American Dental Assocation now lying less about smokeless tobacco

by Carl V Phillips

Brad Rodu recently posted the observation that the ADA no longer erroneously lists smokeless tobacco as a major contributor to oral cancer.

ADA was always one of the worst anti-ST liars out there from the time I first started documenting anti-THR lies. This was due to a combination of the usual reasons and dentists’ obsession with oral cancer.  The least charitable (and widely believed) explanation for this is that many dentists in the US are physician-wannabes who could not get into medical school, so they are looking for some way to claim that they too are saving lives and not just tidying up our smiles.  (Of course, this does not include my dentist, who seems very happy with his role in life — I just wanted to point that out in case he reads this just before sticking pointy things into my mouth.)

[Update:  A dentist who read this informed me that the above was far more hurtful than I ever intended it to be.  It was meant to be lighthearted and merely a lead in to the point about over-emphasis on oral cancer.  But it came across as me, as a health researcher, endorsing a dismissive attitude toward the entire profession (and perhaps that I do not understand how complicated health care is, whatever the body parts involved, which obviously I do know) —  that was not what I meant to do.  I do not think very highly of their trade organizations like ADA because of the anti-THR lies, but the same is true for physicians and some areas of health science, and that does not reflect on the individuals in any of those professions.  The stereotype really does exist (obviously — offhand references to stereotypes cause offense because they exist), but I should not have trafficked in it as a literary device, especially because I am not sure I know anyone who fits it: every dentist as friend, clinician, or colleague I know actively chose the profession as far as I know.  I am not going to change what I wrote to fix the poor choice of words after the fact — memory-holing errors is an ANTZ tactic that I will not adopt.  We should recant and apologize when we make errors, not pretend we did not make them, so I am doing just that.]

The thing is, oral cancer is relatively rare — so much so that the average American dentist will diagnose exactly zero cases of it in his entire career (this is a calculation that I believe Brad — or maybe it was he and I together — did a long time ago).  So even when it was possible to defend the claim that ST increased the risk, it was still a very small risk.  Back when anti-THR was all about hyping the supposed risks from ST, it appeared that there was a concerted effort to “give” oral cancer to ST.   That is, even though other exposures always clearly caused greater risks for oral cancer, those exposures (smoking, drinking heavily, sex) all had “their own” risks, so the nanny-types decided to create a fake correspondence:  {ST is to oral cancer} as {smoking is to lung cancer} and {drinking is to liver disease}.

That is finally changing.  Unfortunately, as Rodu’s post goes on to point out, the ADA is still lying about ST in other ways, with the usual scare tactics, implying it is worse than cigarettes through such tactics as pointing out there is more nicotine in the product itself (which obviously does not matter, but can trick most people) and with weasel words about “chemicals”.   It “has over 3,000 chemicals, including 28 cancer-causing substances” — um, yeah, just like apples.

The biggest lie, in my opinion, is, “People may think that smokeless means harmless, but nothing could be further from the truth.”  Rodu points out that this is a strawman argument, because no expert or respectable advocate argues that ST, or anything else, is completely harmless.

I will take this one step further, though, and say that it is not just misdirection (like the other mentioned claims) but wrong:  Calling ST harmless, while not exactly right, is not all that far from the truth.  Since most people believe the risks are so much higher than the really are, making such a claim would tend to get people closer to the truth, so it might even be considered a kind of a higher truth.  Moreover, there are a lot of claims that are much further from the truth, like suggesting ST is similar to cigarettes in terms of risk.  When comparing the claims “ST is completely harmless” and “ST is like cigarettes”, neither is right, but the former is not very far off (and, indeed, is not inconsistent with the evidence), whereas the latter is an out-and-out lie.