Sunday, 24 April 2011

Regular reviews on Tobacco Harm Reduction

Tobacco harm reduction is a controversial area. I can't comment on the science but I can give an outline. The premise of tobacco harm reduction is that smoke, rather than nicotine, is what makes smoking dangerous. Consequently smokers who want to give up can use smokeless tobacco or e-cigarettes more safely than smoking tobacco.

The emerging tobacco harm reduction market has benefited from scares about the dangers of smoking to by-standers. Urging people to give up smoking has always been easier if you can persuade them that smoke is killing their loved ones. In fact ASH Scotland uses the term 'harm reduction' here (a section from Sheila Duffy's epic 'Beyond Smoke Free' document), to mean that using nicotine replacement therapy beats smoking in front of your children. She seems to feel that smokers should be content with a 'sticking plaster', rather than a satisfying experience.

Users of e-cigarettes and other smokeless tobacco have found themselves faced with the threat of prohibition far more quickly than smokers. The market for e-cigarettes has clearly competed for the same customers that might otherwise have bought nicotine patches and gum from global pharmaceutical companies. Pharmaceutical companies want to develop drugs based on natural substances like tobacco, and the entire anti-smoking establishment has sought to make e-cigarettes unavailable to consumers, in the hope that it will create a captive market for pharmaceutical cessation products (see forum discussion here).

Users of e-cigarettes know that banning their product is not to do with health (even though spurious claims are made about uncertain health risks). They can see cigarettes still on the market, while the product they resorted to in order to stop smoking has been banned – leaving them with the options of stopping smoking without any help or buying the products of pharmaceutical interests.

Smokers have lived with their chosen product being taxed to the heavens: e-cig users live with the threat of their product of choice being made unavailable (for much the same reasons as the rest of us will no longer be able to buy calendula lotion or other common herbal products after 1 May). For most people an e-cigarette ban remains a threat rather than actuality (New York State being closest to an outright ban in the US, and full bans operating in Brazil, Singapore and in Canada except where the e-cigarette is free of nicotine – see here for details).

This guide to essential reading on tobacco harm reduction offers further links and insights. Stories include a possible workplace ban on e-cigarettes in Georgia (together with suggestions for local action) and the opposition of students at the University of Massachusetts to a smoking ban that included e-cigarettes and smokeless tobacco in its reach. There's much more where this came from, and the list will be regularly updated.


westcoast2 said...

When NICE had it's 'Citizens Council' consultation on Tobacco Harm Reduction, they came to the conclusion that THR was only valid if it was a step towards becoming 'Nicotine Free'. They did not see the on-going use of products such as Snus or the E-cig as a valid strategy.

This position was originaly seen as NICE supporting THR when it seems their 'strategy' continues to be one of 'Quit or Die'. They still support NRT (and the medicalization of nicotine containing products) although they have attempted to dress this up as THR. ASH did a similar thing with their apparent support for the e-cig which again turned out to be a sleight of word.

People need to make their own choices based on accurate information. Unfortunately this is not forth coming from the medical establishment (I wrote to Dr Hilary Jones about his lack of knowledge in this area), the 'Charities' or HMG.

Anonymous said...

The NICE Citizens Council was loaded with representatives from the Anti-Smoking lobby.

Anonymous said...

This is more revealing.