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Snuff, chew more dangerous than cigarettes

There is a popular misconception among the lay public that snuff and chewing tobacco are safe alternatives to cigarette smoking. The results of a recent study by the Centers for Disease Control showed that moist snuff and loose-leaf tobacco contain the highest amount of free nicotine that can be easily and rapidly absorbed by the body.

The most popular brands of moist snuff, such as Skoal, Copenhagen and Kodiak contain the highest amount of unbound tobacco that is readily available for absorption. Levi Garrett, the most popular brand of smokeless, loose-leaf tobacco, also contains high amounts of free nicotine. This free form of nicotine is the basis for rapid absorption from the mouth.

The rapidity of absorption is one of the important determinants for addiction, according to researcher Patricia Richter.

Richter and her colleagues studied 18 brands of loose-leaf, smokeless tobacco and moist snuff from five different companies. These products together constitute 91 percent and 76 percent of the market share for moist snuff and loose-leaf, smokeless tobacco, respectively. The samples were analyzed by a private and independent laboratory in Canada.

According to Richter, the amount of nicotine absorbed per dose of smokeless tobacco was greater than the amount of nicotine absorbed from smoking one cigarette. Public health and other health-related organizations and consumer advocacy groups must make the public aware that loose-leaf tobacco and moist snuff are not safe alternatives to cigarettes.

According to a recent survey by the CDC, the percentage of adult smokers in the United States has dropped from 25 percent in 1993 to 22.8 percent in 2001. Preliminary data from January to March 2002 indicate a continued decline in the number of current adult smokers in the nation.

This improvement is at least in part owing to the massive antismoking campaign of the past several years. Similar measures may have to be implemented against smokeless tobacco and moist snuff usage, as well.

One of the national health objectives for the United States is to reduce the prevalence of adult current smokers to less than 12 percent by 2010. The current rate of smoking cessation, however, will not achieve this stated goal by 2010.

Additional measures including educational, economic, clinical and regulatory initiatives might be necessary.

_ V. Upender Rao MD, FACP, practices at the Cancer and Blood Disease Center in Lecanto.