Staff Reporter
The traditional approach of most governments and anti-tobacco organizations to reduce the number of smokers remains to advocate abstinence from all tobacco products, either by spontaneously quitting smoking or by consuming nicotine substitutes that are approved by the medical community (gums, patches, or pharmacological agents).
However, technology has now evolved to explain the causes of smoking related diseases and helped provide better alternatives for smokers in the forms of smoke free tobacco and nicotine products. Unfortunately, due to these reduced risk products being associated with either tobacco or nicotine, are mostly cast aside and in most countries advocated against without even being vetted.
The main argument used against these products is that they could serve as a “gateway” to traditional cigarettes, especially among young people. This conclusion is based on the results of studies showing that adolescents who have tried electronic cigarettes are more likely to smoke a tobacco cigarette than those who have never had contact with it. But as several experts have pointed out, this interpretation is very problematic, because it does not take into account the fact that a young person attracted to tobacco will experience several available forms, and more so the ones that are explicitly advocated against.
In practice, studies show that the vast majority of electronic cigarette enthusiasts, young or old, already smoke traditional cigarettes. Since this combined use of electronic and traditional cigarettes is associated with an increase in the rate of smoking cessation, it therefore seems reasonable to encourage (and not discourage) smokers to adopt these alternative product in order to decrease their exposure to toxic substances that are present in burning tobacco. Rather than a gateway to smoking, these alternatives could therefore, on the contrary, represent a “way out”, a concept supported by certain European studies showing that around 6.1 million smokers have quit smoking with help from the e-cig and 9.2 million others have reduced their consumption of combustible tobacco with these products. There are several researches which have clearly shown that smoke free alternatives do not represent a springboard towards traditional smoking and that its use has on the contrary contributed to drastically reducing the smoking rate.
Unfortunately, heated tobacco products or electronic cigarette are still not considered a valid alternative and their use is even strongly discouraged, despite the large number of scientific data showing that these products are much less dangerous for health than traditional cigarettes. And so the potential of non-combustible tobacco products remains unexplored in the fight against smoking.
It is, therefore, time to modernize tobacco control taking into account the harm reduction that new non-combustible tobacco products, in particular electronic cigarettes, can bring. It is widely agreed upon that the outright elimination of tobacco use is the ultimate goal of tobacco control, but that does not mean that it is not desirable to reduce the damage caused by tobacco use in people who cannot or persist in quitting. This concept of “harm reduction” has been used for several years to mitigate the negative impacts of various high-risk behaviors and there is no reason why this approach cannot be applicable to smoking.
