Letter to the Editor
Letter to the Editor in Response to “An Epidemic that Deserves More Attention: Epidemiology, Prevention, and Treatment of Smokeless Tobacco”
Abstract
To the Editor:
Overall, Dr. Arabi provides a more balanced review of smokeless tobacco (ST) use than is typical in the public health and medical literature.1 However, we would like to correct a few points that he discussed: 1) The ST products used in India often contain lime or betel (areca) nut in addition to tobacco, and the epidemiologic evidence suggests that they are far more harmful than the modern western smokeless products used in North America and Sweden2,3; 2) ST has been accurately promoted for its harm reduction potential or as a safer alternative to smoking, but we have never heard anyone claim it is “harm-free nicotine;” and 3) it has not been shown that “… nicotine replacement therapy (NRT) is much safer than ST.”
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