But smokeless makers would like to be
able to do that, and regulation of the tobacco industry by the Food
and Drug Administration could provide the mechanism for it.
Congress is considering legislation
that would allow the FDA to regulate tobacco products. The proposal
is backed by Philip Morris USA, which could benefit from regulation
because of its dominance of the cigarette market. Regulation could
limit advertising and create barriers for new competitors to enter
the market.
But some smokeless manufacturers
don't like the legislation, arguing that it would not distinguish
between cigarettes and smokeless products.
"The biggest effect would be to
limit and restrict the ability of manufacturers to communicate with
adult tobacco users," said Seth Moscowitz, a spokesman for
tobacco company Reynolds American Inc. "It would make it much
more difficult for various products to compete against one
another."
Sara Machir, a spokeswoman for
Chester-based tobacco company Star Scientific Inc., said the FDA
should be able to set objective standards for what constitutes less
risky tobacco products. "The standards that are articulated in
this current bill are so high that it will actually discourage
companies rather than incentivize them to come up with products that
are less harmful," she said.
Lennart Freeman, chief executive
officer of Swedish Match North America, wants the FDA to be able to
approve some smokeless products as reduced-harm products. He also
said there should be fewer restrictions on smokeless products than
cigarettes.
Some research does indicate that
using smokeless tobacco is far less risky than smoking, although it
still carries health risks. The government requires smokeless
products to carry three, rotating warning labels that say the
products can cause mouth cancer, gum disease and tooth loss and are
not a safe alternative to cigarettes.
A study by London's Royal College of
Physicians said that smokeless was 10 to 1,000 times less hazardous
than cigarettes, depending on the product. Carcinogen levels in
various types of smokeless tobacco can vary greatly. Officials with
Swedish Match say that research on snus in Sweden has shown that
product carries little or no risk of oral cancer, which they say is
more often the result of smoking. Sweden does have far lower rates
of oral and lung cancer among men than countries where smoking is
more prevalent, though it's important to remember that Swedish-style
snus is processed and stored differently than other smokeless
tobacco, resulting in reduced cancer-causing nitrosamines.
A study by the Swedish National Board
of Health in 2005 concluded that "it is impossible to exclude
that there are risks associated with snus, although they are very
minor in relation to the risks associated with smoking. For every
snus user who takes up smoking, there are four smokers who switch to
snus when they give up smoking," the board wrote, concluding
that the net effects are positive in public health terms.
Freeman said he is frustrated by the
tendency to equate all tobacco products as equally risky. "I
don't understand why we can't acknowledge that there can be a
tobacco product that is less harmful than cigarettes," he said.
While some public-health experts
agree that smokeless carries fewer risks, they worry that labeling
any tobacco product as less risky could encourage more people to
start using it, and ultimately lead more people to cigarettes.
"It is hard to know whether the
increased sales [of smokeless] represent a switch," from
smoking, said Scott Tomar, a public-health dentist and
epidemiologist at the University of Florida. "I would say the
available evidence suggests that is a small piece of the market, and
it suggests [smokeless] is more of complement to smoking."
There is no precise data on how many
cases of oral cancer are caused by smokeless tobacco in the United
States, because many smokeless users also have a history of smoking,
he said.
"The best estimates that are out
there is that there is roughly a four to six-fold elevation in the
risk of oral cancer from using smokeless tobacco." That is
"probably less" than from smoking, he said.
Gregory N. Connolly, a professor of
public health at Harvard University who follows the smokeless
industry, said a large-scale switch to regulated smokeless products
might provide some public-health benefit.
Consumer acceptance is a problem
faced by smokeless-tobacco makers in attempting to offer innovative,
potentially reduced-risk products, he said. The products either
require spitting, or they have to be altered in such a way that it
lowers nicotine levels compared with cigarettes, or they don't
deliver nicotine as efficiently as cigarettes.
"Most of these products haven't
done well in marketplace, that is the reality," Connolly said.
"If we can get everyone to
switch to smokeless tomorrow, it would be a public-health
miracle," he said. "But that type of thinking is totally
unrealistic. It is a fantasy."
