CDC’s wonkish publication, Morbidity and Mortality Weekly Report (MMWR) just published one of the usual (boring but potentially useful for something) mining of statistics that shows that some smokers also use some other tobacco products. The report itself starts with the usual anti-tobacco boilerplate myths — just background noise — and then reports the statistics (with misleading precision, as usual, but basically legitimate work). Then the political actors took over from the epidemiologists. First, no legitimate scientist would try to get the popular press to report on these results, since they are utterly meaningless to anyone who is not studying particular trends and such, but they did so. Worse, the CDC politicos tried to spin this as a reason to focus on discouraging dual use and, thus, to discourage switching to low risk alternatives.
In touting this to the press, CDC Director Thomas R. Frieden said in a news release. “The more types of tobacco products people use, the greater their risk for many diseases caused by tobacco, such as cancer and heart disease.” What nonsense. A cigarette smoker who puffs the occasional cigar is at greater risk as a result? Or, worse, someone who substitutes smokeless tobacco (ST) for some of their cigarettes, who is undoubtedly at lower risk, is in CDC’s crosshairs. The spin is that more needs to be done to discourage smokers from using other tobacco products in addition.
Presumably the people at CDC who are behind this are aware that switching from smoking to ST almost always goes through a period of using both. This lowers their risk substantially even if it never changes, though the hope is that they will then find that using ST alone is an acceptable choice. But since such tobacco harm reduction (THR) is a threat to the anti-tobacco extremist agenda — because people who use low-risk nicotine products, unlike smokers, have very limited incentives to quit — the extremists need to discourage people from reducing their risks. The brief editorial accompanying the statistical report notes the Healthy People 2010 (better hurry!) goal to reduce cigarette smoking to 12.0% (you have to love that extra decimal place — it almost makes it sound like the number was not just pulled out of the air) and “spit” tobacco use to 0.4%. (Note to Brad Rodu: Yes, they are still using that inaccurate and derogatory term despite your efforts.) Of course if they really cared about Healthy People, they would encourage the use of ST instead of smoking. Indeed, the only (yes, absolutely only) method that has ever lowered the smoking prevalence in a population as low as 12% is getting the ST prevalence to go much higher (i.e., the Swedish experience of using ST instead of smoking).
One last litmus test: It will be impossible to take CDC seriously on this topic until they stop publishing statistics that lump together ST, bidis (almost certainly worse than regular cigarettes), pipes and cigars (used in a huge variety of ways, quite often casually), etc. into the useless category “other tobacco products”. This is a clear sign that they care more about the mere use of tobacco (i.e., extremism) rather than about health effects.
– Carl V. Phillips