Smokeless Tobacco Dangers?>
Be Well

Smokeless Tobacco Dangers

by David Tuller, DrPH

While the rate of cigarette smoking among working-age adults in the U.S. fell from 22.2 percent to 19.1 percent between 2005 and 2010, the rate of those using smokeless tobacco products did not, according to a report last week from the U.S. Centers for Disease Control and Prevention (CDC). The CDC’s most recent statistics indicate that 3 percent of working adults used chewing tobacco and snuff in 2010, a slight increase from five years earlier.

Smokeless tobacco includes both chewing tobacco and snuff. More recently, a Swedish product called snus, a moist tobacco powder, has also become widely available in the U.S. Smokeless tobacco is known to cause oral, esophageal and pancreatic cancer. Of current cigarette smokers, 4.2 percent also reported smokeless tobacco use.

The data, drawn from the annual National Health Interview Survey of the U.S. civilian population, found the highest rates of use in the mining industry—a whopping 18.8 percent. When the data were broken down by actual occupation, those working in “construction and extraction” and “installation, maintenance and repair” had the highest rates, at 10.8 percent and 9 percent, respectively.

The reasons why cigarette smoking declined but use of smokeless tobacco did not remain unclear, but the report notes that “tobacco industry advertising encourages cigarette smokers to use smokeless tobacco as an alternative in locations where smoking is not permitted.” The report also suggests that some people might switch to smokeless tobacco as a form of harm reduction or in an effort to stop smoking altogether. Such strategies, of course, are misguided and ineffective, given that smokeless tobacco carries its own risks of harm and that there is no evidence that it can help bolster smoking cessation.

The report suggests that employers should impose not just no-smoking policies but no-tobacco policies to reinforce the message of the dangers of smokeless tobacco. It also recommends focusing tobacco cessation efforts on industries with high rates of smoking and smokeless tobacco use. The goal—ambitious yet worthy—is to reduce smokeless tobacco rates to the 0.3 percent target for all U.S. adults cited in Healthy People 2020, the government’s blueprint for its priorities in improving the country’s health status.