Talking sense on smokeless

Several recent news articles have flagged up the madness of prohibiting less hazardous tobacco products like snus, dip and (if you can call it a tobacco product) the e-cigarette.

From Forbes:

Antismoking crusaders treat all tobacco products as equally lethal. They aren't. The smokeless varieties--nicotine strips, lozenges, snuff, chewing tobacco and the like--are dramatically less harmful than traditional cigarettes. Yet Washington prohibits companies from marketing smokeless products as a safer alternative. This is murderously foolish.

It's difficult to argue with this, but that doesn't stop the intensive care contingent of the anti-smoking lobby trying. The usual cliche is to say that switching from cigarettes to safer alternatives is like jumping from the 30th floor of a building instead of the 35th. This is garbage. In the case of smokeless tobacco products, it's more like climbing out of a ground-floor window. People who know much more than me about these things say that these products are at least 99% safe. 

From the Wall Street Journal:

The experience of another effort to induce American smokers to switch clouds the picture for Terry Pechacek, associate director for science in the Centers for Disease Control and Prevention's office on smoking and health. He recalls that many smokers switched to low-tar cigarettes beginning in the 1960s, under the mistaken belief they were safer. "We need to be careful not to repeat this experience," says Dr. Pechacek. Public-health officials, he adds, are reluctant to advocate any form of tobacco use. "We do not need to make the American public guinea pigs."

But the American public already are guinea pigs, Mr Pechacek. They are guinea pigs in an experiment to rid the country of a plant that has been used as a extremely popular recreational drug for thousands of years. No one knows how such an experiment is going to end, but the omens from history are not good.

The comparison with low-tar cigarettes is, in any case, a dubious one. Apart from the fact that there is ample evidence that the high-yield cigarettes of the 1960s were more hazardous than today's brands, there is no knowing how many people would have quit if tar yields had remained high. I suspect not too many. More importantly, cigarettes of whatever strength are not analogous to snus, smokeless and e-cigarettes—there is a vast difference in risk.

The New York Times Freakonomics blog gets to the nuts and bolts of the issue in characteristic style. 

Offer a life raft and more people will jump off a sinking ship. Many will be saved, but some will drown off the life raft.

Mandatory seat belts do this—lives are saved, but people also drive faster and more accidents occur.

Sex education does this—there are fewer pregnancies per sexual encounter, but more sexual encounters are undertaken.

Unemployment insurance does this—it is a life raft for the working, but it attracts people into the workforce who are more likely than others to be unemployed.

I’ll bet that snus, like the other examples, will reduce the total damages of the risky behavior, but more people will engage in the behavior because they expect its costs to be lower.

As Carl V. Philips said in Liverpool two weeks ago, reducing risk is likely to increase usage. Let's not pretend otherwise. The question is what the overall impact on public health? Smokeless tobacco reduces risk to the individual and it reduces the risk in population terms. So what's not to like?

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