When the Facts are too boring

The following is the English translation of an article Dr. Rutqvist wrote today in Aftenposten.no.  This is a link to the original article by Dr. Rutqvist.

Life could have been spared the Norwegian smokers had been advised of the health difference between snus and cigarettes.

Smokeless tobacco is 90 percent less harmful than cigarettes. You know Tom K. Grimsrud in the Cancer Registry. Yet he chooses in Aftenposten on 14 August to continue to spread disinformation about the link between tobacco and adverse health effects. A debate about the health effects of pleasure products is important, but only if it is based on facts and not scare.

In the article in Aftenposten Grimsrud argues that it is a bad idea to replace cigarettes with snuff and snus increases the risk of cancer. Royal College of Physicians has concluded that smokeless tobacco is at least 90 percent less harmful than cigarettes. It is now over 10 years since the EU from a scientific standpoint removed cancer warning on snuff box. Fact is that if everyone who smoked went over to snuff it would have had major positive health effects.

Life could have been spared the Norwegian smokers had been advised of the health difference between snus and cigarettes. This has happened in Sweden, and is about to happen in Norway…..

Get negative effects

Smokeless tobacco includes tobacco, but it has few or none of the negative health effects of cigarettes. On the contrary, snuff is the most widely used and clinically proven most effective means to stop smoking. Everyone knows someone who has quit smoking by using snus. A committee of experts who work on behalf of the EU Health Authority in 2008 concluded that the Swedish public health is improved because many smokers have quit using smokeless tobacco.

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Grimsrud argues that the WHO Cancer Research (IARC) has concluded that smokeless tobacco and cancer. This is a gross oversimplification. IARC has concluded that its smokeless tobacco as a whole must be regarded as carcinogenic. This category includes many different products, from products that are almost as harmful as cigarettes in one end of the scale to snuff on the other end. IARC report from 2009 is based primarily on research on African and Indian products which have health effects that look more like cigarettes than smokeless tobacco.

It Grimsrud not mention is that WHO has compared the health effects of smokeless tobacco with nicotine medicines. Swedish snus produced by industry standard GothiaTek have lower levels of unwanted items (nitrosamines and bone pyrene) than the limits WHO recommends for smokeless tobacco.

At one point, Grimsrud absolutely right. Pregnant and breastfeeding women should not pry. They should stay away from anything that contains nicotine, also drugs.

Prevention of cancer

Over the years I was head of cancer registry in Stockholm (part of the Swedish Cancer Registry) was the highest goal of the work to prevent cancer and thus contribute to a better public health. It does not seem like Grimsrud share that view. He mentions not at all public health in their statements. Thus he avoids discussing potential snuff in order to prevent both cancer and cardiovascular disease among smokers.

We must have an active debate about the health effects of products Norwegians use. Should the debate be an intentional effect it must be based on facts. It is not Grimstad statements in Aftenposten.

Lars Erik Rutqvist Professor, cancer specialist and scientific advisor to Swedish Match AB