Recent articles on Washington’s smoking rate to the point of being the 3rd lowest in the US seem at first glance to be reports of good news (lower smoking means fewer health costs all round) yet reveal themselves to be little more than vehicles of the standard quit or die propaganda.
In Wash. adult smoking rate now 3rd lowest in nation, after reporting the happy decline, the first bit of bad news is that the rate has remained unchanged among the poor. Yes, while it is common knowledge that most of the drops in smoking have been confined to those who need it least, this is still not a happy state of affairs. But then this is followed by the double whammy of:
Health Secretary Mary Selecky says the other bad news in the survey is the increased use of smokeless tobacco, including dissolvable products that look like candy.
Readers of this blog and our website will be aware that using smokeless tobacco (ST) is a very low risk activity in comparison to smoking. Any smoker switching to it virtually eliminates the risk of tobacco related cancer and greatly reduces other smoking related risks as well (ignoring the lingering but dissipating risks from prior smoking). These same readers might also know that switching to ST use is almost as good as quitting smoking.
Now a rise in ST use and a drop in smoking rates does not mean that all the new ST users were ex-smokers but it is quite likely that many of them are. The most likely users of any nicotine source will be people who already find nicotine attractive. But is it so bad that there are new ST users considering how low risk it is?
Consider electronic cigarettes. Currently every report coming out indicates that almost every e-cigarette user is an ex-smoker. Given how low risk nicotine is, and these devices are, we can expect at some point to see some users who never smoked. This is Tobacco Control’s great fear and you won’t hear the end of it when it starts happening.
But what they don’t accept, and what any growth in the use of the new ST portends, is no less than the evolution of nicotine use. The use of these low risk products by both ex-smokers and new users are the first signs of the great new substitution, nicotine use divorced from serious health costs.
How can this be anything but good? As many or perhaps more people using nicotine but a loss of almost all the health costs.
The second bit of nonsense in that sentence was the tack on of “dissolvable products that look like candy”. I suspect that the reporter perhaps forgot to work in kids somehow but this sentence which is purely descriptive comes across as pejorative. If you were arguing against the pervasiveness of sugar and confectionary would be a target, you could use the same sentence regarding mints. But the larger point is that for successful harm reduction, the substitution should be as attractive and painless as possible. You want users and potential users to be drawn to the safer product and away from the other. Flavor is a powerful way of doing that which makes one wonder if the whole anti-flavor movement is really an underhanded attack on harm reduction.
Yes, the signs are all good; evolution is afoot and the days of the Quitordienosaurs are numbered.
-Paul L. Bergen