The Food and Drug Administration is failing to follow established ethical principles by leaving the public in the dark about the relative dangers of smokeless tobacco compared to cigarettes.
The failure of the FDA to adequately inform the public that smokeless tobacco products are significantly safer than cigarettes stands in the way of achieving the best outcomes for public health, according to a paper published in Addictive Behaviors by professor David T. Sweanor and assistant professor Lynn T. Kozlowski.
In 2016, the FDA announced it would be shelling out $36 million on a campaign to inform young people that “smokeless doesn’t mean harmless.” The goal of educating young people about the risks of smokeless tobacco is certainly praiseworthy, but such a campaign throws up a host of questions, the first being, “Is it even needed?”
Almost nobody believes smokeless tobacco is safe. In fact, the majority of people incorrectly believe smokeless tobacco products are just as or even more dangerous than traditional combustible cigarettes.
According to a survey by the National Cancer Institute, 74 percent of people do not believe smokeless products are less dangerous than cigarettes while just nine percent said smokeless products are less dangerous than cigarettes.
Sweanor and Kozlowski point to a national youth survey showing 31.8 percent of respondents reporting smokeless tobacco was riskier than cigarettes and only 7.1 percent reporting smokeless was less risky. In total, 93 percent of those surveyed didn’t know smokeless tobacco is less hazardous than cigarettes.
These are damning results given that smokeless tobacco is estimated to be more than 90 percent less harmful than cigarettes. The lack of knowledge surrounding the risks of smokeless versus combustible tobacco has real life consequences for public health.
For those who are not interested in quitting, or are experimenting with tobacco, it is vital they are fully aware of the relative risks of different products. If smokers had full knowledge of the trade-offs between products many may choose to reduce their risk by switching to a smokeless tobacco.
From a purely public health standpoint, more current and would-be smokers opting for smokeless tobacco products would be a net positive.
Highlighting this fact does not in any way undermine the case for deterring youth from using tobacco in the first place. But it does serve to inform the many adult smokers and would-be youth smokers who are currently unaware of the risks they are taking that there is a safer option.
There is no contradiction between recommending tobacco abstinence for minors while simultaneously conveying the relative risks of different products.
“These consumers and potential consumers have a fundamental right (based on the principles of autonomy, health communication, and health literacy) to be well aware of the dramatic differential harms from the various products they are already or might consider using,” say Sweanor and Kozlowski.
The paper’s authors point to the example of sex education in schools, where it is accepted that abstinence-only and harm-reduction programs can work hand in hand to effectively reach all young people leading to better outcomes.
It is a major indictment of government health authorities that so many smokers are unaware of how they can reduce their risk of death and disease by using different products.
In some cases, the authorities have been responsible for spreading disinformation to the public. Up until 2002, the Centers for Disease Control and Prevention’s kids webpage for the Surgeon General on smoking posed the question: “Is smokeless tobacco safer than cigarettes?” The answer “NO WAY” was provided.
If the FDA is going to spend tens of millions of taxpayer dollars to inform young people who may start using tobacco about its dangers, the very least we should expect is accurate information so the public can make the best decisions possible for their health and welfare.
Guy Bentley is a contributor to the Washington Examiner’s Beltway Confidential blog. He is a consumer freedom research associate at the Reason Foundation and was previously a reporter for the Daily Caller.