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Anti-Smoking Campaigns Don't Reach Older Adults

New approaches needed to help hard-core smokers kick habit, study says

WEDNESDAY, Feb. 20, 2002 (HealthDayNews) -- Anti-smoking campaigns in the United States have little impact on hard-core smokers over the age of 40, and new ways of helping them quit have to be considered, including nicotine medications and smokeless tobacco.

That's the conclusion of a new study from University of Alabama at Birmingham researchers, who say longtime smokers are so addicted to nicotine that health warnings, education campaigns and other anti-smoking efforts have virtually no effect on them.

"We think the [anti-smoking] campaign needs to be revisited when it comes to these inveterate smokers. Do we just continue to tell them 'no,' or do we provide them with different options that perhaps acknowledge their nicotine addiction, but have them service that addiction in a different manner?" asks study author Dr. Brad Rodu.

He and his co-author, Dr. Philip Cole, an epidemiology professor, reached their conclusion by looking at various factors, including lung cancer death statistics for white men born between 1901 and 1942, how long those men were exposed to anti-smoking messages, and how many of them quit smoking.

"We looked at white men because they've done the bulk of smoking over the past century, and they have the largest proportion of tobacco-related illness and death," Rodu explains.

The researchers found that among white male smokers born between 1926 and 1942 who were exposed to 20 to 32 years of anti-smoking campaigns, an average of 52 percent quit smoking after age 40.

That percentage indicates many of these men don't respond to anti-smoking messages and it represents a public health problem, says the study. It appears in the current issue of the International Journal of Cancer.

For this study, Rodu received funding from United States Tobacco Co., the nation's largest smokeless tobacco company and a subsidiary of UST Inc.

There are about 47 million American smokers, according to the Centers for Disease Control and Prevention (CDC). More than 400,000 Americans die each year from tobacco-related disease, and tobacco is responsible for more than $50 billion in direct medical costs each year in the United States.

The CDC says 23.5 percent of Americans smoked in 1999, compared to 25 percent in 1993, and 42.4 percent in 1965, when anti-smoking campaigns first started.

"The good news is that the American anti-smoking campaign has resulted in a continuous sustained decline in male smokers that are younger than age 40," Rodu says.

"But we see a sort of plateau in the impact that the campaign has had on smokers between the ages of 40 and 60," he says.

He describes nicotine as "one of the most powerful of human addictions," and says a different approach is needed to help older smokers who just can't shake their habit.

That could include using nicotine medications or smokeless tobacco, also called chew or spit tobacco. That way, hard-core smokers could satisfy their addiction but avoid the health threat of cigarettes, Rodu says.

He says nicotine itself doesn't cause any of the diseases -- cancer, heart disease or emphysema -- associated with smoking.

"We believe that permanent nicotine maintenance with a variety of available products is potentially the best strategy for this group of people who simply are irreversibly addicted," Rodu says.

Smokeless tobacco products are much safer than cigarettes, he contends. There is the danger of mouth cancer, but that risk is one-third to one-half less than it is with smoking, Rodu says.

However, a cancer expert dismisses the suggestion that smokeless tobacco is a suitable way for smokers to kick cigarettes.

Dr. Michael Thun, head of epidemiologic research for the American Cancer Society, does agree that smokers, no matter what age, need more help to fight their addiction. That includes health insurance plans that cover tobacco-cessation treatments and better education for doctors about newer treatment methods, including nicotine medications.

However, smokeless tobacco is not an option, Thun says. It may eliminate the smoking, but users still risk cancers of the mouth, pharynx, larynx and esophagus.

"Smokeless tobacco is a popular approach with U.S. Tobacco, but I don't think it's the way to solve the problem," Thun says.

He notes that UST Inc. has asked the Federal Trade Commission to issue an advisory opinion that would let the company advertise its smokeless tobacco as less hazardous than cigarettes.

"The tobacco industry is ever ready to market its products on any grounds available. The real solution to reduce diseases from tobacco is to reduce tobacco use," Thun says.

What To Do

For more information about the dangers of smoking, go to the American Lung Association or the CDC.

You can learn more about the health risks of smokeless tobacco at kickbutt.org.

Here's information on federal and state programs to help smokers quit.

SOURCES: Interviews with Brad Rodu, M.D., oral pathologist, University of Alabama at Birmingham; Michael Thun, M.D., head of epidemiologic reseach, American Cancer Society, Atlanta; February 2002 International Journal of Cancer
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