95 e-Letters

published between 2007 and 2010

  • A Belated Reply to Foulds et al. and Bates
    Scott L. Tomar, DMD, DrPH

    First, an apology is in order for taking so long to respond to the online discussion surrounding the review by Foulds et al. [1] and the opinion piece by Bates et al. [2]. As we had promised in our earlier reply to Foulds et al. (19 December 2003) and have been reminded by Bates, we are belatedly responding to the specific points raised by Foulds et al. in their e-letter dated 5 December 2003:

    1. “Misrepresentation of...

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  • Boffetta et al
    Jeffrey R Johnstone

    The authors quote a study by Boffetta et al to support the idea that second-hand smoking causes disease. The Boffetta study does not support that claim. Boffetta et al found no significant association between lung cancer and passive smoking from spouse or workplace. They did find a significant association with childhood exposure: those so exposed were less likely to develop lung cancer. The results of Boffetta et al are...

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  • Response to Rodu’s and Bergen & Phillips’ Comments
    Shu-Hong Zhu

    Rodu is correct in stating that because the U.S. population is so large, even a small percentage of cigarette smokers switching to smokeless would mean many thousands of people [1]. However, he has done only half the math- the other half is that exclusive smokeless users also switch to cigarettes. In fact, it is easy to see from Table 2 in Zhu et al. that the number switching from smokeless to cigarettes is much greater th...

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  • Still no response - but there's still time
    Clive D Bates

    I thought I would revisit this debate some five years on, only to find that the promised response (19 December 2003) has not yet been done.

    None of the facts have changed much - those that wish to intervene to prevent smokers choosing tobacco products that are many times less hazardous still have the upper hand - not in argument or evidence, but in dominant public health approach and (in Europe) in the most...

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  • Response to Zhu et al. (1, 2)
    Paul Bergen

    The authors of this paper (1), the responders (3), and most everyone else agree that smoking is high risk, and that the use of smokeless tobacco is fairly low risk. In any other area, the obvious conclusion would be to encourage smokers to switch to the lower risk alternative.

    However, what follows instead is a strange and yet quite common argument that because many smokers might not switch, this alternative...

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  • Evidence From Zhu et al. That American Smokers Have Switched to Smokeless Tobacco
    Brad Rodu

    Zhu et al. reported that 0.3% of men who were exclusive current smokers in 2002 became smokeless tobacco users at follow-up in 2003 (1). Similarly, they reported that 1.7% of men who were former smokers of one year or less duration and 0.3% of men who were former smokers for a longer time were smokeless tobacco users in 2003.

    These percentages are quite small, prompting the first author to issue a statement in...

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  • Response to Nitskin and Rodu's Comments
    Shu-Hong Zhu

    Nitzkin and Rodu raise several interesting points about harm reduction and how they would like to see the current FDA bill (HR1108/S625) be improved [1]. However, the purpose of Zhu et al.’s paper is not to advocate for or against harm reduction. It is simply to examine whether current US data replicate the Swedish results [2].

    If large numbers of US smokers could be induced to switch to smokeless tobacco, tha...

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  • Promoting Snus Will Save Lives in the USA
    Joel L Nitzkin

    Zhu, et al., when comparing tobacco-related behaviors in the U.S. and Sweden concluded that “promoting smokeless tobacco for harm reduction in countries with ongoing tobacco control programs may not result in any positive population effect on smoking cessation.” [1]

    We believe that this conclusion is too pessimistic.

    Promotion of snus in the U.S., as a low-risk alternative for smokers unable or unwillin...

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  • Mental disorders and smoking: Correlation is not causality
    John Hughes

    A recent article in Tobacco Control 1 reported that 33% of cigarettes are consumed by smokers who had a current mental disorder. The title, abstract and discussion of that article stated that this 33% represented how much “mental disorders contribute to tobacco consumption in New Zealand.” This statement is misleading for at least two reasons. First, although 33% of smokers had a current mental disorder, 21% of nonsmok...

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  • This may be due to Low DHEA
    James M. Howard

    It is known that smoking increases DHEAS, the precursor of DHEA. The same should happen because of exposure to secondhand smoke.

    DHEA is the active molecule, so increases in DHEAS may indicate that smoking is reducing DHEA. DHEA is known to be important to normal pregnancy-associated outcomes.

    I suggest the findings of Peppone, et al., may be explained by reduced DHEA in these women.