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The Oral Cancer Risk of Smokeless Tobacco Products

Smokeless Tobacco Use and Cancer of the Upper Respiratory Tract. Published in Oral Surgery, Volume 93, pages 511 to 515, May, 2002. By Brad Rodu and Philip Cole. (UAB)

Birmingham, AL. Use of powdered, dry snuff carries a much higher relative risk of oral-cavity cancer than does the use of other smokeless tobacco products (moist snuff and chewing tobacco) according to University of Alabama at Birmingham (UAB) researchers in the first major review of studies of such risks since 1986.

"No one had tried to separate out the relative risks of the different types of smokeless tobacco (SLT) products," said lead author Dr. Brad Rodu in an interview. "Although dry snuff increases the risk of oral-cavity cancer, the other types of smokeless tobacco actually have a lower relative risk than we previously thought. Since these other products are much less risky than tobacco smoking, they may be considered as a safer alternative by hard-core, recidivist smokers."

Rodu and co-author Dr. Phil Cole are leading proponents of SLT as a way of reducing the harm of cigarettes to those people who have extreme difficulty, or who are unable, to quit smoking. Cole is scheduled to debate the dangers of SLT at a symposium in New York City on Wednesday, June 26, sponsored by the American Council on Science and Health.

SLT use is a public health concern, say the authors, but the products increase the risk of oral-cavity cancer only minimally as compared to quitting smoking altogether. Rodu, an oral pathologist, and Cole, a cancer epidemiologist, analyzed 21 studies published over the past half-century. Their work was published this month in the scientific journal Oral Surgery, Oral Medicine, Oral Pathology.

The UAB researchers found that the relative risk of getting cancer by use of either moist snuff or chewing tobacco is 0.7. The risk rises to 4.0 with use of dry snuff. The authors decided to distinguish the relative risk of cancer from the different types of smokeless products because dry snuff is an SLT product used almost exclusively by women, especially in the southern United States.

One drawback of most of the available studies, the authors said, was that they did not take into account participants' alcohol intake and cigarette smoking, two activities that are known to increase greatly the risk of oral cancer.

Note: This publication supported by the Tobacco Research Fund (UAB).