SMOKELESS TOBACCO - IS IT SAFE?

Wayland McKenzie and Mary Andersen
Occupational Medicine, UMC

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In 1982, Phyllis Macalady, a volunteer for the American Cancer Society in Ironton, Missouri, discovered that there was a problem with local elementary school children using smokeless tobacco. The children, it turned out, thought that smokeless tobacco, or "snuff," was completely harmless because there were no restrictions whatsoever on their buying or using it, and because their peers and advertisements convinced them it was the "in" thing to be doing.

Ms. Macalady mounted an educational campaign to show kids how dangerous snuff is. She recruited doctors and dentists to talk to the students about the risk of cancer and other problems of the mouth, throat and stomach that can be caused by using smokeless tobacco. Nicotine from smokeless tobacco behaves the same as that from smoked tobacco; it is addictive and is believed to cause heart and circulatory problems. Even more disturbing is the fact that nitrosamines, suspected to be the main villain in causing cancer from cigarettes, are 100 times higher in oral tobacco. Another problem with smokeless tobacco is the spread of contagious diseases due to the need to spit out the tobacco. Ms. Macalady's campaign was aided by 18 year old Sean Marsee of Ada, Oklahoma, who was dying of cancer of the mouth as a result of chewing tobacco, and by others who helped to build a nationwide effort. The students have responded well, but smokeless tobacco is still extremely popular among many other young people who do not understand and have not been told how dangerous smokeless tobacco is to their health.

Tobacco companies have targeted young men, and have been very successful in their efforts. Today nearly one in five college-aged men uses smokeless tobacco, and these figures are higher in some states. Although tobacco companies have claimed that smokeless tobacco is a safer substitute for cigarettes, one study has shown that not only do smokers rarely switch to smokeless tobacco, but that smokeless tobacco users are likely to graduate to smoking. Health officials have been enraged that tobacco companies are knowingly attempting to introduce young people to tobacco addiction. One company communication, for example, said, [Brand X] "is the introductory product, and then we look towards establishing a normal graduation process."

Ms. Macalady and those who have worked with her have made a difference, however. Several cities in Missouri have prohibited sale of all tobacco to minors. The Missouri legislature is considering proposals to add a tax on the sale of smokeless tobacco and to ban its sale to minors. In addition, the Surgeon General now requires a warning on the label of all smokeless tobacco products sold in the United States.

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