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Tobacco Harm Reduction
FAQs

1. Compared to traditional cigarettes, what are the benefits of using reduced-harm products?

Reduced-harm products, such as e-cigarettes and nicotine pouches, present several advantages when compared to traditional cigarettes. A few of the benefits are listed below: 

  1. Reduced-Harm Products Have Fewer Harmful Chemicals: E-cigarettes and nicotine pouches, among others, contain fewer and lower levels of toxicants.
  2. Reduced-Harm Products Lower Health Risks: These products reduce the risk of smoking-related diseases, such as lung cancer and cardiovascular diseases.
  3. Reduced-Harm Products Help with Smoking Cessation: Reduced-harm alternatives can help smokers quit by providing a less harmful way to consume nicotine.

Reduced-Harm Products Improve Quality of Life: Alternative product users talk about better respiratory health and overall well-being after switching to reduced-harm products​.

2. When looking at safety and effectiveness, what is the difference between nicotine pouches and vaping?

Nicotine pouches and vaping are two of the most popular reduced-harm products. While both are safe and effective when purchased legally, they differ primarily in their delivery methods:

  • Nicotine Pouches are pre-packaged products that are tucked in-between the cheek/lip and gum, releasing nicotine directly into the bloodstream without inhalation. These discreet pouches do not produce vapour or smell and have similar toxicant levels as nicotine replacement therapies (NRTs)​ 
  • Vaping consists of inhaling vapour produced by an e-cigarette or a similar device. It provides a similar experience as smoking, which some find helpful for quitting cigarettes. 

Both methods are considered safer than smoking, but personal preference and lifestyle can influence which is more effective for an individual​.

3. How does the tobacco harm reduction risk continuum work?

The tobacco harm reduction risk continuum is a scientific method that compares and ranks smoking versus nicotine-containing alternatives based on their health risks. This continuum helps guide smokers towards less harmful alternatives, encouraging a shift from high-risk to lower-risk products​ . At one end of the continuum are cigarettes and other combustible tobacco products. These products are ranked as higher risk due to the harmful process of combustion. At the other end are products like nicotine pouches and e-cigarettes – often compared to nicotine replacement therapies such as nicotine gums.

4. When compared to smoking, why is vaping considered to be a harm-reduced alternative?

While smoking involves a combustion process, the absence of this process in vaping reduces harm. During the combustion process, traditional cigarettes burn tobacco and release thousands of harmful chemicals including tar and carbon monoxide, which are responsible for most smoking-related diseases. Contrarily, vaping devices do not require a combustion process. Instead, vapes heat a liquid, often containing nicotine and other flavourings, that produces a vapour. This process has substantially fewer toxic substances when compared to cigarette smoke​. Due to this key difference, vapes are classified as a harm-reduced alternative to smoking cigarettes. 

5. What are the some of the common myths surrounding vaping?

Myth: Vaping is as harmful as smoking.
Truth: As vaping does not involve combustion, it is exponentially less harmful than smoking the harmful chemicals found in cigarettes.

Myth: Vaping causes popcorn lung.
Truth: Popcorn lung (bronchiolitis obliterans) is linked to diacetyl, a chemical that has been largely eliminated from e-liquids. No confirmed cases of popcorn lung have been attributed to vaping.

Myth: Vaping leads to smoking.
Truth: Research shows that vaping is more commonly used by smokers to quit smoking rather than by non-smokers to start smoking​​. Adopting harm-reduced policies that encourage and proportionately monitor vaping can help countries reduce, control and dispel myths regarding vaping as a gateway to smoking.

6. Does vaping increase the risk of developing ‘popcorn lungs’?

The risk of developing popcorn lung from vaping is extremely low. Popcorn lung is a serious and rare lung disease associated with diacetyl, which was used in trace amounts in some e-liquids in the past but has since been removed from most reputable products. There have been no confirmed cases of popcorn lung linked to vaping, and regulatory standards now ensure safer formulations of e-liquids​. In order to make sure that consumers are able to obtain e-liquids that match the regulatory standards, it is vital that governments legalise and support vaping as an alternative to smoking.

7. When compared to other methods, how effective are nicotine pouches in helping smokers quit?

The effectiveness of nicotine pouches in helping smokers quit is similar to that of other nicotine replacement therapies (NRTs). Nicotine pouches offer a steady release of nicotine, which helps reduce withdrawal symptoms and cravings an eliminates the harmful process of tobacco combustion. Studies have shown that nicotine pouches are a viable alternative to cigarettes for the purpose of harm reduction.

8. What are a few steps that can be taken by smokers who want to switch to harm-reduced alternatives?

In the process of switching to harm-reduced alternatives, smokers can:

  1. Research the Right Product for Them: It is important to select products that suit their lifestyle and preferences, whether that be the more discreet nicotine pouch or the similar hand-to-mouth action vapes.
  2. Make Sure to Start Gradually: Smokers can begin by replacing some cigarettes with the chosen alternative and gradually increase usage.
  3. Seek Support from Others: Support services and resources, such as counselling or quitlines, are a useful tool in the cessation journey.

Regularly Monitor Their Progress: Individuals can track smoking reduction and any health improvements to stay motivated​ – and to not get discouraged by any missteps

9. What do the tobacco policies in Asia regarding harm-reduction products look like?

Tobacco policies in Asia regarding harm-reduction products vary widely. In countries like Japan and South Korea, smoking rates have plumeted with the introduction of heat-not-burn alternative nicotine products. On the other hand, countries such as India and Thailand maintain strict bans on e-cigarettes. As the regulatory landscape is evolving, it is important that governments embrace the benefits of a risk-proportionate policy that provides consumer access to safer alternatives​.

10. How does tobacco harm reduction impact public health in the Asia Pacific region?

Tobacco harm reduction has the potential to significantly improve public health in the Asia Pacific region by reducing smoking-related diseases and deaths. With high smoking rates and related health burdens, introducing and promoting less harmful nicotine products can help decrease tobacco-related morbidity and mortality. However, the impact is influenced by regulatory frameworks, public awareness, and access to harm-reduction products. Countries adopting harm reduction policies have seen positive outcomes. Despite this, broader acceptance and implementation are needed to maximise benefits across the region​.