Friday, February 19, 2010

In Harm Reduction's Way

There is currently a battle raging between anti-tobacco zealots, who refuse to countenance any use of any form of the weed at any time, and a rather saner segment that favors what is called a "reduced harm" strategy. The vehemence of the ATZs makes it clear that they think that the tobacco leaf is the pustulent rotting foliage of Satan's favorite houseplant and, mostly being good liberals, slot tobacco company execs at the penultimate nadir of human slime mold just below concentration camp commandants and only just above the arch villain Limbaugh. ATZs will apparently not rest until every fibrous vestige of Nicotiana tabacum is expunged from the society of humankind.

A significantly less rhetorically incindiary group known as reduced harm advocates admit that the reduction of smoking is a Good Thing but instead of punitive taxation and nanny-state coercion they prefer the considerably more effective course of offering smokers substitutes that deliver nicotine in a far less unhealthy fashion.

There are number of harm reduction products (patches, gum, "electronic" cigarettes and the like) available which eschew tobacco entirely. Other products can accomplish similar goals although they are not designed expressly as such. This unintentionality is represented by products known generically as "smokeless" tobacco. Until recently in American terms this has meant primarily snuff (moist and dry) and various forms of chewing tobacco. So you got your dip and your chew which are widely popular in the relatively rural hinterlands but have sundry aesthetic drawbacks that hinder a greater level of big-citified adaptation.

Having closed in on diminishing returns regarding smoking elimination ATZs have set their sights on demonizing, taxing, and to whatever degree possible impeding the "spread" of smokeless tobacco. A favorite tag line for anti smokeless propaganda is "If you think dip is safer than smoking then think again." That overwrought sentiment is in fact a plain baldfaced lie. Dip and chew do in fact have some health repercussions but they utterly pale compared to smoking. Their use is wildly safer with health consequences that are negligible compared to inhaling a pack or two of cigs a day. And oh yeah even the supposedly sober science oriented American Lung Association propagates this abominable lie.

When pressed hard antis may admit that smokeless may in fact safer than smoking but are quick to trot out the shibboleth that smokeless products are a "gateway" to smoking for young people. There is virtually no scientific evidence to support this but antis seem to believe that if they say it often enough and with sufficient force and sincerity then it must be true. Further antis assert that the recent increase in flavors of smokeless tobacco is a scurrilous and naked attempt to attract impressionable children to such products. Nonsense. It is an attempt to cash in on the proliferating public smoking bans in all parts of the country which affect adults more than whippersnappers. In New York City "Nanny" Bloomberg is busy pushing the ban of flavored smokeless products except for traditional flavors such as "natural" and wintergreen. How this might keep youngsters from using smokeless is a mystery entire. Without doubt steep tax increases, the first refuge of the Progressive, are soon to follow.

There is one smokeless tobacco product that in addition to making inroads in the U.S. market in recent years is not only far safer than smoking but is safer yet than traditional American dip and chew. It hails from Sweden and is known as snus which is pronounced "snoose". The word simply means snuff in Swedish but any resemblance to traditional inhaled dry snuff or American dip is entirely lacking. Snus is packaged primarily in "portions" which are gram sized amounts of finely ground tobacco encased in a soft tea bag like tube or pouch. These portions are intended to be inserted between one's upper lip and gum and deliver nicotine and flavor in a fashion that is accurately, if inelegantly, labeled "spitless". This means that they draw far less saliva than traditional dip and do not require the spitting out of juice which elevates the social acceptability level dramatically.

This spitless behavior is due to the way Swedish snus is manufactured. Instead of the normal American practice of fire curing/fermenting snus is steam pasturized which not only renders any adverse microorganisms inert but also greatly reduces the levels of carcenogenic nitrosamines found in dip and chew. In fact it reduces them to near microscopic levels that are far lower than dip and chew--vanishingly low. As a result the deleterious consequences of snus usage are essentially nonexistent. A variety of Swedish government and academic medical studies have shown snus to be by far the most harmless tobacco product sold, period. One study indicated a possible tiny increase in pancreatic cancers among snus users while others have failed to establish any increased disease risk at all.

What these studies have also shown is that snus is not only not a gateway to smoking but is in fact a brightly lit EXIT sign for smokers. Snus has been made and used in Sweden for over 200 years but its popularity soared in the 1970s when, in addition to the original "lös" or loose form which required hand forming into a small cylinder, the product was offered in "portions". Portions made snus usage nearly invisible socially and were rather less messy than the lös form. The actual product, and the strict Swedish regulation of its manufacture, was not changed. Since then usage has greatly increased so that now over one million people (out of a population of only nine million) uses snus in Sweden and thousands of smokers switch each year. As snus usage increased smoking waned as did overall health consequences. Now Sweden has the lowest rates of lung and mouth cancer of any developed country.

