Let’s consider this logically first, and then apply current research. Logically, since smokeless tobacco (ST) use does not expose the lungs to tar, carbon monoxide, particulates, and thousands of chemicals of combustion, ST use does not cause lung cancer, which accounts for 120,000 of the 443,000 of the deaths that the CDC attributes to cigarettes. An additional 103,338 deaths are attributed to respiratory diseases, as well as 49,400 deaths attributed to second-hand smoke exposure. It is simple math to add up these numbers and deduce that if all smokers switched to ST, at least 272,738 lives could be saved, each and every year.
There is a wealth of research available on the health effects of switching from smoking to snus in Sweden, Norway, and North America. Lee’s “Summary of the epidemiological evidence relating snus to health” reveals that the relative risk (RR) for snus users of developing heart disease ranges from 0.91 to 1.12 and the RR of strokes ranges from 0.95 to 1.15. These average out to 1.01 and 1.05 respectively–nearly equal to the risks for a non-tobacco user. Thus, switching to snus would eliminate most of the 128,497 annual deaths related to cardiovascular diseases. Lee’s analysis also states, “After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97, 95% CI 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites.”
In a presentation to the FDA, toxicologist Dr. Neal Benowitz reviewed the research on ST and extrapolated from the RRs of snus use to determine that long-term use of Nicotine Replacement Therapy )NRT) products would be much, much safer than continued smoking. A more recent form of THR is electronic cigarettes, which have helped countless smokers who previously had been unable to quit regardless of which approved treatment product or method they tried. When surveyed about the health effects, 90% state that their lung health has improved. Many respiratory specialists are now recommending e-cigarettes to their patients who have been repeatedly unsuccessful in quitting smoking.
Conflict of Interest Declaration: I am a volunteer director of the non-profit Consumer Advocates for Smoke-free Alternatives Association (CASAA). I receive no compensation from tobacco companies or electronic cigarette companies. I finally quit smoking on 3/27/2009 after switching to an e-cigarette.