Harm Reduction

Tobacco is a uniquely dangerous consumer product and there is no safe level of use. Most of the harm comes from the poisons in tobacco smoke. Smokeless tobacco products are less hazardous but are associated with an increased risk of mouth and throat cancers. Although nicotine is the addictive component of tobacco, it is relatively benign compared to the other toxins in tobacco. Therefore it is possible to use ‘clean’ nicotine that is found in medicinal nicotine replacement products without causing lasting harm. One way of reducing the harm caused by tobacco may be to facilitate the switch from smoked tobacco products to the use of ‘clean’, non-tobacco, nicotine products.

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The lessons of light and low tar cigarettes
Without effective regulation, 'reduced risk' tobacco products threaten public health. Report by the US House of Representatives
Author: Committee on Government Reform Published By: US House of Representatives Published : 02/06/2003

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Health effects associated with smokeless tobacco: a systematic review
Article in Thorax of a systematic review of studies relating the smokeless tobacco.
Author: J A Critchley, B Unal Published By: Thorax Published : 30/04/2003

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EU policy on smokeless tobacco: a statement in favour of evidence-based regulation for public health
The report outlines the case for lifting the ban on certain types of oral tobacco in the European Union. The European Union denies smokers to other tobacco options available to them.
Author: Clive Bates, Karl Fagerstrom, Martin Jarvis, Michael Kunze, Ann McNeill, Lars Ramstrom Published By: ASH Published : 03/02/2003

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Snuffing, smoking and the risk for heart disease and other vascular diseases
The impact of smokeless tobacco use on smoking in northern Sweden. A review done for ASH.
Author: K Aasplund, B Rodu, B Stegmayr, S Nasic, P Cole Published By: ASH Published : 28/10/2002

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Chronic Disease Mortality in a Cohort of Smokeless Tobacco Users
The purpose of this study was to characterize the relation between smokeless tobacco use and the risk of all-cause and disease-specific mortality. The authors assessed the 20-year mortality experience of smokeless tobacco users.
Author: Neil A. Accortt, John W. Waterbor, Colleen Beall, George Howard Published By: American Journal of Epidemiology Published : 21/05/2002

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Harm Reduction Seminar
Held by the Health Development Agency (from 2005 called the National Institute of Clinical Excellence), ASH and Pharmacy Healthcare Scheme at the Russell Hotel. The aim of the meeting was to discuss the role that a harm reduction strategy can play in tobacco control.
Author: Association for Official Shorthanders Ltd Published By: ASH Published : 15/05/2002

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Harm reduction seminar: ASH background information
Background paper on issues and conflicts over harm reduction strategies for tobacco. The product is harm reducing if lower total tobacco related morbidity and mortality even though that product may involve continued exposure to tobacco related toxicants. 
Author: Clive Bates Published By: ASH Published : 15/05/2002

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Tobacco harm reduction: a framework
Conceptual structure and nomenclature for analysis and research. The goal of tobacco control has always been to reduce death and disease due to tobacco use. Recent discussions have broadened the concept of tobacco control beyond cessation and prevention to include concepts such as the use of medications to achieve reduction in tobacco use, chemoprevention to reduce disease, modifications of tobacco products to reduce toxicity, and behavioural approaches to change smoking and tobacco use behaviour.
Author: Saul Shiffman, Joe Gitchell, Kenneth Warner, John Slade, Jack Henningfield, John Pinney Published By: Nicotine & Tobacco Research Published : 25/03/2002

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Harm reduction, public health and human rights.
Smokers have a right to be informed of significant harm reduction options Public health policy needs to be assessed for effects on human rights as well as public health. Although promoting harm reduction products to cigarette smokers might lead to greater total public health harm, if the products become too popular, human rights issues also need to be considered.
Author: Lynn Kozlowski Published By: Nicotine & Tobacco Research Published : 16/10/2001

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ASH's critique of the US Institute of Medicine report
ASH's critique of the US Institute of Medicine (IOM) report published as an editorial in the Tobacco Control Journal (June 2001).
Author: Clive Bates Published By: Tobacco Control Published : 31/05/2001