95 e-Letters

published between 2009 and 2012

  • Response to Ramstrom
    Shu-Hong Zhu

    If we understand him correctly, Ramstrom considered our findings on what has happened in the U.S. too obvious to be interesting. It is obvious because, for over 50 years, Sweden has had a particular smokeless tobacco product, snus, that the US did not have [1]. He apparently considered the history of U.S smokeless tobacco use (which is over 100 years) of no significance and he was confident that the U.S. smokeless tobac...

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  • Questionable PREP selection
    Hank H Stocker

    The products mentioned in the study appear to be selected specifically selected for their low nicotine content. While the paper succeeds in adapting existing methodology for traditional tobacco products to these new classes of smokeless tobacco products, only testing PREPs containing a low amount of nicotine understates their potential as a smoking cessation aid.

    Star Scientific Inc. (manufacturers of Ariva) pro...

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  • Potential utility of switching to smokeless tobacco
    Lars M Ramstrom

    The study by Zhu et al. "Quitting Cigarettes Completely or Switching to Smokeless Tobacco:Do U.S. Data Replicate the Swedish Results?" has raised a number interesting questions. [1] However, the conclusions of the study need further scrutiny in addition to the previously published comments.

    The main conclusion “The Swedish results are not replicated in the U.S.” is certainly true, but not very interesting since...

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  • Overestimate of cost of smoking to the NHS
    Christine Callum

    This paper addresses a number of important issues around the costs of smoking to society, and in particular to the UK National Health Service (NHS). However there are methodological issues which result in the paper overestimating the costs of smoking to the NHS. While smoking does represent a significant cost to the NHS, the estimates provided in this paper, based as they are on a mixture of very old data and parameters...

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  • Response to Nitzkin March 24 eletter
    Shu-Hong Zhu

    We appreciate Dr. Nitzkin’s desire to improve the current FDA bill. Our paper clearly stated that smokers are generally uninformed about the relative risk of various tobacco products and that is an issue that the public health community still must address (1). However, it is important not to equate providing accurate risk information with promoting the use of specific tobacco products. Nitzkin does not seem to make this...

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  • Response to Zhu February 24 e-letter
    Joel L Nitzkin

    This note is in response to the latest communication from Zhu, relative to whether a harm reduction component to tobacco control programming in the United States would yield public health benefits. Zhu is very skeptical. Nitzkin and Rodu are certain such a benefit would accrue. In his latest posting, Zhu suggests that Rodu “only did half the math” -- and suggested that one can read anything one wants into the available...

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  • 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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