Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, August 1, 1995 TAG: 9508010090
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: RICK ANSORGE COLORADO SPRINGS GAZETTE TELEGRAPH
DATELINE: COLORADO SPRINGS, COLO. LENGTH: Long
But to this, other anti-smoking activists say ``Ptooey!''
The controversial dentist was in Colorado Springs recently to attend an oral pathologists' convention and promote his new book, ``For Smokers Only: How Smokeless Tobacco Can Save Your Life.''
``We have 420,000 smokers dying every year from smoking-related diseases,'' he says. ``This proposal could cut that death rate by 98 percent if it was fully implemented.''
Rodu's opponents concede that such a switch would greatly reduce the incidence of lung cancer, but worry that users would still be at high risk for oral, throat and esophageal cancers.
``Suggesting this switch is like telling someone to use a rifle instead of an Uzi,'' says Barbara Moles, associate executive director of the American Association of Oral and Maxillofacial Surgeons.
Rodu, 40, developed his proposal after observing patients for 16 years at the University of Alabama's Comprehensive Cancer Center. He's now a senior scientist at the center and chairman of the oral pathology department at the university's dental school.
Because the South has a high incidence of smokeless-tobacco use, Rodu expected to see a correspondingly high incidence of oral cancers. But he hasn't.
``Most all the oral cancers we see are smoking-related,'' he says. Intrigued by this seeming contradiction, Rodu reviewed medical literature.
``Smoking produces about double the risk for mouth cancer that smokeless tobacco does,'' he says.
Rodu found that the incidence of oral cancer among long-term smokeless-tobacco users is low (26 out of 100,000, according to the New England Journal of Medicine). He also found that the disease usually strikes only after decades of use (an average of 551/2 years, according to the National Cancer Institute.)
Rodu says he found no evidence linking smokeless tobacco with one of cigarettes' most lethal and well-documented consequences: heart disease.
``Is smokeless tobacco safe? No, of course not. But it's 98 percent safer than smoking,'' he says.
His conclusion: Smoke kills people, not nicotine.
He believes that switching to smokeless tobacco is a sensible alternative for adult smokers who can't shake their nicotine addiction. ``It's an efficient way to get the same feelings a smoker gets when lighting up,'' he says.
A nontobacco user, Rodu denies any connection with the tobacco industry. But his findings, if true, would be great news for the rapidly expanding smokeless-tobacco industry. Since 1972, smokeless-tobacco sales have more than tripled, according to the American Association for World Health.
Today, about 10 million Americans - including 3 million under age 21 - use smokeless tobacco, according to the National Centers for Disease Control in Atlanta. Teen-agers are drawn to the habit in part because of its high visibility among premiere professional athletes - 45 percent of whom use smokeless tobacco, according to a 1992 survey published in the American Journal of Public Health.
Rodu, however, finds this trend alarming. ``Children should not be using tobacco in any way, period,'' he says. ``We have laws in all 50 states that cover such use.''
At the Comprehensive Cancer Center, Rodu runs a quit-smoking program that teaches clients to use smokeless tobacco without grossing out family, friends and co-workers. Snuff packed in paper pouches is the most discreet, he says.
Part of the incentive to switch is money. By switching from two packs of cigarettes a day to two cans of snuff a week, many of Rodu's clients have reduced their weekly tab from $28 to $4.
Rodu plans to publish a study of the program, which he describes as part of a national trend.
``Data from the Centers for Disease Control show that 11/2-2 million people have already done this on their own,'' he says. ``Obviously, given the incredible amount of tobacco opposition, that particular fact has not been very well publicized.''
Such statements burn up traditional anti-smoking activists, who oppose any use of tobacco.
In 1986, the U.S. Surgeon General warned that smokeless tobacco ``is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous oral conditions.'' Like other tobacco products, snuff and chewing-tobacco packages are required to carry a health warning.
Dr. John Muth, director of the El Paso County, Colo., Department of Health and Environment, disputes Rodu's claim that there would only be 12,000 cases of oral cancer per year if all 46 million U.S. smokers had instead used smokeless tobacco.
``This may be a gross understatement,'' he says, basing his conclusions on studies showing a high incidence of oral cancer in countries like Sweden where smokeless tobacco is an established tradition.
Muth also questions the notion that smokeless-tobacco users aren't at increased risk for other cancers.
``I don't see how you can avoid getting a lot of crap into your bloodstream,'' he says.
Tobacco leaves contain 2,500 different chemicals, many of which have yet to be studied. Three are confirmed carcinogens: polonium 210, benzopyrene and nitrosamines. An ounce of chewing tobacco contains 100 times the amount of nitrosamines found in an ounce of bacon. Tobacco smoke contains 43 confirmed carcinogens.
As for Rodu's claim that smokeless tobacco doesn't cause heart disease, the jury is still out, Muth says: ``Some studies say yes, other studies say no.''
At the heart of the case against smokeless tobacco is that it's as addictive as cigarettes. Although smokeless products come in inviting packages and include such additives as mint, cherry and honey, they're still mostly tobacco. Some brands contain as much as 3.35 percent nicotine, a drug that creates its lift by raising blood pressure, increasing heartbeat and constricting blood vessels. Even low concentrations of nicotine are enough to create a powerful craving in a matter of weeks.
``We discourage the use of smokeless tobacco as a safe substitute for cigarettes,'' says Susanne Wheeler, director of the American Cancer Society's El Paso/Teller Unit.
At a recent International Conference on Smokeless Tobacco, researchers noted it's more common for smokeless users to graduate to cigarettes than for cigarette smokers to switch to smokeless.
``There is a clear potential for [spit tobacco] to serve as a gateway substance for cigarette smoking and the use of other addictive substances,'' concluded the conferees.
Despite the criticism his proposal has received, Rodu plans to continue pressing his case.
``This is a serious proposal,'' he says. ``It's a viable and doable option for the nation's 46 million smokers. There are simply too many lives at stake.''
by CNB