When I joined this group, one of the first projects was to do a follow up to Carl’s seminal paper: You might as well smoke; the misleading and harmful public message about smokeless tobacco.
That 2005 paper trolled the net to see what the dominant messages were regarding smokeless tobacco in comparison to smoking and found with very few exceptions that the message from both official and unofficial agencies was that there was no difference in risk between the two and hence the title of the article. Our followup was to see if the same message was still in effect and what we found was that there had been little improvement and the only evidence-based comparitive risk information could be traced to either Brad Rodu or our still relatively new website.
As another part of the study and assuming that some of these messages were simply iterated without knowing they were faulty, we wrote detailed letters to the providers illustrating the conflict that existed between their words and the actual evidence and how such misinformation was potentially fatal to smokers who otherwise might have switched. We managed to get a few to change but among those who did not respond were the AAO ( American Academy of Otolaryngology) which even at that time was rabidly inaccurate.
And now, a recent press release shows that they will still make no concessions to the evidence and continue to say that smokeless tobacco is actually worse than smoking when it comes to oral cancer and possibly the most puzzling aspect of this is that these people claim an expertise in the area of head and neck cancer.
Given that ample evidence exists, the only explanations for this are that either they are quite ignorant in their own field (but still are trusted by oral cancer victims) or that they do know better but are deliberately suggesting that if given a choice people should keep smoking with its well supported correlation with oral cancer rather than switch to an alternative with a hardly better than chance association.
But to go to the words from the mouth of the horse:
“Using smokeless tobacco products, like chew, is not a safe way to quit or a healthier alternative to smoking,” said Daniel Deschler, MD, chair of the AAO-HNS Head and Neck Surgery/Oncology Committee. “The use of these products just shifts the increased risk of cancer to the mouth, head, and neck.”
Smokeless tobacco users run the same risks of gum disease, heart disease, high blood pressure, and addiction as cigarette users, but an even greater risk of oral cancer.
It is simple enough to point out that they are simply and utterly wrong but how is it that, in this day and age, an institution that supposedly cares about its own reputation, doctors who in order to function well need their patients to trust them, that this trust is best built through transparency and truth, that with such a potential for undermining all the good work (which I assume even if perhaps I shouldn’t given this travesty) that they do.
And this following fast on the heels of the Mayo clinic (see Brad’s detailed analysis of that nonsense) also making sure that when it comes to good health information, smokers (and everyone else too) can just stay at the back of the bus.
-Paul L. Bergen