by Carl V Phillips
There have been a spate of claims recently, stemming from this junk science paper (“Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries” by Kamran Siddiqi, Sarwat Shah, Syed Muslim Abbas, Aishwarya Vidyasagaran, Mohammed Jawad, Omara Dogar and Aziz Sheikh) that there is some huge health burden from smokeless tobacco. This piece of utter crap — bad even by the standards of tobacco control “research” — deserves a detailed point-by-point critique, but it is just so bad that I cannot stand to do it right now. So I am going to provide the short version.
1. The headlines from the study include the claim that most of the burden from smokeless tobacco use is in India. This should be a sufficient clue that the whole thing is junk, since people in India and neighboring countries do not use smokeless tobacco (within a rounding error of not at all). A lot of people in that region use oral dip products that are measurably harmful, some of which contain tobacco as a tertiary agreement. But since we know that the tobacco itself causes little or none of the health effect (based on evidence about using actual smokeless tobacco), it is lying to suggest that the problem has anything to do with tobacco. It is basically like speaking of the “obesity burden from tomatoes”, which are frequently a tertiary ingredient (as sauces, condiments, etc.), when reporting the effects of eating too much pizza, fries, burgers, etc.
Basically any analysis that calls South Asian dip products “smokeless tobacco” (e.g., the Nutt et al. paper I have mentioned a few times recently because it is the source of the claim that e-cigarettes are 5% as harmful as smoking) is either the product of unforgivable ignorance or intentional lying. More on this here, particularly here.
2. The deaths attributed to cancer from smokeless tobacco use are based on a meaningless mash-up of the measured effects of the South Asian products that cause health problems due to their non-tobacco ingredients (which there is epidemiology about, though it is mostly very poor quality), Western smokeless tobacco (where the epidemiology shows no measurable risk), and other dirtier forms of smokeless tobacco (e.g., East African) which might cause some risk but we do not really know.
3. The deaths attributed to cardiovascular disease come from the junk INTERHEART study, which basically threw together data from a random collection of people from very different populations worldwide and attributed outcome difference to differences in tobacco use. I hope I do not even need to explain why the elevated death rate of Iraqis and Sudanese compared to Australians should not be attributed to the former populations using more tobacco (or any other particular lifestyle choice).
That is all. As I said, this is the short version — enough to show that this was clearly junk, though only scratching the surface of its problems.