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Tobacco Harm Reduction and Science

Harm reduction encourages public health initiatives that have the potential to decrease the harm associated with a particular behavior without necessarily eliminating that behavior. That is not to say that the alternative behavior does not pose some risk; it is that the behavior poses less risk.

Examples of public health programs seeking to minimize the impact risky behaviors have on society include alcohol use (e.g., minimum age laws, designated drivers, limiting store hours/locations), road safety laws and needle exchanges for intravenous drug users.

Given the success of harm reduction strategies with these other behaviors, a number of scientists and public health officials are embracing tobacco harm reduction as an additional tool to reduce the harm associated with cigarette use.

In general, the use of smokeless tobacco products has been shown to present less risk than does the use of cigarettes; therefore, this category of products could play a valuable role in reducing tobacco consumers' risks.

For example, a Technical report issued in 2008 by the World Health Organization’s study group on Tobacco Product Regulation concluded: “There is little question that, in general, smokeless tobacco products are less harmful than combusted tobacco products such as cigarettes.” 

This research, and other studies, indicate that it is the combustion of tobacco (i.e., cigarette smoking) rather than the nicotine that exposes tobacco consumers to the most risk.

Other studies support the use of smokeless tobacco as a way to obtain nicotine rather than smoking. A 2007 report from the Royal College of Physicians states that it is the process that one goes through to get nicotine, not the nicotine itself, that determines risk levels.

These researchers similarly concluded that, depending on the product, smokeless tobacco was on the order of 10–1,000 times less hazardous than cigarette smoking; and, if nicotine could be provided in a form that was acceptable and effective as a cigarette substitute (e.g., smokeless tobacco), millions of lives could be saved.

These and other researchers suggest the existence of a pronounced "continuum of risk" of tobacco and nicotine products.