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Tobacco Harm Reduction

Sound Science

Cigarette smoking is a leading preventable cause of death. Smoking cigarettes has been linked to increased risk of lung cancer, heart disease, chronic bronchitis, emphysema and other serious diseases and conditions. Yet many smokers are unwilling to choose complete abstinence of nicotine and tobacco.

According to the CDC:

  • More than 16 million American adults live with a smoking-related disease.
  • Each year, smoking-related illness in the U.S. costs more than $300 billion, of which nearly $170 billion is for direct medical care for adults.

As a cigarette burns, the tobacco is inhaled while burning at an average of 3,000 degrees Fahrenheit. This combustion of tobacco releases harmful chemicals, including carcinogens. It is these chemicals, rather than nicotine, that contribute to the high-risk profile of cigarettes. Because smokeless tobacco products do not burn tobacco, they provide a less risky alternative to cigarettes for millions of adult smokers.

With respect to vapor products, another category of non-combustible tobacco products, a growing body of scientific evidence shows that they may present less risk than cigarettes. A 2014 study found that although “…e-cigarette vapors contained some toxic substances... The levels of the toxicants were 9–450 times lower than in cigarette smoke and were, in many cases, comparable with trace amounts found in the reference product [a medicinal nicotine inhaler].” A study from the University of Victoria, Centre for Addictions Research of British Columbia found that “vapor from e-cigarettes contains only a fraction of the toxins (18 of 79) found in tobacco cigarettes and generally in substantially lower levels. [E-cigarettes] also do not deliver tar. In addition, vapor is airborne for only 30 seconds, compared to 18-20 minutes for cigarette smoke, thereby greatly reducing second-hand exposure.”

However, some in the tobacco control community advocate a precautionary approach. For instance, a 2016 Surgeon General’s note states that “[vapor] products are now the most commonly used form of tobacco among youth in the United States, surpassing conventional tobacco products, including cigarettes, cigars, chewing tobacco and hookahs.” In addition to concerns over youth usage, the Surgeon General also expressed concerns over the variability of ingredients and manufacturing processes, which have raised questions as to the harm reduction potential of this category.

The Surgeon General has also expressed concerns about the effects of nicotine on developing brains and pregnant women. While nicotine alone can increase heart rate and blood pressure, nicotine is not a major source of harm to otherwise healthy adults who are not pregnant. In fact, according to Professor John Britton, who leads the tobacco advisory group for the Royal College of Physicians: “Nicotine itself is not a particularly hazardous drug. It’s on par with the effects you get from caffeine.” Mitch Zeller, Director of the FDA Center for Tobacco Products agrees, saying: “When nicotine is attached to smoke, it will kill. But if you take that same drug and put it in a patch, it is such a safe medicine that it doesn’t even require a doctor’s prescription.” Despite science to the contrary, 80 percent of Americans believe nicotine is a carcinogen.

RAI’s subsidiaries’ research and development efforts focus on creating a broad portfolio of new and innovative products placed throughout the risk continuum that align with changing consumer preferences. Their research includes:

  • Analytical chemistry and toxicology;
  • Epidemiology and clinical research; and
  • Materials science and engineering.

Tobacco harm reduction is a complementary approach to prevention and cessation which may lead to greater reduction in smoking and an improvement to overall public health. Reynolds American and its subsidiaries believe accurate, credible information needs to be available to smokers so they can make informed decisions about switching to smoke-free alternatives.

"We may well have missed, or are missing, the greatest opportunity in a century. The unintended consequence is more lives are going to be lost”
David B. Abrams, senior scientist at the Truth Initiative, an antismoking group, on the potential presented by vapor products