“a treat not a treatment”? origins of tobacco industry efforts to promote smokeless tobacco for harm reduction

Objective: Describe the evolution of strategies used by tobacco companies to influence science and policy to help promote smokeless tobacco (ST) for “harm reduction.”

Methods: Qualitative analysis of previously secret tobacco industry documents triangulated with data from national newspapers, trade press, Internet.

Results: After the 1964 Surgeon General's report, tobacco companies recognized that the image of cigarette smoking would deteriorate, and considered producing ST products which delivered “nicotine satisfaction” as a convenient and desirable “treat not a treatment” for smokers. Internal studies confirmed some consumers perceived ST as safer than cigarettes. Absence of warning labels reinforced perceptions of relative ST safety. In the late 1980s, public discourse emphasized a lawsuit filed by the family of Sean Marsee, a high school athlete who developed mouth cancer from using snuff, which drew public attention to ST dangers and predatory marketing targeting youth. However, by the early 2000s tobacco companies planned to advertise new smokeless products as a reduced-harm alternative to cigarettes. In 2002 USST filed a request to the FTC for permission to claim in advertisements that using snuff was safer than smoking. Subsequently, several scientists and organizations with financial ties to the industry endorsed the use of ST for cessation, and public discussion shifted to harm reduction.

Discussion: Promotion of ST as reduced-harm product is a strategy used by tobacco companies to maintain sales that has gained success with what appears to be third party scientific endorsements. This strategy is similar to past industry attempts to manipulate science on secondhand smoke.