Increasing numbers of Americans are using smokeless tobacco, because
they think it is a safe alternative to cigarettes. Upcoming federal
guidelines on smoking prevention and cessation should include
information about the health risks associated with smokeless tobacco,
Maureen Hannley, PhD, of the American Academy of Otolaryngology--Head
and Neck Surgery, said at a meeting sponsored by the Agency for
Health Care Policy and Research (AHCPR) on smoking prevention
and cessation guidelines.
Smokeless tobacco, also known as "spit" or chewing tobacco,
is often used by young children and teens, who see professional
athletes chewing it during sporting events. "Society sees
chewing tobacco as an accoutrement to sports success," said
Dr. Hannley, the Academy's Associate Vice President for Research
and Development. Education about the risks of smokeless tobacco,
therefore, must be aimed at young children, and these lessons
should begin in the early school years, she said. They must be
made aware that both cigarette smoking and smokeless tobacco are
Guidelines Expected by 1996
The smoking cessation guidelines--which are expected to be completed
in early 1996--are the first of three on preventive health- care
issues scheduled by the AHCPR. The panel will evaluate intervention
therapies used for nicotine dependence treatment and the evidence
of their effectiveness. The panel is chaired by Michael C. Fiore,
MD, associate professor, University of Wisconsin School of Medicine,
and director of its Center for Tobacco Research and Intervention.
It also includes experts in pulmonary medicine, psychology, pediatric
and adolescent medicine, cardiology, dentistry, and pharmacology;
there are no oncologists on the panel.
According to Dr. Hannley, the guidelines also should address the
hazards of passive smoking. It has been estimated that at least
9 million US children live with one adult smoker, and these children
are at increased risk for respiratory illnesses and other diseases,
she said. The Academy plans to target passive smoking in educational
materials and public service announcements over the next several
years, she said.
A representative of the American Lung Association said the guidelines
need to help physicians realize that even modest improvements
in quit rates have enormous public health implications.