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Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking?

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  • Scott L. Tomar

    (University of Florida College of Dentistry, Gainesville, 1329 SW 16th Street, Suite 5180 P.O. Box 103628, Gainesville, FL 32610-3628 USA FL, USA)

  • Brion J. Fox

    (University of Wisconsin Comprehensive Cancer Center, #385 Warf Office Building, 610 Walnut Street, Madison, WI 53726 USA)

  • Herbert H. Severson

    (Oregon Research Institute, 1715 Franklin Blvd., Eugene, OR 97403 USA)

Abstract

Four arguments have been used to support smokeless tobacco (ST) for harm reduction: (1) Switching from cigarettes to ST would reduce health risks; (2) ST is effective for smoking cessation; (3) ST is an effective nicotine maintenance product; and (4) ST is not a “gateway” for cigarette smoking. There is little evidence to support the first three arguments and most evidence suggests that ST is a gateway for cigarette smoking. There are ethical challenges to promoting ST use. Based on the precautionary principle, the burden of proof is on proponents to provide evidence to support their position; such evidence is lacking.

Suggested Citation

  • Scott L. Tomar & Brion J. Fox & Herbert H. Severson, 2008. "Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking?," IJERPH, MDPI, vol. 6(1), pages 1-15, December.
    • Handle: RePEc:gam:jijerp:v:6:y:2008:i:1:p:10-24:d:3738
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    References listed on IDEAS

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    1. Glover, E.D. & Laflin, M. & Edwards, S.W., 1989. "Age of initiation and switching patterns between smokeless tobacco and cigarettes among college students in the United States," American Journal of Public Health, American Public Health Association, vol. 79(2), pages 207-208.
    2. Bolinder, G. & Alfredsson, L. & Englund, A. & De Faire, U., 1994. "Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers," American Journal of Public Health, American Public Health Association, vol. 84(3), pages 399-404.
    3. Savitz, D.A. & Meyer, R.E. & Tanzer, J.M. & Mirvish, S.S. & Lewin, F., 2006. "Public health implications of smokeless tobacco use as a harm reduction strategy," American Journal of Public Health, American Public Health Association, vol. 96(11), pages 1934-1939.
    4. Muggli, M.E. & Forster, J.L. & Hurt, R.D. & Repace, J.L., 2001. "The smoke you don't see: Uncovering tobacco industry scientific strategies aimed against environmental tobacco smoke policies," American Journal of Public Health, American Public Health Association, vol. 91(9), pages 1419-1423.
    5. Nelson, D.E. & Mowery, P. & Tomar, S. & Marcus, S. & Giovino, G. & Zhao, L., 2006. "Trends in smokeless tobacco use among adults and adolescents in the United States," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 897-905.
    6. repec:cdl:ctcres:qt0554n98z is not listed on IDEAS
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