University at Buffalo Tobacco Policy Expert Says Official Warning Label May Have Misled Tobacco Consumers for Years

Lynn Kozlowski, PhD

Published July 25, 2018

“The American public has become mostly unaware that smokeless tobacco is much less harmful than cigarettes.”
Lynn Kozlowski, PhD, Professor, Community Health and Health Behavior

In 1986, the U.S. government passed legislation requiring a series of warnings for smokeless tobacco products, one of which advised “This product is not a safe alternative to cigarettes.”

That warning, however, obscured an important distinction — that cigarettes are much more harmful to health than smokeless tobacco products — and over the 30-plus years since, the American public has mostly been unaware that smokeless tobacco is much less harmful than cigarettes, one of the nation’s leading tobacco policy experts writes in a recently published paper.

“It is important to distinguish between evidence that a product is ‘not safe’ and evidence that a product is ‘not safer’ than cigarettes or ‘just as harmful’ as cigarettes,” said paper author Dr. Lynn Kozlowski, professor of community health and health behavior in the University at Buffalo School of Public Health and Health Professions. “The process at the time of the establishment of official smokeless tobacco warnings in the 1980s paid no attention to this distinction,” added Dr. Kozlowski. “The American public has become mostly unaware that smokeless tobacco is much less harmful than cigarettes.”

Dr. Kozlowski’s paper was published in Harm Reduction Journal. In it, he examines the origins of the 1980s warning labels and the war that was brewing between the smokeless tobacco industry and U.S. cigarette companies — separate at the time — which contributed to the “not a safe alternative to cigarettes” labeling for smokeless tobacco products. Neither liked the warning labels that many states were in the process of requiring, which referenced the addictive nature of smokeless tobacco. The concern was that cigarettes would be next on the list to be declared addictive.

In addition, U.S. cigarette companies and health authorities balked at a successful advertising campaign for Skoal’s wintergreen flavored moist snuff. The campaign encouraged consumers to “Take a pouch instead of a puff,” which, to some groups, implied that the Skoal product was a safe choice compared to smoking cigarettes.

With smokeless tobacco gaining in popularity, many states began to take action, and by January 1986 more than two-dozen states had passed legislation requiring warning labels for smokeless tobacco products. Many labels noted the products contained nicotine and were addictive, and some warned that smokeless tobacco could cause mouth cancer. None, however, included the “not a safe alternative to cigarettes” message. That came at the urging of the cigarette industry, Dr. Kozlowski says. There were fears that the tough labels states were requiring for smokeless tobacco products could also affect cigarette package warnings.

Dr. Kozlowski reviewed more than 400 documents distributed or published between 1964 and 1990 to gain a better understanding of the historical context of the warning labels. The review included internal industry documents, legislative materials and media reports, among others.

One thing in particular stood out, Dr. Kozlowski said: “The evidence that the cigarette industry was concerned about smokeless tobacco being marketed in a way that seemed to promote smokeless as less harmful than cigarettes.”