Quitting Smoking
[6.0] Why should I switch products? I am planning on quitting altogether.
If you are a smoker who wants to quit using nicotine entirely, and believe that you can quit soon, that is great. We encourage you to go ahead and quit. There are plenty of sites on the web that offer advice for quitting, so we will not attempt to present that information here.
Tobacco harm reduction is focused on people who choose to not quit using nicotine, or who try to quit and find they cannot. It turns out that many people who try to quit, even those who are quite sure they are ready and able to do so, start smoking again. Even people who quit for a few months often start again in a year or two. For these people, we try to offer an alternative other than a never-ending cycle of failed quit attempts.
[6.1] What if I end up using smokeless tobacco but don't quit smoking? Then I'll have two bad habits.
In Sweden, most people who successfully switch over take some time making the full transition. At first, it might seem that you have just added another habit in addition to smoking when you are really on the path to quitting smoking. These things take time.
If you find yourself using it at times...right direction. Since we promote the use of smokeless tobacco for the purpose of reducing smoking, we would not consider it progress if you only used it at times you could not smoke anyway (like at work when you cannot take a break, or on an airplane). On the other hand, it is not going to hurt you much to use it only at those times (there is no point in being miserable craving a cigarette if you are not going to quit entirely), and if you find yourself getting used to using it then, try it sometimes at other times too.
Though many people have successfully switched, we cannot guarantee you will either find this substitute satisfying enough, or that you will necessarily quit smoking, but we think that in the interests of a healthier life, you should at the very least try it and see if it works for you.
[6.2] Is there evidence that switching to smokeless tobacco can really help me quit smoking?
Yes. In addition to the experience in Sweden, there is U.S. data that shows many people have used smokeless tobacco to quit cigarettes, and they probably did that without even realizing how much less harmful it is. If you talk to smokeless tobacco users, you will probably find that many of them switched from cigarettes. There has even been a clinical trial that tried to get smokers to switch, and it proved quite successful.
Switching from smoking to smokeless tobacco will probably not work for everyone who tries it. (See our General Forum for letters from people who have used smokeless tobacco to try to quit smoking.) The good news is that you can try it, and if it does not work for you, you have not really lost anything. When you do try it, make sure to really give it your best shot. See below for a description of the kind of experience most people have who have successfully switched.
[6.3] Can I use smokeless tobacco to help me quit using nicotine entirely?
That might work. We do not have a lot of good scientific evidence about this because the prevailing politics favor pharmaceutical nicotine products and oppose any use of tobacco. If you want to taper off, little-by-little, you might find that it is easier with smokeless tobacco than with cigarettes. Or you might not. You might find pharmaceutical products work better. There is no reason not to experiment to see what might work for you.
If you replace long-term use of cigarettes with long-term use of smokeless tobacco, you might find it easier to quit sometime in the future (though again, the evidence is not very clear on this). There is some evidence that a large fraction of smokeless tobacco users just quietly quit after a few decades of use, which is not true for smokers. Smokeless tobacco users may find it much easier to just quit than smokers do (or it may just be that the most dedicated nicotine users choose to smoke – we cannot be sure).
[6.4] I am sure I will quit smoking someday, so wouldn't it be better to just wait until then, rather than switching to another habit?
Perhaps not. It depends a lot on when you will quit, if you will succeed, and what you mean by "better". Every day that you smoke is another day that your smoking might kill you. Even though the health risks from smoking accumulate over a lifetime, there will be that last straw. For every smoker that died from smoking, there was a time she could have quit and avoided the disease that killed her, and a time after that when it was too late. If you are quitting smoking to protect your health, you should try to make sure you do it before, and not after your habit has caused a preventable disease.
It is impossible to know this for sure, but if switching to smokeless tobacco reduces your risk by 99%, for the average smoker this would be about the same as quitting entirely about three months later. (This will vary a lot depending on age and a lot of unknowns, but it provides some idea). This means that if you are a 45-year-old man and expect to quit entirely a year from now, you would probably be better off switching to smokeless tobacco now (especially since you may find that you cannot quit right away).
If you are worried about the financial expense or other impacts of using tobacco, or the possible small risk from nicotine, then quitting altogether might be your goal. Even then, if you could switch to smokeless tobacco now, and then quit entirely later, you would avoid the health risks from continuing to smoke until the day came when you quit nicotine entirely.
[6.5] I am interested in switching. Can I do it all at once?
In Sweden, where most of our knowledge of switching comes from, the typical switcher did not immediately jump from only smoking to only using smokeless tobacco but transitioned over an 18 month period. Usually, they start with a bit of experimentation, then using smokeless tobacco while still smoking some, and then gradually progressing to smoking not at all or very little.
In other words, switching may take a little time and effort. Allow yourself time to get used to it and gradually shift from one to the other. Of course, in terms of health, the sooner you can give up smoking entirely the better, but take consolation in the fact that even if you cannot do that, every little move in that direction works in your favour. Don't worry if it takes a little longer than you planned. Any major life changes, and quitting smoking is a big one, takes time.
Even before you have entirely switched over you will experience less smoky smell in your hair and clothing, more fresh air in general, and clearer lungs. That increase in general well being should help keep you focussed on quitting smoking entirely.
[6.6] But seriously, isn't promoting smokeless tobacco just a tobacco industry strategy to keep the profits rolling in?
Does it really matter what their motive is? Every company produces products in order to profit. Pharmaceutical companies produce lifesaving drugs to make money. Should we not use those drugs because someone is profitting? Most of these drugs would not exist if someone wasn't trying to make a profit. The point is to take the action that improves your health.
If you continue to smoke because you dislike that they profit from selling smokeless tobacco, you are still giving them your money while you are damaging your health.
References
1. Tilashalski K, Rodu B, & Cole P. 2005. Seven year follow-up of smoking cessation with smokeless tobacco. Journal of Psychoactive Drugs 37: 105-108. Abstract.
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