Dr. Brad Radu is a senior scientist in our comprehensive cancer center. He writes and speaks extensively on the use of smokeless tobacco as a smoking alternative (he is pro). He writes this commentary in today’s Washington Times – News you can’t use
Dr. Richard Carmona, the Surgeon General and the Bush administration’s primary adviser on the nation’s public health, demonstrated that he is sadly ill-informed about the nation’s No. 1 health problem, cigarette smoking, during testimony at a House Energy and Commerce subcommittee hearing on June 3.
Dr. Carmona’s first blunder was his contention that “there is no significant scientific evidence that suggests smokeless tobacco is a safer alternative to cigarettes.” Dr. Carmona ignored decades of published research and the prestigious British Royal College of Physicians, who reported last year that smokeless tobacco products are “on the order of 10 to 1,000 times less hazardous than smoking.”
Surely Dr. Carmona knows that cigarette smoking is a major risk factor for lung and other cancers, heart diseases and emphysema, resulting in 440,000 deaths annually in the United States. But he doesn’t seem to appreciate that smokeless tobacco use carries no risk for lung cancer, heart diseases or emphysema.The only consequential risk for long-term smokeless use is mouth cancer. Fifty years of research prove that even this risk is very low (less than half that associated with smoking). In fact, smokeless tobacco use is about as safe as automobile use.That’s 98 percent safer than smoking.
Now while not all experts agree with Dr. Radu, he makes a very important point. We must look carefully at the evidence, even if the evidence does not coincide with our preferred world view. He is asking, albeit in a challenging way, the Surgeon General to study prior to speaking out on an issue. In that Radu is correct.
Dr. Carmona’s other blunder was his support for banning tobacco products. Asked if he “would support banning or abolishing all tobacco products,” Dr. Carmona responded “I would at this point, yes.”This marked the first time a Surgeon General has called for outright prohibition, and he sent would-be supporters running from the Hill. Even the Campaign for Tobacco-Free Kids, which has shown little interest in helping inveterate adult smokers, couldn’t support Dr. Carmona. Its spokesman commented that “We would all like to see a tobacco-free world…we can’t just take away their tobacco.”Dr. Carmona’s boss can’t be happy; Bush administration officials responded quickly. “That is not the policy of the administration,” commented White House spokesman Scott McClellan, saying that Dr. Carmona’s comments represented only his views as a doctor.
But Dr. Carmona’s views as a doctor are just the point. He occupies one of the most trusted positions in American medicine and in American government. The Bush administration should do more than distance itself from these dangerous and irresponsible positions. It should direct Dr. Carmona to read the dozens of scientific research papers on tobacco harm reduction. It should direct him to review the evidence from Sweden that smokers can quit by substituting smokeless tobacco.
Finally, it should require that he tell American smokers the truth about all available options for quitting. After all, the 10 million smokers who will die over the next two decades are, in a very tangible way, his responsibility and his legacy.
We need scientific integrity even in political discussions. We also need common sense in leaders. Calling for a complete ban on tobacco is almost as stupid as alcohol prohibition was and marijuana prohibition is.