Tobacco harm reduction: The need for new products that can compete with cigarettes

• Tobacco harm reduction aims to reduce illness and death caused by smoking tobacco.
• The medical and regulatory consensus is that nicotine itself is relatively safe.
• Snus use in Sweden provides strong evidence in support of harm reduction.
• E-cigarettes are seen by many smokers as an attractive alternative to cigarettes.
• Regulated, safer nicotine alternatives may substantially improve public health.

Published: 10 November 2013


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Karl Olov Fagerström
Kevin Bridgman


Over the last 50 years, the concept of tobacco harm reduction has been well established. It is now understood that nicotine itself is not very harmful and nicotine replacement therapy products have been widely used as an aid to quit, reduce to quit or temporarily abstain from smoking for many years. The popularity of the unlicensed electronic cigarette has increased despite an unknown risk profile and snus use in Sweden provides strong evidence in support of a harm reduction strategy. The regulatory environment around harm reduction has changed in the UK and is continuing to evolve across the globe. The need for more appealing, licensed nicotine products capable of competing with cigarettes sensorially, pharmacologically and behaviourally is considered by many to be the way forward. The significant positive impact on public health that could be gained from encouraging people to switch from cigarettes to licensed medicinal nicotine products cannot be ignored.



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