What is tobacco harm reduction?
The main purpose of tobacco harm reduction is to reduce (not necessarily eliminate) the harm from smoking. The aim is not to stop nicotine as nicotine causes little harm. Tobacco harm reduction involves encouraging smokers to switch from high-risk combustible (burnable) cigarettes to a lower-risk nicotine alternative such as vaping.
Complete cessation of all tobacco and nicotine consumption is always the ideal goal. However, a large proportion of smokers are unable or unwilling to quit, therefore remaining at high risk of smoking-related death and illness. THR aims to reduce the health risks in continuing smokers by switching from combustible tobacco to lower-risk smokeless nicotine alternatives. Smokeless products are not risk-free but are much safer than smoking.
Reduced-risk products include vaping (using an e-cigarette), Swedish snus (small pouches of special tobacco placed under the upper lip), nicotine pouches (similar to snus but without tobacco) and heated tobacco products (which heat tobacco without burning it). Burning tobacco causes almost all the harm from smoking. It releases over 7,000 chemicals, tars, carbon monoxide, other toxic gases and solid particles.
Safer nicotine products can complement (not replace) traditional tobacco control strategies which target complete quitting.
Tobacco harm reduction is no different from other harm reduction strategies which are generally very effective and widely accepted. These include methadone for heroin users, clean needle exchange programs and even car seat belts. And similar to other harm reduction strategies, THR is not merely about ensuring access to products which reduce risk. It entails the reduction and, ultimately, elimination of external harms usually caused by governments, such as criminal penalties, punitive taxation, and the fomentation of stigma. It involves the empowerment of individuals to make informed decisions and respecting those decisions, whether they choose to continue using nicotine or not.
Tobacco harm reduction is one of the three pillars of Australia’s National Tobacco Strategy. One objective of the NTS is to “reduce harm associated with continuing use of tobacco and nicotine products” (p11). Australia is legally obligated to support tobacco harm reduction as a signatory to the World Health Organisation Framework Convention on Tobacco Control.
The FCTC provides an obligation on governments to not only allow reduced-risk products but actively promote them as part of implementing their tobacco control policies. Currently Australia is in breach of its international obligations as no harm reduction strategies are supported in practice.