ST = Smokeless tobacco
ST leukoplakias only rarely progress to cancer. For example, one prospective study found no case of cancer in 1,550 ST users with leukoplakia who were followed for 10 years [65], and a second study reported no case of oral cancer among 500 regular ST users followed for six years [66]. A retrospective study of 200,000 male snuff users in Sweden found only one case of oral cancer per year, an extremely low frequency [67]. In comparison, a follow-up study reported that 17% of smoking leukoplakias transformed into cancer within seven years [68].
These studies have received considerable attention among tobacco researchers, particularly in Europe, because they are viewed as showing no oral cancer risk for Swedish products. They formed the basis for the Swedish government's decision in 1999 to recommend that the European Union (EU) oral cancer warning labels be removed from ST products. An EU directive in 2001 accomplished that objective and specified a new warning, "This tobacco product can damage your health and is addictive" [80]. Notably, the other five studies contributing to the summary RRs for moist snuff were American, and they reported RRs very similar to those of the Swedish studies.
However, even with these limitations, the results of these studies are reasonably consistent with regard to mouth cancer risks from long-term use of moist snuff and chewing tobacco. In their review Rodu and Cole concluded that "the abundance of data now available indicates that commonly used ST products increase the risk of oral and upper respiratory tract cancers only minimally."
In 2005 the American Cancer Society (ACS) reported that ST users did not have significantly increased risks for oral and pharyngeal cancer in either the first or the second Cancer Prevention Study [92]. Despite this finding, the ACS website continues to focus on ST as a cause of mouth cancer, erroneously stating that "risk of cancer of the cheek and gums may increase nearly 50-fold among long-term snuff users" [95]. A later section of this report will discuss this type of misinformation.
numerous epidemiologic studies have not demonstrated that ST use is associated with risk of cancer at any site outside the mouth.
In 2003, Asplund completed a comprehensive review of the cardiovascular effects of ST use [102]. He concluded that, in distinct contrast to smokers, ST users do not exhibit any significant differences from nonusers of tobacco with regard to the following measures of cardiovascular health: heart rate, blood pressure, cardiac output and maximal working capacity, levels of hemoglobin and hematocrit, leukocytes, antioxidant vitamins, fibrinogen, components of the fibrinolytic system, C-reactive protein and thromboxane A2 production. In addition, ST users did not show important smoking-associated vascular changes, including increased thickness of blood vessels and atherosclerotic plaque development. In summary, most of the medical and epidemiologic evidence documents that ST users do not have elevated risks for cardiovascular diseases.
Nicotine has been characterized as powerfully addictive. But nicotine itself poses little or no health hazard. For example, it does not cause emphysema or cancer [105,106], and there is no evidence that it plays a direct role in the development of cardiovascular diseases [106,107]. A report from a meeting at the United Nations Focal Point on Tobacco or Health concluded that "long-term nicotine use is not of demonstrated harm, with the possible exception of use during pregnancy" [108].
The established health risks associated with ST use are vastly lower than those of smoking. In the past 25 years, almost 80 peer-reviewed scientific and medical publications have acknowledged the differential risks between the two tobacco products
In 1994 Rodu noted that ST use posed a lower risk for mouth cancer than smoking [10]. In 2001 this was confirmed by a comprehensive report on tobacco harm reduction by the Institute of Medicine, which stated that "the overall [oral cancer] risk [for ST use] is lower than for cigarette smoking, and some products such as Swedish snus may have no increased risk"
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1779270
Christ. What a propaganda machine tobacco has on it. Apparently, STs aren't getting pushed simply because of the stigma on tobacco. What madness.
These studies have received considerable attention among tobacco researchers, particularly in Europe, because they are viewed as showing no oral cancer risk for Swedish products. They formed the basis for the Swedish government's decision in 1999 to recommend that the European Union (EU) oral cancer warning labels be removed from ST products. An EU directive in 2001 accomplished that objective and specified a new warning, "This tobacco product can damage your health and is addictive" [80]. Notably, the other five studies contributing to the summary RRs for moist snuff were American, and they reported RRs very similar to those of the Swedish studies.
However, even with these limitations, the results of these studies are reasonably consistent with regard to mouth cancer risks from long-term use of moist snuff and chewing tobacco. In their review Rodu and Cole concluded that "the abundance of data now available indicates that commonly used ST products increase the risk of oral and upper respiratory tract cancers only minimally."
In 2005 the American Cancer Society (ACS) reported that ST users did not have significantly increased risks for oral and pharyngeal cancer in either the first or the second Cancer Prevention Study [92]. Despite this finding, the ACS website continues to focus on ST as a cause of mouth cancer, erroneously stating that "risk of cancer of the cheek and gums may increase nearly 50-fold among long-term snuff users" [95]. A later section of this report will discuss this type of misinformation.
numerous epidemiologic studies have not demonstrated that ST use is associated with risk of cancer at any site outside the mouth.
In 2003, Asplund completed a comprehensive review of the cardiovascular effects of ST use [102]. He concluded that, in distinct contrast to smokers, ST users do not exhibit any significant differences from nonusers of tobacco with regard to the following measures of cardiovascular health: heart rate, blood pressure, cardiac output and maximal working capacity, levels of hemoglobin and hematocrit, leukocytes, antioxidant vitamins, fibrinogen, components of the fibrinolytic system, C-reactive protein and thromboxane A2 production. In addition, ST users did not show important smoking-associated vascular changes, including increased thickness of blood vessels and atherosclerotic plaque development. In summary, most of the medical and epidemiologic evidence documents that ST users do not have elevated risks for cardiovascular diseases.
Nicotine has been characterized as powerfully addictive. But nicotine itself poses little or no health hazard. For example, it does not cause emphysema or cancer [105,106], and there is no evidence that it plays a direct role in the development of cardiovascular diseases [106,107]. A report from a meeting at the United Nations Focal Point on Tobacco or Health concluded that "long-term nicotine use is not of demonstrated harm, with the possible exception of use during pregnancy" [108].
The established health risks associated with ST use are vastly lower than those of smoking. In the past 25 years, almost 80 peer-reviewed scientific and medical publications have acknowledged the differential risks between the two tobacco products
In 1994 Rodu noted that ST use posed a lower risk for mouth cancer than smoking [10]. In 2001 this was confirmed by a comprehensive report on tobacco harm reduction by the Institute of Medicine, which stated that "the overall [oral cancer] risk [for ST use] is lower than for cigarette smoking, and some products such as Swedish snus may have no increased risk"
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1779270
Christ. What a propaganda machine tobacco has on it. Apparently, STs aren't getting pushed simply because of the stigma on tobacco. What madness.