Media Watch: The Telegraph Caught With Its Hand in the Clickbait Cookie Jar

I’m not old enough to remember the time when the only people who lied about tobacco products were Big Tobacco and the morally bankrupt scientists they bought and sold. Yet, sometimes, I feel a faint nostalgia for that bygone era. Mainly because at least you knew where you stood.

Nowadays, it’s almost impossible to decipher the motivations behind the steady flows of lies (both of omission and direct), distortions, and misinformation about the harms of tobacco.

Case in point: The Telegraph’s latest piece, “One in three oral cancers linked to smokeless tobacco products like snus.”

Headlines don’t get much scarier than that. Then, when you consider that many people incorrectly use the words “snus” and “nicotine pouches” interchangeably, it’s easy to see how people would be put off the absolute safest way to consume nicotine in the UK.

So, what’s going on here? Is oral tobacco much more deadly than we believe? Or do the Telegraph think that their readers are that dim?

The paper

The source of this terrifying statistic comes from this hot-off-the-presses paper called Global burden of oral cancer in 2022 attributable to smokeless tobacco and areca nut consumption: a population attributable fraction analysis. It was published in The Lancet Oncology, and its author is Harriet Rumgay, whose previous work focused on the link between alcohol and cancer.

The paper states that one in every three global cases of oral cancer occurred due to smokeless tobacco and areca nut. In total, that means 120,000 separate reports.

The bulk of these cases occurred in “low- and middle-income countries in South-Central Asia,” which account for 88% of these 120,000 incidents of oral cancer.

India alone contributed 83,400 cases to the mix. So, considering that’s 70% of all reported incidents, let’s take a look at the reports within the South Asian powerhouse.

The paper states that 77% of cancer reports from 2022 were from men, so we’ll use that data. Here is the breakdown of linked products.

• Khaini 47%
• Gutka – 43%
• Betel quid with tobacco – 33%
• Areca nut 32%.

But what are these products?

Firstly, areca nut is not tobacco. Instead, it’s a stimulant made from the seed of the areca palm. It’s commonly mixed with tobacco in these regions to make both gutka and betel quid.

Khaini, betel quid, and gutka all use slaked lime, which is also called calcium hydroxide. Slaked lime helps increase the pH levels of these products to assist with mucal absorption.

Other than that, khaini is made from coarse sundried or fermented tobacco leaf, while gutka adds spices to the tobacco, and betel quid uses betel leaf, thanks to its flavour, aroma, and mild stimulant properties.

How is Swedish snus different from these products?

While the above products and snus can all be categorised as smokeless tobacco, that’s a rather broad umbrella.

Let’s explore some of the significant differences between the products.

Swedish snus is:

• Made from ground tobacco.
• Steam pasteurised to reduce known carcinogens, such as tobacco-specific nitrosamines (TSNAs).
• Made with controlled pH levels, ensuring nicotine delivery is more consistent.
• Subject to strict regulatory scrutiny, adhering to the GothiaTek standard.
• Regulated as a food product, meaning all ingredients must be included on the packaging, ensuring greater transparency.
• According to research, not strongly associated with increased oral cancer risk.

What is the Telegraph playing at?

While the author needs to take some blame, it’s the headline and sub-headline that do the most damage.

This research is not about snus. What’s more, the danger of these South Asian products has not been overlooked in the slightest, no matter what the subhead claims.

The framing of the article — the headline, subhead, and the image of snus — paints a very misleading picture.

It’s honestly like saying, “I bought some food from a street vendor in India, and now I feel sick. Regulators need to do something about Swedish food processing standards.” It’s that embarrassing and out of touch.

As mentioned above, the fact that snus is used as a synonym for nicotine pouches makes this article all the more pernicious.

If snus was a major driver of oral cancer, we would expect to see this reflected in high rates in Sweden. However, data shows this is not the case. If anything, Sweden’s oral and pharyngeal cancer rates are a bit below the EU average.

Final thoughts

This article is tantamount to defamation of harm reduction products like snus. Additionally, it could scare people away from a product that could save lives.

Snus and nicotine pouches are vital tools in the battle against smoking. The Telegraph’s attempt to lump them in with crude, unregulated products that have been proven to cause oral cancer is an insult to truth, integrity, and The Telegraph reader’s intelligence.