Smokeless tobacco may help some men stop smoking, but more often it is a nicotine gateway to cigarettes, according to a new study.

The study by Dr. Scott L. Tomar of the University of Florida College of Dentistry appears in the October issue of the American Journal of Preventive Medicine and raises doubts about research being conducted at UAB that advocates smokeless tobacco as a safer alternative to cigarettes. The new study is the latest scientific argument in a debate over a proposed "harm reduction" strategy of getting hard-core smokers to switch from cigarettes to snuff, a finely milled tobacco that is placed between the lip and gum. Tomar studied the smoking and snuff habits of about 14,000 men who completed a 1998 health survey. His analysis showed that 2.5 percent of men were former snuff users who switched to cigarettes, and 1 percent of men were former cigarette users who switched to snuff. The numbers show that smokeless tobacco is far more likely to serve as a gateway to smoking than an escape hatch from it, Tomar said. Dr. Brad Rodu, an oral pathologist who has been conducting smokeless tobacco research at the University of Alabama at Birmingham, said he wasn't surprised by the new study's findings, but disagreed with Tomar's conclusions. For decades people have been told by the anti-tobacco movement that smokeless tobacco is just as dangerous as cigarettes, he said. "Smokers believe this message," he said. "They've been misinformed." This has discouraged a movement away from cigarettes and toward smokeless tobacco, Rodu said. But he said smokeless tobacco carries 2 percent of the health risks of cigarettes. UST Inc., the largest producer of smokeless tobacco in the United States, supports the UAB research and wants to market smokeless tobacco products as safer alternatives to cigarettes. "We realize it's a controversial subject," said Mike Bazinet, a spokesman for UST. He said the company is gathering data for a request before the Federal Trade Commission to change its advertising and labeling to reflect smokeless tobacco's safer-than-cigarette quality. Tomar said there's no good scientific evidence to indicate that U.S. smokers would switch to snuff for health reasons. "We have to have the science to show this would work," he said. "I have just not seen credible evidence." It's more likely that trying to encourage such a switch would create more smokers and nicotine addicts, given the marketing strategy of smokeless tobacco producers, Tomar said. He said smokeless tobacco producers deny it, but lawsuits against the industry have provided evidence that the products are designed to develop dependence with increasing dosages of nicotine. This is just the opposite of smoking cessation products such as patches that work with decreasing levels of nicotine. Tomar said smokeless tobacco users start with products such as Skoal Bandits, with a low dose of nicotine. They move on to products such as Skoal Long Cut Cherry, with a sweet taste and higher dose of nicotine. And they graduate to a product such as Copenhagen, with the highest levels of nicotine. "By that point, the person is very well addicted," Tomar said.

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