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Misleading Conclusions From Altria Researchers About Population Health Effects of Dual Use

2011; Oxford University Press; Volume: 13; Issue: 4 Linguagem: Inglês

10.1093/ntr/ntr016

1469-994X

Stanton A. Glantz, Pamela M. Ling,

Behavioral Health and Interventions

Frost-Pineda, Appleton, Fisher, Fox, and Gaworski (2010) from Altria Client Services reviewed the available literature on the health effects of “dual use” of smoked and smokeless tobacco and concluded that, “Overall, the concern about dual use appears to be contradicted by the evidence in the literature that dual use of smokeless tobacco and cigarettes may result in reduction in smoking-related harm as smoking intensity is decreased and smoking cessation increases.” This conclusion is surprising, given that the confidence intervals for smokers and dual users overlap for all health endpoints (cancer, ischemic heart disease, stroke, and acute myocardial infarction) that they present. These results would include the effects of any reduction in cigarette consumption that might occur among dual users. They also represent the U.S. study by Zhu et al. (2009) as supporting the assertion that smokeless tobacco use promotes cessation despite the fact that Zhu et al. concluded, “Promoting smokeless tobacco for harm reduction in countries with ongoing tobacco control programmes may not result in any positive population effect on smoking cessation.”