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Smokeless Tobacco

[2.0] What is smokeless tobacco and why is it such a good substitute for cigarettes?

Smokeless tobacco refers to tobacco products that are used orally, but are not burned. The most popular products in developed countries are moist snuff (also known as snus), which is used by placing a packet or pinch of loose tobacco between the lip and gum or cheek and gum, and chewing tobacco. (Certain products which are popular in other parts of the world are discussed below.) Some recent products even put finely-ground tobacco into a hard lozenge that is used in a similar way as snuff.

Of these, and other nicotine products that are currently available, we believe that moist snuff that comes in pouches (like little teabags you put in your mouth) or as hard lozenges (like breath mints) are the most promising substitutes for smoking and they have very low health risks compared to cigarettes. Both of these points are expanded upon in section 3 of the FAQ. Smokeless tobacco is a very effective way of getting nicotine, and getting nicotine is the main reason why most people smoke.

We provide more information about other nicotine-containing products below.

[2.1] Do I have to spit? - No.

Fortunately, there are a variety of modern products that do not require spitting and do not make a mess in your mouth.

Various moist snuff products are available in teabag-like sachets that hold the tobacco in place. Because the tobacco is contained, you can tuck it under your upper lip, which does not cause you to salivate (and thus need to spit), like putting something in your lower lip or cheek would. These products come in various sizes and flavors, so there are different products for different tastes. There are even some products that are solid lozenges, like a breath mint, that you can hold in your upper lip as they dissolve, with nothing to discard. Most smokers seem to find these products easy to use, even if they have never used them before.

[2.2] Why is smokeless tobacco a good substitute source of nicotine?

Nicotine occurs naturally in tobacco, and there are several ways to get it out. Smoking gives a big and fast dose because the burning releases lots of nicotine and it is efficiently absorbed in the lungs (and mouth). Smokers are accustomed to getting that big and fast dose of nicotine. While smokeless tobacco does not exactly duplicate that dose, it comes fairly close, much closer than the popular pharmaceutical nicotine products, like patches and gums. Most smokers do not find that smokeless tobacco provides nicotine exactly the way smoking does, but many find it to be a satisfying substitute.

[2.3] Are you trying to sell people on using smokeless tobacco? - Instead of smoking, yes; otherwise, no.

We are not encouraging anyone who does not already use nicotine to try it or use it (in any form). Nicotine products cost you money and time, and even smokeless tobacco and pharmaceutical nicotine products are probably a little bit bad for your health.

It is unlikely that many people reading this have never tried nicotine, or that our harm reduction message would cause those people to start. Most people who try nicotine do not like it enough to become regular users. Many who become regular users find later that smoking no longer suits them, and quit. But some keep using nicotine. These are the people we are trying to reach.

For those who are already smokeless tobacco users, we want to make sure they do not switch to smoking. Anti-tobacco activists frequently claim that all tobacco products are equally risky, which is the same as telling smokeless tobacco users "you might as well smoke". For those who have chosen to smoke, we want them to know there is an alternative besides "quitting or dying".

Does this mean if our message is successful that fewer cigarettes and more smokeless tobacco will be sold? Of course it does. But so what? When public health experts suggest that people eat more vegetables and whole grains, and less meat, some products sell better and some worse (assuming anyone takes the advice). Health advice is very often advice about consumption (and thus about purchases). None of us work for the tobacco industry (cigarettes or smokeless), invest in it, or are dependent on its profitability or lack thereof. For those of us who have received research grants from industry sources, the grants are not going to get any bigger or smaller if the markets shift a bit. Indeed, there is a trend toward the same companies marketing cigarettes and smokeless tobacco, which means that, more and more, any substitution is a wash for them. The only big change is the huge potential health benefit.

Frankly, we wish the companies that make smokeless tobacco would aggressively market it to smokers as a reduced-harm alternative which would really help our public health mission. Our impression is that the companies believe they would be forbidden from making such claims in most jurisdictions, and would face nasty attacks by anti-harm-reduction advocates. They make decisions based on what is best for their profitability (we have no illusions otherwise) and we direct our efforts based on what is best for public health. Sometimes those coincide, but not always.

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