Tobacco harm reduction: key themes

Seven million people die annually from smoking. The WHO estimate that by the end of the century, one billion lives will be lost to smoking. The death and disease caused by smoking cigarettes, constitute the primary reason why international goals to reduce significantly non-communicable disease by 2030 will not be met.

Smoking prevalence has been declining especially in western countries, but even here the rate of decline has been slowing down – Australia being a good example of this. And even in the West, smoking rates among those with drug, alcohol and mental health problems remain stubbornly high, upwards of 60% in many countries.

The situation is far worse, for example on the African continent where smoking estimates among the general population, far from declining are predicted to rise in the coming years due to population growth.

Traditional smoking control measures such as bans on public smoking, advertising and high taxation have had their effect (although the unintended consequence of high taxation is a surge in the growth of a global illicit cigarette market). But these controls are clearly not enough, nor has nicotine replacement therapy made any appreciable difference not least because NRT does not replicate the smoking experience in any way. Smokers need to be offered alternatives to the combustible cigarettes, which is the most dangerous nicotine delivery system, even if it means continuing to consume nicotine which is a relatively harmless substance.

This is the goal of tobacco harm reduction (THR): offering consumers the right to choose safer nicotine products (SNP); e-cigarettes, heat not burn devices or Swedish style snus. However, despite growing international, independent peer-reviewed scientific and clinical evidence, the value of using SNP alongside other measures to reduce smoking remains highly controversial often on moralistic and political rather than public health grounds in an environment not dissimilar to that which drug harm reduction did and still does face.

This structured session aims to provide delegates with an overview of the synergies with drug harm reduction, a review of the available evidence concerning the public health benefit of SNP, a map of the policy landscape and consumer input on THR as a human rights issue. Generally it is hoped to be able to dispel many myths and misconceptions around this topic.

The presentations will cover:

1. Drug and Tobacco Harm Reduction synergies
2. An overview of the scientific and clinical evidence base in support of THR
3. The landscape of global regulation and control
4. THR as a human rights issue

There are a number of possible expert presenters who could deliver presentations in each of these areas, but if the abstract is accepted, then presenters will be approached.