legacy Foundation, the National Cancer Institute and others. Other examples of this scientific travesty were described in a comprehensive review of tobacco harm reduction penned by William Godshall and me in 2006.
Today, e-cigarettes are attracting growing support from public-health proponents who recognize their value as safer alternatives for cigarette smokers. It is consternating, however, that some of these experts persist in demonizing smokeless tobacco products whose relative safety is supported by dozens of irrefutable epidemiologic research studies.
