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Introduction
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Selection Process
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If You Only Read One Paper...
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Acknowledgements
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Sub- Categories
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Introduction
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Approaches that aim to reduce the harm for those who continue to use tobacco / nicotine have received little attention to date. This set of documents is intended for people who are interested in how harm reduction can be applied to tobacco use. These documents may be used to improve advocacy for tobacco harm reduction, carry out research or develop new policy. They may also be used to plan new services or improve or evaluate existing services. This collection is intended to benefit policy makers, practitioners, communities and tobacco users around the world. These harm reduction approaches should be seen as an additional and complementary strategy to the other key tobacco control strategies.
Tobacco harm reduction is a policy or strategy for tobacco users who cannot or will not stop, which explicitly includes the continued use of tobacco or nicotine and is designed to reduce the health effects of tobacco use. Examples of harm reduction interventions could include using potentially reduced-exposure products (PREPs), reducing consumption, switching to long-term nicotine replacement therapy (NRT), switching to smokeless tobacco products, and using replacement products for temporary abstinence.
The premise behind these strategies is that dependence on nicotine is the critical factor underpinning most tobacco use. However, it is not the nicotine that causes most of the harm but rather some of the other 4000 constituents of cigarette smoke, of which 60 are known carcinogens. Drawing an analogy with illicit drug use, the cigarette is the equivalent of the ‘dirty syringe’. Consideration therefore needs to be given to separating the drug from the delivery system. The strategies considered here examine the potential for switching some or all cigarette use to other, less harmful nicotine delivery systems.
This collection contains over 80 major documents covering a range of 10 topics related to tobacco harm reduction. Until now, there has been no single, readily accessible source of up-to-date key documents about tobacco and harm reduction. This collection of tobacco and harm reduction documents is periodically reviewed, and we would welcome any feedback or suggestions contact IHRA.
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Selection Process
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Papers were preferred if they were recent, brief, readable, accredited by an international or national organisation, published as a paper in a high impact factor journal, and/or scientifically rigorous.
During the search process, preference was also given to documents that were of practical use to advocates, policy makers, programme managers and harm reduction practitioners. This was not an attempt to compile a scientific evidence base (although, as harm reduction is not currently being practiced widely in tobacco control, the majority of the papers are academic). In addition, consideration was given to avoid long and complex documents, because the collection may at a later date be translated.
An International Reference Panel of experts was set up to ensure that the selected documents were of a high standard and reflected global perspectives. Unfortunately, the majority of the papers and documents are from the developed world, as little work on tobacco harm reduction has been done in developing or transitional countries to date.
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If You Only Read One Paper...
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This paper reviews the evidence and expert opinion on tobacco harm reduction strategies such as smokeless tobacco. It advises on how to advocate for these interventions with both policy makers and, essentially, smokers themselves.
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Kozlowski LT, O’Connor RJ & Edwards BQ (2003) Some practical points on harm reduction: What to tell your lawmaker and what to tell your brother about Swedish snus. Tobacco Control, 12, 372-373
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Acknowledgements
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This collection was the result of funding from the Open Society Institute (OSI), and was put together on behalf of IHRA by Ann McNeill (Professor in Health Policy and Promotion at the University of Nottingham). Ann was supported in this work by Gerry Stimson (IHRA Executive Director), Jamie Bridge (IHRA Communications and Project Development Officer), and Erdem Pulcu (Freelance Research Consultant).
Particular thanks must also go to the International Reference Panel:
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- Philip Alcabes
- Karl Fagerstrom
- Jonathan Foulds
- Nigel Gray
- Martin Jarvis
- Lynn Kozlowski
- David Sweanor
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We would also like to acknowledge the following:
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- Action on Smoking and Health (ASH) (http://www.ash.org.uk/)
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- Framework Convention Alliance for Tobacco Control (http://fctc.org)
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- Harm Reduction Journal (BioMed Central) (http://www.harmreductionjournal.com)
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- John Wiley & Sons, Inc (www.wiley.com)
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- New England Journal of Medicine (http://content.nejm.org)
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- Royal College of Physicians (www.rcplondon.ac.uk)
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Sub-Categories
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To make these documents easier to navigate and locate, this collection has been divided into various sub-categories which each define a certain area of research or interest.
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Click here to view Sub-Categories
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