Nicotine may be the stepping stone towards the tobacco endgame



With smoking being one of the leading risk factors behind non-communicable diseases and resultant deaths around the world, the global public health has been under a constant threat from the rising number of cigarette smokers who continue to put their health at risk despite the widespread awareness of the harms associated with it.

Although concerned authorities and health agencies have been pushing for different tobacco control measures, the fact that there are currently1.1 billion smokers in the world and this figure is projected to remain the same in the coming yearsis a testament to the progress, or the lack thereof, on ground. This lack of real improvement seems to be stemming from the lack of pragmatic and scientific thought being put into the approach towards achieving the tobacco endgame. While tobacco control advocates have been trying different methods to end cigarette use, increasing scientific researches and evidences have shown that in cases where immediate, absolute cessation is not viable, switching to smokeless nicotine products such as e-cigarettes, heated tobacco products, and snus can help adult smokers, who would otherwise continue to smoke, reduce the harm to their health.

These alternatives are proven to be less harmful than cigarettes since they do not involve the burning of tobacco and do not produce smoke which is found to contain the majority of toxins that cause smoking-related diseases. Instead, these products only deliver nicotine which, while not risk-free, does not cause diseases associated with smoking. In the words of Professor Michael Russell, a pioneer in the study of tobacco dependence, “People smoke for nicotine but die from the tar.”According to Britain’s National Health Service, “clean forms of nicotine are licensed to help smokers quit.

These are much safer than smoking as they’re nicotine only, don’t have other additives or toxic chemicals, and are proven to be safe and effective.” These smoke-free alternatives to cigarettes, thus, deliver nicotine with minimal risks, removing smoke and the other harmful toxins contained within the cigarette smoke. This approach is based on Tobacco Harm Reduction, a public health strategy that aims to provide nicotine through less harmful alternatives to reduce the harm caused by smoking to people who are unable or unwilling to immediately quit smoking completely.

Of course, the best option for smokers to quit smoking altogether, but the key to helping the millions of existing smokers quit is to provide them with the choice to switch to a less harmful alternative and a step-by-step guide to eliminating tobacco consumption completely. The first logical step, therefore, is to help adult smokers, who would otherwise continue to smoke, switch to smoke-free alternatives that do not produce toxins contained in cigarettes and only provide them with the nicotine fix, enabling them to at least move to the less harmful end of the spectrum as opposed to leaving them with no option but to let them continue smoking cigarettes. Countries such as the UK, Canada, Japan, and the Philippines are already working to incorporate scientifically-substantiated less harmful alternatives to achieve their tobacco control goals. Manycountries have also shown progress in bringing down their number of smokers and reducing the health burden on their public health caused by cigarettes. It is time that our policy-makers and regulators also pay heed to incoming evidence and realign their tobacco endgame goals and approach accordingly.


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