The comparative health benefits of snus are utterly incontrovertible and as an aid to smoking cessation it exhibits higher percentages of efficacy than any other method. It still delivers nicotine of course but being merely addicted to nicotine is fantastically preferable to smoking. The varying nicotine delivery levels of different brands are what aid smoking cessation because snusers can vary the level according to need. A cigarette delivers about 1mg of nicotine over a few minute period. Snus delivers its nicotine in a time frame of 30 to 60 minutes with some levels as low as 4mg and as high as 19. The lower levels can be used in a "maintenance" strategy and there are versions strong enough to kill even the strongest cigarette cravings.

Snus is available in a wide variety of flavors and packagings, and nicotine strength of course, which accommodates virtually any taste. Snusing in Sweden cuts across all social, economic, and gender lines, from horny-handed working men to fashionista femmes in executive suites, and thus has no shortage of cosmopolitan cachet. It is practically de rigueur for club hopping and hanging.

In the past half dozen years snus has begun to make market inroads in the U.S. although its share is still tiny. An extremely enthusiastic and boisterous online community has sprung up with many sites offering commentary and reviews of snus products. A number of online retailers have opened to service this growing market and sales are increasing steadily if not spectacularly.

A few U.S companies have made timorous forays into the market, most notably RJR with its Camel SNUS line. The brand has had modest commercial success but sales have recently stalled. Snus congnescenti in general disdain the Camel version as greatly inferior in taste and nicotine delivery compared to the real Swedish deal. Some even mutter that RJR is using its weak tea snus version merely as an adjunct to smoking with little intent to displace sales of cigarettes. Having tried it I concur with this assessment. A Marlboro branded snus has made an appearance on store shelves but the less said about this excremental junk the better. Regardless of that if snus continues to rise in popularity the U.S. companies will likely take greater notice and offer product more competitive with the genuine article.

Snus may well be a boon to clubs and bars since so many municipalities are banning smoking in virtually all public venues. There would be absolutely zero chance of any allegedly harmful "secondary" fumoria for antis to fret and fuss about. Snusing in restaurants will be less popular because although drinking liquids whilst using is possible, and even rewarding, eating is another matter.

I forsee the advent of the Snus Bar which would offer a selection of product along with the usual sorts of adult beverages. For the non-alchoholic set the coffehouse business model might prove attractive. And just as importantly snusing at work, or at the countless places that now ban smoking, will not involve fleeing outside into rain cold or snow to get a nic fix. Snusing at the movies? By all means. Snusing on hospital visits? Bring it on. Snusing in church? Whatever your conscience will tolerate.

This rosy future is under threat by the usual suspects. Not only are states and municipalities socking smokeless tobacco with draconian new taxes but ATZs and their progressive fellow travelers in Congress are pushing a bill which is currently oozing its way through the legislative process. It is the PACT bill, short for Prevent All Cigarette Trafficking Act, and is aimed at illegal cigarette trafficking but threatens to ensnare snus in its blundering nanny-state dragnet. The bill will, among other things, impede and raise the cost of internet sales of tobacco products which are the principal means of obtaining Swedish snus since U.S. local retail sales are as yet fairly spotty. Ironically cigars are exempt from the bill's provisions which raises dark suspicions that the bill's authors think that fat cat CEOs and stogie lovin' pols wouldn't have supported it for fear of having access to their favorite pricy predilection impeded.

ATZs from hither and yon are naturally applauding the bill because it is, of course, "for the children". O' Lawd give me strength. Oblivious twits that they are most antis are likely unaware of either snus or its potential benefits to the smoking population. Even if they were aware their vehemence would doubtless be unmodified since snus cleanly and conveniently delivers the vile poisonous addictive drug nicotine. Nicotine is of course addictive but in amounts consumed normally by humans the health hazards of the chemical by itself are inconsequential compared to the ravages of the most widely used delivery system which is smoking. Snus usage entirely eliminates the hazards of smoke, threatens no one with secondary effluvia, and is about as minimal a cause of health problems as is statistically conceivable.

Incidentally the FDA is maliciously complicit in the ATZ's preposterous deceptions by requiring that snus labels have a warning that states "This product is not a safe alternative to smoking." or "This product may cause mouth cancer." No you bloody fools it is a completely safe alternative and will cause no cancer of any kind. How the devil would the FDA know anyway? They have done exactly zero testing of genuine Swedish snus and are apparently unaware of the many studies that have been done by the Swedes, Brits, Australians, and others. If they are not unaware of these studies then the warning labels are a cruel malfeasance which is likely born of being in thrall to, or fearful of, ATZ's eliminationist demagoguery.

Snus usage will likely increase because of its benefits and enjoyment of use, even while laboring under punitive measures, but if propagandic mendacity, onerous taxation, and relentless perspectiveless pursuit of tobacco bans continue to be employed by ATZs then they will have finally marked themselves as heedless blinkered obsessives who have willingly let themselves be led into abject criminal irresponsibility by impeding one of the most effective methods of quitting smoking.

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