Chapter 9 Harm reduction policies for tobacco

Tobacco smoking is the leading cause of preventable premature mortality and disability in European and other developed countries. This chapter first reviews strategies that (1) aim to reduce harm to non-smokers (public smoking bans and reduced ignition propensity cigarettes) and (2) aim to reduce harm to the smoker who is unable or unwilling to quit nicotine use, namely, regulating the harmfulness of cigarettes, and encouraging smokers to switch to less harmful nicotine products. The putative tobacco harm reduction products discussed include: modified tobacco cigarettes and cigarette-like devices, smokeless tobacco products and pharmaceutical nicotine products. The evidence for the harm reduction potential of each of these is discussed, as are adverse public health outcomes that may potentially arise from their promotion. The chapter concludes with a description of the most promising options for promoting tobacco harm reduction.