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Snuff's Not a Safe Cigarette Substitute

Smokeless Tobacco Unlikely to Help Smokers Quit

WebMD Health News

Oct. 28, 2002 -- As millions of smokers are increasingly banned from lighting up in public, some have proposed that a pinch of smokeless tobacco might be a more acceptable and less harmful way to provide a nicotine fix or even help smokers quit. But new research shows that men who use snuff might find it harder to quit smoking and face a greater health risk from using both forms of tobacco.

The study, published in the October issue of the American Journal of Public Health, found about 40% of snuff users continued to smoke cigarettes or started smoking after they began using snuff.

"Men were more than 2.5 times as likely to have switched from snuff to cigarettes than to have switched from cigarettes to snuff," says researchers Scott Tomar, DMD, DrPH, professor of public health services and research at the University of Florida's College of Dentistry, in a news release.

"Snuff may be a gateway form of nicotine dosing among U.S. males that may lead to subsequent cigarette use," says Tomar.

Snuff is finely milled tobacco that quickly delivers a high dose of nicotine into the bloodstream. Users typically place a pinch of the product between their front teeth and lower lip.

Previous studies have shown that snuff and smokeless tobacco use increases the risk of cancers of the mouth, pharynx, larynx, and esophagus. The products have also been linked to gum disease, bone loss in the jaw, tooth decay, tooth loss, and heart disease, as well as other conditions.

The study was based on information gathered from the 1998 National Health Interview Survey conducted by the CDC every four years. It found 26% of the 14,000 men surveyed smoked, and 4% used snuff. About 1% used both forms of tobacco, which equals about 1 million men in the U.S.

Researchers found men who reported using snuff "on some days" were more likely to smoke and less likely to quit than those who used snuff every day. The men who used both products also tended to smoke just as many cigarettes per day, an average of 18, as those who didn't use snuff.

When it came to quitting, daily snuff users were more likely than those who had never used smokeless tobacco to have stopped smoking in the last 12 months.

But the study also found that American men were much more likely to be former snuff users who currently smoked, than former smokers who currently used snuff.

In addition, occasional snuff users were more likely than never users to have tried to quit smoking in the previous year, but they tended to be less successful in their attempts.

Tomar says these findings suggest that snuff use may be keeping smokers in the market who otherwise might have quit.

"Supplementation of smoking with snuff may have reduced smokers' success in quitting smoking while probably not appreciably reducing their risk for smoking-associated disease," writes Tomar.

And he says, "A major concern should be that the promotion of a dangerous product as less harmful than another undermines the efforts to achieve tobacco cessation. Also these products could increase smoking initiative among people who probably would not have started."

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