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 us.