TCS Daily

Lightening Up

By Roger Bate - April 7, 2003 12:00 AM

Recently the World Health Organisation agreed to a Framework Convention on Tobacco Control. EU Health and Consumer Protection Commissioner David Byrne, praised WHO Director, Dr Gro Harlem Brundtland, and welcomed the historic agreement as a major advance 'in the battle to empower our citizens to live healthy lives, free from the scourge of tobacco'. And the Convention may have a positive effect, since it will probably help reduce smoking around the world. It may also have a more dubious impact by restricting commercial free speech, through tobacco advertising bans, which is why Germany may not sign on. It could even have an overall affect not dissimilar to the Convention on climate, which is making America similarly wary of taking part.

But if Mr Bryne really wants to help the over-taxed and shunned smokers of Europe he should remove the Europe-wide ban on smokeless tobacco. This may seem an odd request, even odder when it is supported by anti-tobacco activists in Britain, but it's actually very rational; of all the types of tobacco, smokeless, sucked or chewed tobacco, or wet snuff, causes the least cancer. The evidence is overwhelming, says Professor Robert Nilsson, a toxicologist at Stockholm University, and formerly with the EPA-like Swedish Chemicals Inspectorate that 'snus is the least dangerous form of tobacco'.

Snus is the Swedish name for sucked snuff and Sweden is the only country in Europe where it can be sold. When Sweden joined the Union it demanded the right to continue to sell the product domestically, but accepted that it would be unable to export it.

European politicians have generally argued that because there is limited knowledge of how smokeless tobacco would be used or about its health effects that we should invoke the precautionary principle and keep it banned until more evidence emerges. And that has been the situation for over a decade - a ban based on precaution.

But in 1998, with the publication of Professor Nilsson's review of the evidence in the Journal of Regulatory Toxicology and Pharmacology (along with other experts' analysis), it became obvious that Sweden has the lowest male rates of relevant smoking diseases across Europe. Activists had maintained that oral cancers would be higher among those chewing tobacco, but according to Professor Nilsson 'it has not been possible to detect any significant increase in the incidence of cancer or the oral cavity or pharynx - the prevalence of which by international standards remains low in Sweden'. According to a study by the eminent British epidemiologist, Dr Richard Peto, Swedish lung cancer rates are half the EU average. And the explanation for this is that only 16 percent of the male population smoke, compared with an EU average of nearly 30% and over a third of the tobacco consumed in Sweden is Snus, whereas in the rest of the EU its close to zero.

Some of this evidence has been around for a while, with no action taken. But the data have accumulated and the status quo was changed when Swedish Match, the main producer of snus, targeted EU legislation (Article 8 of directive 2001/37/EC), with the evidence. Swedish Match wanted the legislation overturned saying the EU's actions were unreasonable, unfair, unjustified, disproportionate and arbitrary.

And most unexpectedly, a remarkable set of announcements from well-respected anti-tobacco activists indirectly supported their action. British notables like Clive Bates of the Action on Smoking and Health and Martin Jarvis of the Imperial Cancer Research Fund, as well as continental experts from Sweden and Austria, recently said that 'We believe that the partial ban applied to some forms of smokeless tobacco in the European Union should be replaced by regulation of the toxicity of all smokeless tobacco'. They are most concerned that the highly toxic chewing tobaccos available in India are actually permitted in the EU at present, whereas much less dangerous products, like snus, are banned. 'The current regulation is absurd. A rational regulatory approach would reverse this situation, and effectively ban the most toxic smokeless tobacco products' they conclude.

Ironically, these academics and activists, like Swedish Match, although funded independently, were also demanding that Article 8 of directive 2001/37/EC be amended or replaced by a 'new regulatory framework'. They claim that it is 'ethically wrong to actively deny users the option to reduce their risk' from smoking tobacco. They also consider 'it is important to consider where the EU draws its moral (and legal) authority to make such 'life-or-death' choices on behalf of its citizens - especially as, on the basis of the Swedish evidence, it appears to be making the wrong choices'.

Do-Gooders Make a Compelling Case

I have always had a sneaking suspicion that the anti-tobacco activists were more interested in stopping people enjoying themselves than in saving lives, but these recent statements are making me re-think. There is little doubt that banning the safest form of tobacco from European nicotine fiends is stupid, bordering on homicidal, and it is to their credit that the activists are using their credibility to push a repeal of the ban.

The devil is in the detail as always, but here the detail is even more convincing. Not only is chewing tobacco safer it actually leads people away from smoking. Far more people switch from smoking to chewing than the other way around. And it is this fact that really attracts the anti-tobacco activists. They would prefer people to quit entirely but if smokers switch their health is likely to improve significantly, and this is a far better second outcome than for the smoker to continue as before.

Furthermore, the activists have even had the temerity to attack the use of the precautionary principle as a reason for maintaining the ban. Its application is inappropriate because all the available evidence shows that the more precautionary approach would be to allow smokeless tobacco to be sold - to invoke change.

The evidence is overwhelming: the smokeless tobacco industry, European politicians and the strongest opponents of smoking in Europe consider the status quo 'absurd'. So how about it Mr Byrne, will you do what makes sense for Europe's smokers and repeal the ban on smokeless tobacco?

Dr Roger Bate is a fellow of the International Policy Network and a TCS columnist. A version of this article recently appeared in the Wall Street Journal Europe.

TCS Daily Archives