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Smoking Cessation Guidelines Should Include Smokeless Tobacco

Smoking Cessation Guidelines Should Include Smokeless Tobacco

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 harmful.

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.

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