Tobacco harm reduction: opportunity and opposition (2013)

Purpose - This paper aims to provide a brief summary of the effectiveness and efficacy of tobacco harm reduction (THR). THR is the substitution for cigarettes of low-risk alternatives, including Swedish or American-style smokeless tobacco, pharmaceutical nicotine products, and electronic cigarettes. The paper then very briefly summarizes the current social and political situation regarding THR.
Design/methodology/approach - This paper is a review of the evidence.
Findings - The risk from smoke-free tobacco/nicotine products is so low as to be unmeasurable. For most smokers, adopting THR is a lower risk option than to trying to become nicotine abstinent. THR products have been widely adopted in some populations, providing great public health benefits. There is currently an explosion of interest in electronic cigarettes. However, THR is a threat to the business model of the tobacco control industry, and so they are fighting hard to discourage it. Because they cannot admit their real motives for discouraging THR, anti-THR activism is an entirely dishonest enterprise.
Practical implications - Tobacco harm reduction is the greatest untapped public health initiative in the developed world. It is more promising than further attempts to promote tobacco/nicotine abstinence. The future inevitably includes a large portion of the population using low-risk tobacco/nicotine, but anti-THR efforts might keep people smoking in the short run.
Originality/value - While most of the content of this paper is well known to experts on THR, many ostensible experts on health, as well as other opinion leaders and policy makers, are unaware of the truth.