Smokeless tobacco: the epidemiology and politics of harm

@article{Phillips2009SmokelessTT,
  title={Smokeless tobacco: the epidemiology and politics of harm},
  author={Carl V. Phillips and Karyn K Heavner},
  journal={Biomarkers},
  year={2009},
  volume={14},
  pages={79 - 84}
}
The health burden from tobacco smoking results almost entirely from inhalation of the components of smoke, although this is not widely known. The primary benefit of smoking is nicotine delivery, but nicotine can be obtained without combustion. Thus there is potential for tobacco harm reduction (THR), the substitution of lower-risk nicotine products for smoking. Epidemiological evidence suggests that smokeless tobacco causes about one one-hundredth the health risk of smoking. Despite the… 

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References

SHOWING 1-10 OF 27 REFERENCES

You might as well smoke; the misleading and harmful public message about smokeless tobacco

TLDR
Through websites containing information about ST and health risks, ST users are told, in effect, that they might as well switch to smoking if they like it a bit more, representing violations of ethical standards.

Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure? An analysis of the scientific evidence and commentary on the implications for tobacco control and public health practice

  • M. Siegel
  • Medicine
    Epidemiologic perspectives & innovations : EP+I
  • 2007
TLDR
Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers.

Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey

TLDR
Switching to ST compares very favorably with pharmaceutical nicotine as a quit-smoking aid among American men, despite the fact that few smokers know that the switch provides almost all of the health benefits of complete tobacco abstinence.

Warning: Anti-tobacco activism may be hazardous to epidemiologic science

  • C. Phillips
  • Political Science, Medicine
    Epidemiologic perspectives & innovations : EP+I
  • 2007
TLDR
These stories suggest a willingness of influential anti-tobacco activists to hurt legitimate scientists and turn epidemiology into junk science in order to further their agendas, and the willingness of epidemiologists to embrace such anti-scientific influences bodes ill for the field's reputation as a legitimate science.

Defending legitimate epidemiologic research: combating Lysenko pseudoscience

  • J. Enstrom
  • Medicine
    Epidemiologic perspectives & innovations : EP+I
  • 2007
TLDR
This analysis presents a detailed defense of my epidemiologic research that found no significant relationship between environmental tobacco smoke (ETS) and tobacco-related mortality and compares many aspect of ETS epidemiology in the U.S. with pseudoscience in the Soviet Union during the period of Trofim Denisovich Lysenko.

The burden of mortality from smoking: Comparing Sweden with other countries in the European Union

  • B. RoduP. Cole
  • Medicine, Economics
    European Journal of Epidemiology
  • 2004
TLDR
The mortality currently attributable to smoking in the European Union (EU) is described, and the change that would result if all EU countries had the smoking prevalence of Sweden is described.

The Decline of Smoking in Northern Sweden

TLDR
For the first time snus use is also associated with a decrease in smoking prevalence among women, and these patterns of tobacco use have implications for all smoking-dominated societies.

Commentary: Lack of scientific influences on epidemiology.

  • C. Phillips
  • Political Science
    International journal of epidemiology
  • 2008
TLDR
Ethical guidelines regarding expert testimony should address concerns of all parties in the judicial process, and should be applicable to every scientist, regardless of whether the scientist serves corporate, public or academic interests.

The Reduction of Drug-Related Harm

This book gathers together an international group of practitioners who argue persuasively about the paramount importance of harm reduction strategies rather than total abstention in the fight against

Publication bias in situ

  • C. Phillips
  • Medicine
    BMC medical research methodology
  • 2004
TLDR
Examples are presented that show how easily PBIS can have a large impact on reported results, as well as how there can be no simple answer to it.