Consumers not getting accurate information about smokeless tobacco

Information on the internet about the health risks associated with the consumption of smokeless tobacco usually overstates the risk. This is the conclusion of research published today in the Open Access journal BMC Public Health, entitled “You might as well smoke; the misleading and harmful public message about smokeless tobacco”. A study of 316 internet websites showed that most government, health advice, and advocacy websites suggested that smokeless tobacco use is as harmful as cigarette smoking, even though the risk is actually extremely small compared to that from smoking.

Carl V. Phillips, of the University of Texas School of Medicine Center for Clinical Research and Evidence Based Medicine and School of Public Health, and colleagues report that the public is unlikely to find accurate information on the comparative risks of smokeless tobacco and cigarettes, leading to misconceptions amongst consumers. Phillips notes, “smokers can dramatically cut their risks by switching to smokeless tobacco, a strategy called ’harm reduction’, but they have little chance of learning this. Similarly, authoritative organizations are telling smokeless tobacco users, in effect, ’you might as well smoke,’ a public health message that actually encourages people to switch to a much more dangerous product.”

Phillips and colleagues conducted a systematic review of popular sources of information available on the internet, by looking at the content of websites that provide information about smokeless tobacco and health, found using a Google search. They found that of the 316 sites that were suitable for inclusion in the review, “almost every website had statements that played up the health risks from smokeless tobacco without caveat”. Furthermore, “a large portion of websites directly stated or implied that the risks from smokeless tobacco and cigarettes are similar”. The websites of organisations including the U.S. National Cancer Institute and other government agencies, the American Cancer Society, and several of the most popular health advice sites contained information that either explicitly or implicitly suggested that the risks of smokeless tobacco and cigarettes are comparable.

According to the authors, this association of the risks of smokeless tobacco and cigarette smoking may have important negative health implications. “Through these websites, smokers and policy makers are told there is no potential for harm reduction, an unethical message that is both false and harmful to people’s health”, conclude the authors.

The harmful effects of cigarette smoking have been well researched and documented. Different tobacco products are associated with different levels of health risks, and smokeless tobacco (the most popular form of which in Europe and North America is moist snuff, held between the lip and gum) is substantially less harmful when compared with cigarettes. Estimates typically put the risk of dying from snuff use in the range of 1% or 2% of that from cigarette smoking, though some experts put the estimate at or near zero since snuff use has not been definitively linked to any fatal disease.