Harm reduction in tobacco control: where do we draw the line?

Introduction:
This article discusses the limitations and concerns surrounding the use of harm reduction strategies in tobacco control, specifically focusing on the use of non-pharmaceutical alternatives such as chewing tobacco and e-cigarettes. The authors argue that these alternatives may not be effective in promoting smoking cessation and could potentially pose other health risks.

Key Points:

* Harm reduction in substance abuse involves reducing or replacing use of a harmful product with a less risky agent.
* Many tobacco smoking harm reduction alternatives have shown inconclusive results and continued use.
* Some alternatives, like e-cigarettes, have been linked to an increased likelihood of tobacco smoking.
* Many alternatives also pose other health risks not found in traditional tobacco smoking.
* Efforts should focus on promoting nicotine replacement therapy and other pharmacologic agents for sustained smoking cessation.
* Public health should regulate tobacco alternatives with the same stringency as tobacco and target evidence-based and safer pharmaceutical grade or behavioral alternatives in social marketing efforts.

Main Message:
The main message of this article is that the limitations and health risks associated with many tobacco smoking harm reduction alternatives make them less desirable options for smoking cessation. The authors argue that public health efforts should focus on promoting nicotine replacement therapy and other pharmacologic agents with a better chance of producing sustained smoking cessation. Additionally, public health should regulate tobacco alternatives with the same stringency as tobacco and target evidence-based and safer pharmaceutical grade or behavioral alternatives in social marketing efforts.

Al-Hamdani M, Manly E. Harm reduction in tobacco control: where do we draw the line? Journal of public health policy. 2022;43(1):149-154. doi:10.1057/s41271-021-00327-5