Friday, May 11, 2012

FDA should look to EU/Swedish statistics when considering smoke-free regulations

Death by regulation: the EU ban on low-risk oral tobacco

By Clive Bates
Is it right to ban certain types of smokeless tobacco from sale in the European Union?  The short and unequivocal answer is  ’no’.
But surely banning any type of tobacco can only reduce the size of the overall tobacco market and therefore be good for health?  No, not at all, it just isn’t that simple…
The reason for allowing it on the market is that smokeless tobacco is an effective substitute for smoking, but far less hazardous to health than cigarettes.  The chart to the left puts it quite well. It models the effect on life expectancy of switching from smoking to a type of smokeless tobacco (‘snus’ or Swedish oral snuff) at a given age. These are dramatic findings.  Switching provides a substantial health benefit to smokers who switch, in fact switching is not that much different to quitting smoking altogether.
Furthermore, the risks of the product itself (the bottom red line) are quite low (Gartner et al 2007 - see SCENIHR p117).   However, these products are banned in the EU (other than in Sweden), and smokers have been denied the option to switch to this much lower risk way of taking nicotine. Given the addictiveness of nicotine and how difficult some smokers find quitting even if they really want to,  this amounts to death by regulation.   What has gone wrong?

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