When Philip Morris International gained FDA approval this summer for a new “modified risk tobacco product” called IQOS, one of the first people to weigh in was UoL prof Brad Rodu, D.D.S. He called the new heat-not-burn product “good news for Americans who have been unable or unwilling to quit smoking.”
A professor of medicine and the endowed chair for Tobacco Harm Reduction Research at UofL, Rodu spends his time studying data on tobacco alternatives, and he has come to some surprising conclusions. He arrived at UofL 15 years ago thanks to the Kentucky Research Challenge Trust Fund (better known as the “Bucks for Brains” program), and his research is supported both by that fund and by unrestricted grants from the tobacco industry.
So what’s a dentist doing researching tobacco? It all started when he worked at the University of Alabama Birmingham. “As an oral pathologist I was responsible for interpreting biopsies of suspicious areas in the mouth, head and neck area from oral surgeons and ENT specialists all over the Southeast,” he says. And despite conventional wisdom, virtually none of those cases involved people who used smokeless tobacco. “Here I am in the middle of smokeless tobacco country, and virtually nobody that I see with mouth cancer chews or dips at all,” he recalls.
So Rodu began a campaign to convince smokers that smokeless tobacco was a viable alternative to cigarettes if they weren’t willing or able to quit altogether. “It’s the delivery system where all of the diseases are,” he says. “When you inhale smoke, you’re not only inhaling nicotine but you’re inhaling 7,000 chemicals, and many of those over a career start wearing down the body, giving people increased chances for many different cancers, heart attacks, strokes, emphysema. And those are just a few of the diseases.”
At UofL, Rodu uses federal and industry data to study a range of smoking alternatives, everything from e-cigarettes (which he thinks have a bad reputation they don’t deserve) to heat-not-burn products like IQOS to the ZYN nicotine pouches Swedish Match manufactures in Owensboro. “They’re small teabag-like pouches, and it’s pure nicotine with flavorings,” he says. “They’re three- and six-milligram strengths for each pouch, and that market is really expanding right now.” (By comparison, you typically get about a milligram of nicotine from a cigarette, although it’s absorbed much faster into the bloodstream.)
For example, Rodu’s most recent research paper (written with lead author and UofL colleague Nantaporn Plurphanswat, Ph.D., and researchers in Vermont and Sweden) looked at who’s using ZYN. “We were able to get a dataset from Swedish Match that they had collected when they first marketed ZYN in 14 Western states,” he says. “We found that the majority of ZYN users are current smokeless tobacco users, and that just 4% have never used tobacco.”
Although only time will tell, Rodu hopes the product offers smokers another offramp from their dangerous addiction.