Tobacco harm reduction is a pragmatic approach to reducing the harm of smoking related diseases. People smoke because they are addicted to nicotine and seek a 'hit', but it is the other toxins in tobacco smoke that cause most of the harm. Nicotine can be obtained from a range of products, which vary in their level of harm and addictiveness, from smoked tobacco (i.e. cigarettes) at the top end of the harm/addiction spectrum, to medicinal nicotine (i.e. nicotine replacement therapy products) at the bottom end. A harm reduction approach to tobacco control encourages those smokers that cannot, or are unwilling to, stop smoking, to switch to using nicotine in a less harmful form, and ideally would result in them ultimately quitting nicotine use altogether.
Potential harm reduction products
- Nicotine Replacement Therapy (under construction);
- for Philip Morris promoting QuitAssist, a nicotine patch as a quitting strategy, see the page on Duke University and the Tobacco Industry
Industry-Funded Research Promoting Harm Reduction
Tobacco harm reduction has been controversial and divisive in public health, in particular where the debate has focussed on a possible role for other tobacco products such as Snus, within a tobacco harm reduction strategy. One of the reasons harm reduction is a sensitive topic is that it could involve engaging with the tobacco industry, which has a history of manipulating public debate and public health policy (with tactics highlighted on this website). To fully understand the harmfulness of potentially reduced risk products and their effectiveness for smoking cessation, tobacco industry investments and research into harm reduction and potentially reduced risk products should be carefully scrutinised. Who has paid for the research, which scientists, organisations and institutions are involved?
In fact, a number of scientists leading the debate on harm reduction and/or potentially reduced risk products are funded by the tobacco industry. Examples include:
- Jed E. Rose is director of the Center for Nicotine and Smoking Cessation Research (CNSCR) at Duke University in the USA, an institution with a long history of tobacco money. He is the inventor of the nicotine patch, and a nicotine aerosol technology. The Center, his research and his career are closely interlinked with the tobacco industry, more specifically Philip Morris.
- Also see Duke University and the Tobacco Industry and below, on harm reduction as a CSR strategy.
- The story on Duke University and the Tobacco Industry shows Philip Morris actively promoting the nicotine patch as a quitting strategy, with the research funded by the company and with the endorsement of scientists involved.
- Brad Rodu is a Professor of Medicine at the University of Louisville, whose work is funded by unrestricted grants from Swedish Match, Reynolds American, Altria and British American Tobacco.
- Carl V Phillips, was hired by US Smokeless Tobacco Company as an expert witness to deny any causal association between Smokeless Tobacco and oral- or tongue cancer.
- Riccardo Polosa is an Italian scientist who did a clinical trial for e-cigarettes and is also involved in marketing them - as cessation therapy. The page E-cigarettes: Mixing Research and Marketing also details how his institute was founded with Philip Morris money.
Offset regulatory restrictions
A 2012 editorial in the public health journal Addiction suggested we should not be fooled by industry investments in potentially reduced risk products like snus, highlighting that Philip Morris USA is currently advertising its Marlboro snus ‘for when you can’t smoke’, thus encouraging dual use instead of smoking cessation. Further evidence from the US, where smokeless tobacco is freely available, confirms that smokeless tobacco is being marketed as a tobacco alternative in smokefree environments. This would suggest that contrary to the industry's discourse on harm reduction, and the favoured approach by public health experts advocating tobacco harm reduction, the industry appears to have little intention of promoting snus use as a permanent switch from smoking.
- Gartner, C., Hall, W., Chapman, S., Freeman, B., (2007) The PLoS Medicine Debate: Should the Health Community Promote Smokeless Tobacco (snus) as a Harm Reduction Measure? PLoS Medicine, 4 (7), p1138-1141
- Nigel Gray, (2012) Editorial: Has Marlboro hijacked tobacco harm reduction? Addiction, 107, p1029-1030
- Carpenter, CM. et al, (2008) Developing smokeless tobacco products for smokers: an examination of tobacco industry documents. Tobacco Control, 18, p54-59
- Mejia, A.B & Ling, P,M., (2010) Tobacco Industry Consumer Research on Smokeless Tobacco Users and Product Development. American Journal of Public Health, 100 (1), p78-87