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| Chemical differences between nicotine delivering products |
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| Session |
Harm Reduction-I: Does smokeless tobacco qualify?
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| Date |
Monday, 9th March |
| Author(s) |
Gregory N Connolly
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Abstract Body |
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This presentation will review the toxins and addictive properties of SLT
products sold throughout the world. Products sold in the U.S. will be reviewed
as well as the public health implications of U.S. cigarette industry acquiring
the U.S. smokeless market and how products have been changed. More recently,
IARC concluded SLT (regardless of type) causes oral and pancreatic cancer and
the European SCENIHR Committee drew a similar conclusion and also found
insufficient evidence the SLT aided in cessation, is addictive and questioned
whether snus had any impact on the decline in male smoking in Sweden.
Based on the large number of SLT users in South Asia, high toxins and the high
levels of disease, these products do not qualify as reduced harm agents.
Traditional U.S. snuff is also associated with cancer and other oral health
problems, has high levels of TSNAs, is highly popular with teens and implicated
as a gateway substance to smoking. Based on these factors, it is highly
questionable if traditional U.S. snuff qualifies as a reduced harm agent
particularly at the population level. Swedish and U.S. snus will reduce
individual risk if smokers completely switch from smoking and use the products
as cession aids. However, cigarette manufacturers in the U.S. are clearly
promoting snus as a temporary substitute for smoking in settings where one
cannot smoke possibly contributing to dual use. This marketing message is being
repeated in other countries. States in the U.S. with no history of SLT use and
comprehensive tobacco control programs (California and Massachusetts) have lower
male smoking rates than Sweden, a nation that is often highlighted to support
SLT as a reduced harm agent and comprises only .2% of the world’s smokeless
users.
SLT should not qualify as a reduced harm agent until epidemiological, clinical
and population data show it actually reduces harm. Otherwise, qualifying SLT as
reduced harm agent may encourage the cigarette industry to introduce products
that increase youth tobacco use, promote dual use, drive the pharmaceutical
industry out of the cessation market and send the wrong message to hundreds of
millions of SLT users in developing countries. In the current climate, WHO and
member states have an obligation to treat all tobacco products similarly under
the FCTC.
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