The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIR) has been asked to evaluate effects of smokeless tobacco products (STP) including tobacco for oral use, chewing tobacco, dry snuff and nasal snuff.
The marketing of tobacco products for oral use is banned in all EU countries (Directive 92/41/EEC) except Sweden whereas other STP such as products intended to be smoked or chewed or in powder are allowed.
All STPs contain nicotine, a well renown addictive substance and different percentages of carcinogenic tobacco-specific nitrosamines. STPs are carcinogenic to humans.
The independent committee also showed that:
all STPs cause localised oral lesions
smokeless tobacco is addictive and withdrawal symptoms are similar to those noticed in smokers
high risk of development of oral cancer has been related to various STP
there is an increased risk of fatal myocardial among STP users
Evidence on the effectiveness of STP as a smoking cessation aid is insufficient due to a split of opinion among researchers. There is some evidence from the USA that smokeless tobacco use may lead to subsequent cigarette smoking. However no consensus is risen on this finding: Swedish data do not support this hypothesis.
On the basis of the provided evidence, DG SANCO "wishes to review the scientific basis for the current regulatory framework" (see the Scientific Report).
Comments
The rationale behind the ban of tobacco products for oral use (Directive 92/41/EEC) was to protect public health by preventing people from starting to use a new tobacco product and to ensure proper functioning of the Internal Market since three Member States had adopted such bans. Only Sweden was granted derogation from such ban.
This study shows that STPs are addictive and hazardous to health. Thus, cigarette smokers who switch to STPs are still more likely to develop oral cancer and to be affected of fatal myocardial. Smokers willing to quit who do not succeed without assistance should therefore be encouraged to quit through proven methods such as nicotine replacement and behavioural counselling rather than other tobacco products.
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