Philip Morris Ask for Tobacco Risk Comparison

The Wall Street Journal reported Jan. 6 that Philip Morris and U.S. Smokeless Tobacco Co., both parts of the Altria Group Inc., wrote to the FDA suggesting that tobacco products be ranked on their harmfulness to health. This would most likely result in smokeless tobacco products being ranked as markedly less harmful than cigarettes. Philip Morris apparently claimed the plan would have "a significant public-health benefit." (assuming smokers took the rankings at face value and switched from more to less harmful products).

Now at face value, this sounds reasonably sensible. But when we consider that Philip Morris USA makes the vast majority of its profits from cigarette sales, and the plan would apparently reduce those sales as smokers switched to smokeless products, it is reasonable to wonder what they are playing at.

Firstly, we need to be realistic and accept that all private tobacco companies have a legal duty to maximize fields for shareholders. Public health is neither their business nor primary concern. So what are they up to? The first thing to note is that the recent FDA legislation outlines in some detail the procedures that have to be followed before a tobacco company is allowed to make a claim that one of its products is less harmful to health than an alternative tobacco product (i.e. make a comparative risk claim). The legislation appears to require a significant amount of evidence, not only regarding the relative risks to individual users, but also regarding the total population impact (including for example, estimates of whether the claim or product may result in more tobacco users and potentially greater total harm). Not everyone agrees that this is a fair or reasonable evidential barrier to require before being permitted to make a claim, but this is what the legislation requires. The recent request to FDA may be seen as an attempt either to circumvent some of these procedures, or at least to initiate the process.

The next question is why would tobacco companies want this, if their current profits come mainly from cigarettes (particularly Philip Morris who have the largest market share for cigarettes in the USA)?

Those who are skeptical about tobacco companies motives (and with very good reason) suspect that the companies do not really intend that smokers switch from extremely harmful cigarettes to much less harmful smokeless tobacco. Rather they may see smokeless as providing smokers with a bridge product to use in situations where smoking is not allowed. As smoke-free air legislation sweeps across the United States and the rest of the world, many smokers will find it is just too much hassle to be a smoker and will try to quit. But if these smokers can use smokeless tobacco when in a smoke-free environment, and then return to smoking when they are outside or at home, this could keep people smoking who would otherwise have quit.

The current marketing for smokeless tobacco products has an emphasis on the “for when you cant smoke” message. Skeptics see this as the gameplan. On the other hand, one can see that if you want to tempt smokers into trying a different product, that is the most obvious selling point to get them to try.

My view is that the smokeless tobacco products are clearly much less harmful than cigarettes to the individual user. Even within the category of “smokeless tobacco” the products contain and deliver markedly different amounts of toxins and nicotine. Products that deliver a moderate to high dose of nicotine, with a low dose of toxins (which do exist and are very popular in some countries) have great potential for replacing smoking. But this will only have a significant positive impact on health if the smoker switches completely to the smokeless tobacco product, and quits smoking completely. Of course in this discussion we should not forget that people use these products primarily for the effects of (addiction to) nicotine. A better way to quit smoking is to get some advice and support and use a product (or 2 or 3) that has been demonstrated to be safe and effective for smoking cessation.
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About the Author

MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.