NEWS
HARM
REDUCTION
AND REDUCED
RISK TOBACCO
& NICOTINE
PRODUCTS
Attempting to reduce the risks of conventional cigarettes
remains daunting – there is clearly no such thing as a
safe cigarette – but investment in other reduced-risk
tobacco and nicotine products is paying dividends. Several
innovative products have been developed and are evolving
apace – the most recognisable of which is probably the
electronic cigarette.
Several public health organisations and some regulators
are now also starting to recognise the existence and
possible potential of these reduced-risk products. Mitchell
Zeller, Director of the Center for Tobacco Products at the
US FDA, has, on several occasions, said that ‘It's not the
nicotine that kills half of all long-term smokers, it’s the
delivery mechanism. We have to recognise some of these
realities and figure out how they can impact regulatory
policy.1’
It is the toxicants in cigarette smoke that are responsible
for the development of tobacco related disease. The risk
of developing disease is greater in people who smoke
more cigarettes per day and for longer periods. It makes
sense then, that substantially reducing exposure to smoke
toxicants could reduce their risk of tobacco related disease.
Toxicants levels can be reduced in steps by first eliminating
combustion, as in tobacco heating products; then
eliminating heating entirely, as in snus, and ultimately
eliminating tobacco altogether as is the case with
e-cigarettes and nicotine products. By doing this, you can
26 WINTER EDITION VAPOUROUND MAGAZINE
Dr. Marina Murphy,
Scientific Reputation Manager,
British American Tobacco
start to envision different categories of product presenting
different risks, with the most risky product, the conventional
cigarette, at one end and the least risky product, medicinal
nicotine, at the other.
It has been proposed that as you move across the
categories from more harmful to less harmful products, the
respective regulation of each category should recognise
the difference in potential risk. According to Clive Bates,
ex-Director of ASH UK and an advocate of reduced risk
tobacco and nicotine products, regulation should ‘promote,
rather than inhibit, innovation, diversity and competition in
low risk alternatives to smoking.’ The rationale, he says, is
that ‘these products become better alternatives to smoking
over time, and more smokers find products that suit them.
A regulatory regime should clear out cowboys, but not force
a contraction to only very large companies offering a few
commoditised products.’2
Some in the public health community are beginning to
argue that, much like regulation is used to discourage
would-be smokers from smoking, regulation should also be
used to encourage those who want to use or continue to
use tobacco or nicotine to use a less harmful product. The
rationale is that, if these products are more innovative,
accessible and cheaper than cigarettes and the potential
benefits are understood, then smokers are more likely to
use them.
The US is currently the only legislature to define a