OPINION

The Tragic Combination of Smoking, Cancer, and Suicide

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Every day, 1,300 Americans die from smoking-related diseases. Tragically, some people die from other causes such as suicide because smoking has made them unbearably ill. Rather than focusing on the primary goal of reducing diseases and deaths from smoking by authorizing proven ways to stop smoking, the United States has turned its attention to youth use of novel nicotine products. While the Food and Drug Administration dawdles and delays authorizing life-saving tobacco harm reduction products, adults who smoke have been tossed aside, left to suffer and die from horrible causes. The regulatory process in the United States that makes it nearly impossible for safer nicotine products to replace lethal combustible cigarettes needs to change and embrace innovation.

Smoking is the leading preventable cause of death in the United States.Diseases that are related to smoking include multiple forms of cancer (not just lung cancer) including lip, oral cavity, esophagus, stomach, pancreas, larynx, cervix, kidneys, bladder, liver, and colon.Smoking also causes respiratory and vascular disease.

Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by nearly 90 percent. Older adults also reap benefits from quitting smoking and can experience health improvements. Unfortunately, only about eight percent of people who smoke stop smoking by traditional pathways.

For those who can’t, or won’t quit smoking, there are safer alternatives on the market which allow them to continue to enjoy nicotine without the harms of combustion. Some examples of safer tobacco products are snus, smokeless tobacco, and heated tobacco products. Examples of tobacco-free options are nicotine pouches and vapor products. Tobacco harm reduction is a proven strategy of converting adults who smoke to the use of safer forms of nicotine to reduce the morbidity and mortality caused by smoking. Despite their potential to alleviate smoking-related diseases by tempting people who smoke towards safer forms of nicotine use, the United States regulatory bodies view these innovative technologies with suspicion, mostly based on flawed assumptions.

In the United States too many consumers, physicians, and nurses falsely believe that it is the nicotine in smoking that causes cancer. This is a fallacy that is often spread by the media. The misperceptions about nicotine cause consumers (who can’t stop smoking) to avoid trying tobacco harm reduction products to quit smoking. Meanwhile the European Code Against Cancer and Cancer Research UK accurately informs consumers that nicotine does not cause cancer. Their knowledgeable advice can lead consumers away from deadly combustible tobacco and motivate them to switch to safer alternatives.

Cigarette smoking is linked to about 80 to 90 percent of the lung cancer deaths in the United States. Dual-use of two or more nicotine products can be a pathway for people who are trying to switch from smoking to a safer alternative. For those who smoke heavily, a 50 percent reduction in the number of cigarettes they smoke can reduce the risk of lung cancer. Once they transition completely away from smoking, they reduce their risk even more.

Cancer causes physical, emotional, and financial burdens on patients and their loved ones. And, a cancer diagnosis can lead to other causes of death outside of the potential to die from cancer.For example, the risk of cancer patients dying from suicide is four times that of the general population, with lung cancer patients belonging to the group with the highest risk. In 2020, suicide was the twelfth leading cause of death in the United States, resulting in 45,979 deaths. Nearly twice the number than those that died from homicide.

September is Suicide Prevention Awareness Month. An appealing assortment of quit smoking strategies, including tobacco harm reduction, will help reduce not only the number of people who smoke and die from cancer, it will help diminish the number of people who die from suicide.

It is surely irresponsible to shy away from products which offer potential to reduce the incidence of cancer, heart, and respiratory diseases along with the risk of suicide.  Yet, that is the regulatory environment being created by those who are opposed to nicotine use in whatever form. The country cannot go on ignoring the potential public health prize of tobacco harm reduction based on ideology and prejudice.

Kim Murray is a Research Fellow for the Taxpayers Protection Alliance’s Consumer Center.