Snuffed: Tobacco companies claim their smokeless nicotine chewing gum and similar products are a healthy alternative to smoking cigarettes – but they aren’t.
Tobacco companies such as British American Tobacco (BAT) and Philip Morris are celebrating the rise in sales of their smokeless products, which are often marketed as healthier alternatives to traditional cigarettes.
While nicotine in the form of cigarettes gets the worst press for causing lung cancer, other means of consuming the product — be it chewing, sucking or sniffing — can lead to lifestyle illnesses such as cardiovascular disease and hypertension, experts pointed out this week. Put bluntly, there is no safe alternative, regardless of what the marketing suggests.
“Basically, what they are asking people is whether they want to die from lung cancer or suffer cardiovascular diseases and potentially die from a stroke,” said Lekan Ayo-Yusuf, the director of the National Council Against Smoking.
When tobacco is chewed, sucked or sniffed, it finds its way into the bloodstream. He explained that nicotine — the addictive agent in tobacco — mimics oil poured down the drain by clogging and when it is dislodged it can block the smaller vessels in the brain, causing a stroke.
The other adverse health effects of smokeless tobacco include cancer of the mouth, oesophagus and pancreas. With smoking, the carcinogens in the cigarette damage the tissue in the lungs and, over time, can develop into cancerous cells.
South Africa already has a health crisis caused by non-communicable diseases, with deaths caused by them increasing by 58.8% over 20 years, from 103 428 in 1997 to 164 205 in 2018. Non-communicable diseases such as cardiovascular diseases, diabetes, respiratory diseases and cancers are the major contributors to morbidity and mortality, according to a Statistics South Africa report. Tobacco use has contributed to this increase, among other factors such as sedentary lifestyles and poor diets.
BAT, which owns brands such as Rothmans and Dunhill, recently reported that it was pleased with the performance of its new categories of smokeless products globally. According to the half-year results for the six months to 30 June, this segment now represents 19.6% of the company’s total revenue.
Similarly, in its recent results for the second quarter of the year, Philip Morris International, which owns brands such as Marlboro and Chesterfield, touted strong growth in its smoke-free business, accounting for 38.1% of total net revenue. This was up from 35% the previous period, with about 36.5 million adult users globally. The company said the results highlight its progress towards a smoke-free future.
The company is looking to replace cigarettes with alternatives such as smokeless products, the vice-president for international communications at Philip Morris, Tommaso di Giovanni, told the Mail & Guardian.
“The idea is that this part of our global portfolio will become bigger and cigarettes will become smaller until eventually one would replace the other,” he said.
Di Giovanni said most harmful compounds found in cigarettes are derived primarily from burning tobacco.
“Most people associate tobacco or nicotine with harm. Although those are not risk-free, what causes harm is when those tobacco leaves are set on fire, and not tobacco or nicotine. Anything that is burned changes chemical composition and becomes much worse,” he said.
Di Giovanni added that there was still a demand for cigarettes. “It makes no sense for us to stop selling a product people want because they will buy it from somewhere else. It would not make sense from a business or societal standpoint.”
On average, South Africans smoke 8.5 cigarettes a day. The prevalence of tobacco use among adults is 29.4%, which equates to 12.7 million people, while 4.3% use smokeless tobacco products, according to the 2021 Global Adult Tobacco Survey, which was released by the department of health in June.
But, said Ayo-Yusuf, most people who use smokeless tobacco products also continue to smoke cigarettes.
“The reason is the smokeless is not giving them the satisfaction they get from cigarettes, which have been associated with sensory satisfaction such as the taste and the social aspect of smoking,” he said.
It takes between seven and 10 seconds for nicotine to arrive in the brain and the speed at which it arrives causes addiction, he said. The effect of smokeless tobacco takes a few minutes, because it is absorbed through the skin in the mouth and goes to the venous system before the brain.
Proposed legislation in the form of the Tobacco Products and Electronic Delivery Systems Control Bill aims to ensure that all indoor public places and certain outdoor areas are declared 100% smoke-free.
“This should increase the chances of quitting because you are training your receptors to live without that dopamine, the feel-good hormone, that comes from nicotine,” Ayo-Yusuf said. “But now people are using smokeless products to get that nicotine when they are in spaces where they cannot smoke.”
Because of the practice of using both smokeless tobacco and cigarettes, the country now has more nicotine addicts, he said.
“The presence and increase of this alternative is reducing the ability of South Africans to get off their nicotine addiction.”