'Smokeless Doesn't Mean Harmless' Campaign May be Doing More Harm

Published February 24, 2017

“The public — consumers and would-be consumers — are dangerously in the dark about differences in tobacco/nicotine product risks. The public needs to know these facts,”
Department of Community Health and Health Behavior

Last spring, the U.S. Food and Drug Administration unveiled a $36 million ad campaign focused on the dangers of smokeless tobacco use among rural teens.  But the FDA’s “Smokeless Doesn’t Mean Harmless” campaign may be doing more harm than good, two noted North American public health researchers write in the journal Addictive Behaviors.

That’s because the “Smokeless Doesn’t Mean Harmless” effort, an extension of the FDA’s “Real Cost” ad campaign, fails to provide the public with what the researchers say is much-needed information on the relative risks of smokeless tobacco products, including e-cigarettes, compared to traditional cigarettes. That information is especially critical considering the large number of young adults who both use smokeless tobacco products and smoke cigarettes.

“Telling the public that something is ‘not harmless,’ especially when they already know that, is at best a wasted effort. At worst, when so many smokeless users also smoke cigarettes — and do not know that cigarettes are much more harmful — it may promote their quitting smokeless and continuing smoking,” said Dr. Lynn Kozlowski, professor of community health and health behavior in the University at Buffalo’s School of Public Health and Health Professions.  Dr. Kozlowski wrote the piece with David Sweanor of the Centre for Health Law, Policy and Ethics at the University of Ottawa, Canada.

Their commentary points to research showing that the public already knows that smokeless tobacco is not harmless, but is woefully unaware that cigarettes are much more dangerous. In fact, they cite research indicating that smokeless tobacco is estimated to be more than 90 percent less harmful than cigarettes.

“The public — consumers and would-be consumers — are dangerously in the dark about differences in tobacco/nicotine product risks. The public needs to know these facts,” said Dr. Kozlowski, the former dean of UB’s School of Public Health and Health Professions and a contributor to four U.S. Surgeon General’s reports on smoking and health.

“The FDA’s multi-million dollar campaign attacking smokeless tobacco is almost certainly leading to higher levels of disease by causing Americans to use far-more-hazardous cigarettes,” adds Mr. Sweanor.

In addition, they write, the fear of smokeless tobacco serving as a “gateway” to cigarettes is rendered moot based on the fact that the use of both smokeless tobacco products and cigarettes is common among young users. Previous research shows that in 2014, 44 percent of 12th grade males who used smokeless products also smoked.

“Individuals who are already using multiple products need to be fully aware of the much greater risks from smoked tobacco products,” Dr. Kozlowski said.

In their commentary, Dr. Kozlowski and Mr. Sweanor liken government health agencies’ failure to provide the public with information on relative product risks to Big Tobacco’s efforts to market so-called “low-tar” cigarettes, which misled consumers into thinking they were safer products. In 2006, a federal judge ordered cigarette manufacturers to put an end to low-tar and “light” labeling on cigarette packs.

Explains Mr. Sweanor: “Misleading consumers is unethical, and consumer protection laws aim to prevent companies from engaging in such behavior. Tobacco companies were held to account for misleading the public. But we now have government agencies engaging in similar behavior, and it is no less unacceptable.”