SNUS use in Inveterate (long established, deep-rooted, in-grained) Tobacco Smokers..

February 16, 2008 - Head-to-Head Discussion.. Dr. John Britton Professor of Epidemiology at the City Hospital Nottingham. Smoking currently kills over 100,000 UK citizens each year. Currently 77% of UK smokers want to quit and 78% have tried and failed, mainly because of nicotine addiction. Britton believes that, as a measure of last resort in smokers who have tried all other cessation and substitution options, doctors would be justified in suggesting an individual trial of snus. Whether this approach will prove effective remains to be seen and desperately needs to be tested in clinical trials, he concludes. Dr. Alexander Macara, President of the National Heart Forum, Bristol argues that this Britton's approach could result in increased use of tobacco. He points to evidence that smokeless tobacco is carcinogenic to humans. Studies have also shown increases in the risk of oral and pancreatic cancers and heart attacks related to the use of various smokeless tobacco products. Macara fears that, if legalised, snus might be taken up by people, especially the young, who might never have smoked tobacco but who may then progress to doing so. ERROR: the sentence: He (Macara) acknowledges that smokeless tobacco is less addictive than smoked tobacco, but warns that at least 60% of people who use snus to quit smoking become chronic snus users. Smokeless Tobacco is NOT less addictive than tobacco smoking in fact nicotine blood levels last longer and may even be higher when using smokeless tobacco (the pH of the smokeless tobacco is usually adjusted upward to increase absorption of nicotine in the oral cavity.(Maximum levels of nicotine were similar but, because of prolonged absorption, overall nicotine exposure was twice as large after single exposures to smokeless tobacco compared with cigarette smoking (Benowitz et al., Clin Pharmacol Ther. Jul;44(1):23-8, 1988) (Should doctors advocate alternative sources of nicotine? Head to Head: Should doctors advocate snus and other nicotine replacements?), BMJ - Press releases Saturday 16 February 2008) "There is no evidence smokeless tobacco can help people quit smoking. There are no studies we would consider sufficient." Dr. Terry Pechacek, Associate Director of Science at the Centers for Disease Control Office on Smoking and Health. (SNUS the BUMP, Nordic Reach (The Scandinavian Lifestyle Quarterly}, No.17 Volume XIX, 2007, p53). The vast majority of inveterate smokers will not learn the art of snusing. Murray Kessler, Chief Executive Officer of UST, Inc - the world's leading producer of moist smokeless tobacco products - tells us that 9 out of 10 smokers that try smokeless reject the product. Dr. Britton was soundly defeated in a debate on the topic of the use of snus by Dr. Lewis Keir at the first National Conference for the British Association for Stop Smoking Practitioners in Manchester on September 26, 2007. As pointed out by Dr. Britton himself "It's their (tobacco companies) job to sell as much tobacco as possible, so they will be targeting non-smokers rather than current ones, that's the worry." The initial test marketing of snus in the states by traditional cigarette companies has failed and these companies are either removing the product or calling for more education and public awareness. The EU ban on SNUS must be upheld or all of Europe will end up with another generation of nicotine addicts never able to reach their full potential. (