Key Concept of Tobacco Harm Reduction
Tobacco Harm Reduction (THR) is a public health strategy that aims to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.
Policymakers have been working for decades to control the burden of tobacco-related diseases. The most effective tobacco-control strategy has four main elements:
To provide strong incentives to not start smoking
To motivate and help people to quit smoking
To reduce harm to non-smokers arising from exposure to toxins in secondhand smoke
To reduce harm to those who continue to use nicotine
Harm reduction, which is the fourth element in tobacco control strategy, often receives less attention and evokes hostility from some tobacco control activists. Yet, it is one of the most important tools in improving public health.
However, it’s important to note that the goals of tobacco policy can sometimes be in conflict in cases where nicotine products offer much lower disease risk than smoking.
A crucial insight into tobacco and health strategy is to recognize the ultimate cause of harm. While nicotine is the active drug in tobacco, and the reason why people smoke tobacco, it is not the primary cause of harm arising from smoking.
What is Nicotine?
Nicotine is a chemical compound that is one of the many naturally occurring chemicals found in tobacco. In addition to being found in tobacco, nicotine is also found in tomatoes, aubergines and even potatoes.
Dispelling Nicotine Myths
While it is addictive and it’s not totally risk-free, nicotine is not the cause of cancer, cardiovascular disease or the respiratory conditions that many smokers suffer from. Nicotine is part of the reason why people smoke tobacco, but the cause of most serious tobacco related illnesses comes from the tar released from burning tobacco in cigarettes.
According to the US Food and Drug Administration (FDA), “most people know that cigarettes and other tobacco products are addictive, but many people do not understand the role of nicotine in tobacco addiction, disease, and death. Nicotine is what addicts, and keeps people using tobacco products, but it is not what makes tobacco use so deadly.
Tobacco and tobacco smoke contain thousands of chemicals. It is this mix of chemicals – not nicotine – that causes serious disease and death in tobacco users, including fatal lung diseases like chronic obstructive pulmonary disease (COPD) and cancer.”
Therefore, as a harm reduction tool, nicotine is a useful substitute to combustible tobacco.
However, there is still an urgent need for health professionals and the public to have access to accurate information about the risk profile of nicotine.
Risk Continuum
While nicotine isn’t deadly, it’s important to note that there is still a risk continuum that applies to any product that contains nicotine.
What is Risk Continuum
The risk continuum is a scientific method used to compare the harms of continuing to smoke vs nicotine alternatives such as vaping and nicotine replacement therapies such as gum and sprays.
How does it apply to THR?
Both tobacco and nicotine products can be placed on this risk continuum, with cigarettes classified as high risk and nicotine products that don’t burn tobacco classified as lower risk.
Tobacco Harm Reduction encourages smokers to move down the risk continuum by switching from high-risk tobacco products to far less harmful nicotine products. Nicotine pouches and e-cigarettes rank alongside common nicotine replacement therapies such as gum and sprays on the risk continuum.
Although nicotine is the major addictive substance in tobacco products, it is not to blame for the disease and death caused by smoking tobacco. When you burn tobacco, you inhale smoke that is filled with thousands of dangerous chemicals. When you use nicotine pouches or e-cigarettes you don’t burn tobacco and don’t expose yourself to the same risks. While there is a common belief that nicotine products are the same as cigarettes, the science does not support this.