Tobacco Harm Reduction: The Way Forward
Tobacco Harm Reduction: A Foundation for Success
The availability of Smokeless Products that provide nicotine with substantially fewer toxicants than are present in cigarette smoke has transformed the discussion over the role of Tobacco Harm Reduction (THR) in tobacco control.
THR, underpinned by robust science, is integral to the public health strategy on tobacco. Accordingly, it is critical that we and other stakeholders across the scientific and regulatory ecosystem related to tobacco and nicotine products find common ground to harness its full potential.
There are certain fundamental elements that are necessary to accelerate the adoption of effective Tobacco Harm Reduction strategies and regulatory frameworks. These principles will help us to pave the pathway forward.
Pathway Forward
01
THR is recognised in the WHO’s FCTC (Article 1(d)). It should be a central part of the public health strategy on tobacco
More stakeholder discussion is needed regarding the weight of evidence that validates THR
03
Randomised Clinical Trial data [Cochrane review 2024] and in-market data demonstrate the efficacy of THR to manifest smoking reduction
04
Adult consumers have a right to access legally regulated tobacco and nicotine products
05
Banning Smokeless Products leads to sustaining of smoking rates and the unintended creation of illicit Smokeless Products markets
06
All stakeholders recognise that tobacco and nicotine are never for those below the minimum legal age
07
Market data shows smoking rates are at an all-time low, suggesting in the main, that Smokeless Products are not leading to more smoking. Vigilant post-market surveillance is needed to monitor these trends
08
Data from Sweden confirms mortality and morbidity reduction potential of Smokeless Products alongside more than a decade of usage of Smokeless Products by more than 100 million adult smokers (Chapter 6)
09
While there is a public health risk of sustained or new nicotine usage, more discussion is needed to assess the view that this risk is greatly outweighed by the benefits of THR
10
Public health bodies have confirmed that nicotine is not carcinogenic;[1,2] it is the harmful chemicals generated from the burning of tobacco that cause harm to adult smokers
11
The focus of the public health strategy on tobacco should be to minimise the harm of tobacco on society and this can be achieved via a combination of evidence-based tobacco control measures and THR
12
If adult consumers wish to use Smokeless Products, they should be supplied within a regulatory framework that is enforced to ensure access to legal products without the creation of illicit markets
13
Several public health authorities across the world have stated that THR products present less risk than smoking[3-8]
References
[1] World Health Organization and International Agency for Research on Cancer, IARC Monographs on the Identification of Carcinogenic Hazards to Humans. Available at: https://monographs.iarc.who.int/agents-classified-by-the-iarc/ (Assessed: 15 July 2024)
[2] NHS, Vaping myths and facts. Available at: https://www.nhs.uk/better-health/quit-smoking/vaping-to-quit-smoking/vaping-myths-and-the-facts/#:~:text=Myth%202%3A%20Nicotine%20is%20very%20harmful%20to%20health&text=It%20is%20the%20many%20other,to%20help%20people%20stop%20smoking. (Accessed: 15 July 2024)
[3] AP news. Insider Q&A: FDA official on vaping’s “promise or peril”. 2022. Available at: https://apnews.com/article/science-health-public-tobacco-industry-regulation-6af0d635d7859bab914cc249ef43b6e2. (Accessed: 17 July 2024)
[4] U.S. Food & Drug Administration. CTP Director Discusses Opportunities and Considerations for Addressing Misperceptions About the Relative Risks of Tobacco Products Among Adults Who Smoke. 2023. Available at: https://www.fda.gov/tobacco-products/ctp-newsroom/ctp-director-discusses-opportunities-and-considerations-addressing-misperceptions-about-relative#:~:text=The%20survey%20found%20that%20only,cigarettes%20being%20the%20most%20harmful. (Accessed 8 August 24)
[5] McNeill A., et al., E-cigarettes: an evidence update, Public Health England. 2015. Available at: https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update.
[6] Government of Canada, Vaping and quitting smoking. 2023. Available at: https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/quit-smoking.html. (Accessed 19 July 2024)
[7] Travis N., et al., The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review, Nicotine Tob Res, 2024. p. ntae131. DOI: 10.1093/ntr/ntae131
[8] Vaping Facts, Our position on vaping, Ministry of Health. Available at: https://vapingfacts.health.nz/our-position-on-vaping.html (Accessed 19 July 2024)
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Smokeless Products: An Introduction -
01. Our Vision: A Need for Reappraisal -
02. The Big Questions -
03. Impact of Smoking -
04. Our Smokeless Science -
05. Our Smokeless Products -
06. THR: A Global Transformation -
07. THR: Global Regulation -
08. THR: Scientific Engagement -
09. Our Future Outlook -
10. References -
11. Our Published THR Science
