As the EU considers a back-door ban on snus, the least harmful form of tobacco, a large study from Israel suggests that smokers who reduce their overall consumption of cigarettes do themselves some good.
The study also undermines the case made by activists in the U.S., who oppose the implementation of a tobacco harm reduction strategy. They suggest an unproven concern that truthful modified risk claims on smokeless products will lead to “dual use,” or using cigarettes when possible, and reduced harm products at other times. But the Israeli study suggests that even this worst case scenario would lead to improved outcomes.
As I wrote in a letter published in the Jerusalem Post last week,
Sir, – In “TAU study: Best to stop smoking, but fewer cigarettes can help, too” (November 26), Judy Siegel reports that Tel Aviv University researchers found that while quitting completely is best, reducing cigarette consumption also provides health benefits. This should be obvious, but as the piece explains, it is a controversial issue.
Many anti-tobacco activists believe in a “quit or die” approach – quit using all tobacco forms completely or we can’t help you. This view lacks compassion, is ineffective and, as the study points out, is not based on sound science.
One innovative approach to helping people either reduce the amount they smoke or quit smoking altogether is to encourage them to switch from cigarettes, the most harmful form of tobacco and nicotine use, to less harmful forms, like smokeless tobacco and e-cigarettes.
In Sweden, very few people smoke. Instead, they use a less harmful form of smokeless tobacco known as snus. Tobacco- related diseases plummeted after the population switched from smoke to smokeless. Now available in Israel, Swedish-style snus can help Israelis reduce the deadly toll of smoking as well.
The critical fact is that nicotine, while highly addictive, is not the harmful component of tobacco.
Burning tobacco and inhaling it is the most serious risk.
As the TAU study underscores, even if the approach of reducing harm is only partially successful, people who reduce while not entirely eliminating cigarette consumption stand to gain.