Tobacco Harm Reduction - History

History

Given the varying legal, moral and historical status of tobacco, and the different types of tobacco and tobacco use in different cultures around the world, debates on tobacco harm reduction tend to be geographically defined arguments. For instance, inhalant cigarette smoking is the dominant form in the United States, with a smaller number of users availing themselves of non-inhalant cigars, pipes, and smokeless tobacco. The political climate over the last few decades has led to both restrictions in the sale and use of tobacco and widespread information (and misinformation) about the negative health effects of tobacco use. Despite this, tobacco in all its forms has remained a legal product in most societies. A notable exception is the European Union, where the most dangerous products (cigarettes) are available but smokeless tobacco products, which are far less hazardous, are banned. The exception is Sweden, where there is a long tradition of smokeless tobacco use among men.

Harm reduction, a modality of dealing with other drug use, is beginning to be applied to tobacco use. In October 2008 the American Association of Public Health Physicians (AAPHP) became the first medical organization in the U.S. to officially endorse tobacco harm reduction as a viable strategy to reduce the death toll related to cigarette smoking. Joel Nitzkin, MD, of the AAPHP wrote: "So if we can figure that the nicotine in the e-cigarettes is basically a generic version of the same nicotine that is in prescription products, we have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent, probably lower than one tenth of one percent of the hazard posed by regular cigarettes."