Is oral tobacco an aid for nicotine
addicts like methadone for heroin addicts?
You have to draw the distinction between methadone and oral tobacco as
(ostensible) harm reduction measures. This is a critical
distinction that makes all the difference between good public health
policy and pandering to destructive corporate interests.
1) chemically distinct from heroin, and
2) delivered in a medically controlled environment to patients
receiving treatment to quit an addiction.
Oral tobacco is
1) the same as tobacco, and
2) delivered by tobacco companies in an environment these companies
intend to be supportive of continued tobacco addiction.
The closest harm reduction equivalent of heroin to methadone is tobacco
to NRT. Even this is true only when NRT is used as an aid to
total cessation only and not as an addiction maintenance
mechanism. For tobacco control to follow the harm reduction model
of heroin, tobacco must be removed altogether from the harm reduction
model, just as heroin is removed altogether from the heroin harm
*In addition, methadone therapy has an evidence base demonstrating
in treating heroin addiction [e.g., here's the reference to a
review from the Cochrane database: Mattick, RP. Breen, C. Kimber, J.
Davoli, M. Methadone maintenance therapy versus no opioid replacement
therapy for opioid dependence. [Systematic Review] Cochrane Drugs and
Alcohol Group Cochrane Database of Systematic Reviews. 2, 2008. AN:
00075320-100000000-01658]. Smokeless tobacco has no such evidence base
treatment for smoking.