Rodu, chairman of the oral pathology department at the University of Alabama at Birmingham, notes that oral cancer is the only major, well-established health risk associated with the use of smokeless tobacco (and even that disease is twice as common among smokers). A 1981 study published in The New England Journal of Medicine found an oral-cancer rate of 26 per 100,000 among long-term users of smokeless tobacco, compared to 6 per 100,000 among nonusers. Noting that the survival rate for oral cancer is 50 percent, Rodu estimates that "if all 46 million smokers used smokeless tobacco instead, the United States would see, at worst, 6,000 deaths from oral cancer [a year], versus the current 419,000 deaths from smoking-related cancers, heart problems, and lung disease." (Emphasis in original.) By this measure, he concludes, smokeless tobacco is 98 percent safer than smoking. Rodu and his colleagues estimate that life expectancy for a 35-year-old smokeless-tobacco user is 80.9, virtually the same as for nonusers. The average 35-year-old smoker, by contrast, lives to be 73.1.
Smokeless tobacco is much more prevalent today and growing. It may be time for a new study.