Taboka is just another in a long line of "new" tobacco products from Philip Morris since it was founded in 1881. Both Philip Morris and RJ Reynolds are feeling the erosion of market share in cigarettes and rushing to fill the void with products aimed at kids (their future) and that are a "substitute" for cigarettes in the increasingly smoke-free environments in the United States. RJ Reynolds has been test-marketing Camel Snus--another smokeless product--in Oregon and Texas. The choice of Camel was no accident, since Camel is a favorite with kids.

The marketing ploy of the industry has changed little in basic intent: to suggest to consumers that the product is "better and improved" with either explicit or implicit suggestions of improved safety--less threat to health. In the case of taboka, they are suggesting it as a substitute for smoking--when smoking is impossible (airplanes, smoke-free areas). The company is also suggesting (with no data whatsoever published in peer-reviewed literature) that taboka is either safer than other tobacco products or that it is "spitless"--a claim they currently make. Is it rational to believe that placing a bag equivalent to a small toxic waste dump between your gum and cheek would not produce "spit"?

In this largely unregulated industry, manufacturers can make any claims in their marketing promos without concern for the truth, facts, or science. We know that the "new improved and safer products" seam has worked brilliantly for the tobacco industry for 150 years. I wrote a brief letter in the journal Tobacco Control, an international peer-reviewed journal, which documented that tobacco companies in 1852 were removing the known toxic nicotine to market their products as safer--without the "poisonous" nicotine. I found this evidence serendipitously in an article in Scientific American. The ongoing debate among scientists and tobacco control experts today focuses on the trend of tobacco companies "fessing up" to the addictiveness and toxicity of tobacco and creating new products (both cigarettes and smokeless products) that may be safer--a practice referred to as "harm reduction." With smoking, you have major risks of lung and many other cancers. The cardiovascular risk ratios are also higher for cigarette smokers. With smokeless tobacco, you see oral cancers, major periodontal disease, and cardiovascular disease--increased blood pressure and risk of heart attacks.

In the United States, public health experts are skeptical of the science that purports to show smokeless is much safer than smoking--even if it is, experts worry about the law of unintended effects: Will the introduction of smokeless products increase or decrease smoking rates? With smoke-free ordinances and pressures not to smoke, will the widespread availability of new smokeless products provide a convenient way for smokers to continue their habit, thus decreasing smoking cessation? On the flip side, will young people today see the new products as a "safer" way to use tobacco? Since many smokeless users as youth migrate to cigarettes (the fastest way to get nicotine to your brain receptors), the question is, will these new products spawn new generations of smokers?

The bottom line is that without federal oversight of this industry, we will never really know the answers to these questions because the science will never be done to answer them. For example, the data that some scientists use as evidence of the relative safety of smokeless products is filled with methodological holes. One glaring hole is that no one knows what actually Is in the smokeless or smoking products since the industry is unregulated. How can you do comparative research without knowing precisely what it is you are comparing? Second, none of the studies are prospective, randomized human trials.

My personal bias after looking at this evidence is that the overall premature mortality in lifelong smokers is greater than in lifelong smokeless users. But where I have a problem is in taking the above circumstantial evidence for less toxicity of smokeless and making national policy or endorsing smokeless as a safer alternative to smoking. This, I think, would be irresponsible. The U.S. Surgeon General has stated that smokeless is not a safe substitute for smoking. In Congressional testimony, former Surgeon General Vice Admiral Richard H. Carmona addressed the perception that smokeless tobacco is a good alternative to smoking.

It is a myth. It is not true," Dr. Carmona stressed. "As the nation's Surgeon General, my top responsibility is to ensure that Americans are getting the best science-based information to make decisions about their health. No matter what you may hear today or read in press reports later, I cannot conclude that the use of any tobacco product is a safer alternative to smoking. This message is especially important to communicate to young people, who may perceive smokeless tobacco as a safe form of tobacco use."

I agree with that statement.