Steven Stellman - The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts

Document created by Steven Stellman on Dec 1, 2016
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  Publication Details (including relevant citation   information):

  Levy, D. T., Mumford, E. A., Cummings, K. M., Gilpin, E. A.,   Giovino, G., Hyland, A., Sweanor, D., Warner, K. E. 13  (12) 2035-42-

  Abstract: A nine-membered panel of experts was   asked to determine expert opinions of mortality risks associated   with use of low-nitrosamine smokeless tobacco (LN-SLT) marketed   for oral use. A modified Delphi approach was employed. For total   mortality, the estimated median relative risks for individual   users of LN-SLT were 9% and 5% of the risk associated with   smoking for those ages 35 to 49 and > or =50 years,   respectively. Median mortality risks relative to smoking were   estimated to be 2% to 3% for lung cancer, 10% for heart disease,   and 15% to 30% for oral cancer. Although individual estimates   often varied between 0% and 50%, most panel members were   confident or very confident of their estimates by the last round   of consultation. In comparison with smoking, experts perceive at   least a 90% reduction in the relative risk of LN-SLT use. The   risks of using LN-SLT products therefore should not be portrayed   as comparable with those of smoking cigarettes as has been the   practice of some governmental and public health authorities in   the past. Importantly, the overall public health impact of LN-SLT   will reflect use patterns, its marketing, and governmental   regulation of tobacco products.

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