What Is Tobacco Harm Reduction?

Philip Morris International explores how smoke-free products are an alternative to cigarettes for those who continue to use tobacco or other nicotine-related products

Despite being aware of the evident health risks, many smokers continue to smoke today. According to the World Health Organisation (WHO), there are over one billion smokers worldwide, and it is estimated that this number will not change significantly in the coming years

Smoking causes a number of serious diseases (including cardiovascular, pulmonary diseases and cancer) and increases the risk of early death. With around eight million attributed deaths every year, cigarette smoking is a formidable public health challenge for governments, regulators and health authorities worldwide .

Tobacco harm reduction

Quitting is undoubtedly the right way to go. But how do we convince those who otherwise choose to continue smoking? Harm reduction continues to be a highly-debated topic among public health officials. Quitting is without a doubt the best option to reduce the risk of smoke-related disease. However, for adult smokers who do not quit, the opportunity to switch to scientifically substantiated, less harmful alternatives holds a great potential to accelerate the decline in the number of people smoking cigarettes. This is the principle of tobacco harm reduction (THR).

Many believe that nicotine is the primary issue when it comes to smoking. Nicotine is addictive and not risk-free but, contrary to what many believe, experts agree that nicotine itself may not be the primary cause of smoking-related diseases. It is the chronic exposure to the toxic chemicals in cigarette smoke that are generated when tobacco is burned that cause disease. On average, a cigarette combusts tobacco at temperatures between 600-1,000oC and releases over 6,000 chemicals when lit. Many of these chemicals have been identified as causes or potential causes of smoking-related diseases.

Closing the awareness gap

Nicotine Replacement Therapies (NRTs) like patches or chewing gum have been around for decades, but have proven less effective in changing long-term smoking behaviour. On the other hand, smoke-free products that simulate the ritual and nicotine delivery of cigarettes have made much bigger inroads, shifting adult smokers away from cigarettes in the countries where they are regulated and available. The obstacles adult smokers come across in using smoke-free alternatives lie in a number of critical areas: education, policy and regulation, and institutional support.

The science is there. Proven across many industries and independent studies, smoke-free products, while not risk-free, have been shown to be better alternatives over continued smoking. Raising awareness of smoke-free products that contribute to harm reduction practices requires a combined effort, not just from industry players but also from public health bodies that recognise its benefits and policies.

Tobacco control measures aimed at preventing smoking and supporting quitting play a key role in reducing the harm caused by smoking. In several countries around the world including the UK and New Zealand, the use of regulated novel nicotine and tobacco products is seen as an appropriate alternative for smokers who do not quit and their use is encouraged by public health bodies.

We, at Philip Morris International (PMI), are also playing our part by working closely with regulators to share data from the clinical disease reduction studies we have been conducting for many years now as our organisation works towards delivering a smoke-free future. These studies allow us and the relevant bodies to understand the benefits of quitting smoking on public health in greater depth .

Alternative nicotine delivery

By less harmful alternatives, we are referring to smoke-free, heated tobacco products or electronic or e-cigarette (vape). Although these products are relatively new, emerging and growing in popularity over the last decade as alternative products for adult smokers, the concept of THR was first raised in the 1970s when Michael A H Russell, a British tobacco addiction expert, published an article in the ‘Lancet’ (1974) .

Since THR is a strategy that involves avoiding inhaling cigarette smoke, smokers as well as health authorities and practitioners must separate the risk associated with burning tobacco from that of simply delivering nicotine into the body via smoke-free devices. Therefore, education and science-backed studies should be made available to adult smokers so they can make fully informed decisions.

While not risk-free, when scientifically substantiated and made to appropriate quality and safety standards, smoke-free products are a better alternative for adult smokers who would otherwise continue to smoke.

This article is sponsored by Philip Morris Management Services (ME)