In March 2007, IHRA launched the second in a series of “50 Best” document collections – this time focusing on Tobacco Harm Reduction. The “50 Best” collections have been created by IHRA in order to provide free, accessible harm reduction resources on its website. The idea is to highlight around 50 papers which best summarise the evidence-base, reasoning and justification for various harm reduction interventions and approaches. These resources can then be used by other researchers, policy-makers, advocates or anyone interested in the field.
This particular set of documents was the result of funding from the Open Society Institute (OSI), and was chosen by Ann McNeill (Professor in Health Policy and Promotion at the University of Nottingham) with the support and guidance of IHRA and an International Reference Panel. The idea is to provide a one-stop resource centre for anyone who is interested in how harm reduction principles can be applied to people who are unwilling or unable to give up tobacco and/or nicotine (the psychoactive drug contained in tobacco). Most of the documents in the collection are freely available to download through the IHRA website.
Despite the fact that tobacco use is being significantly reduced in many countries, an estimated 10 million people will die as a result of their tobacco use by 2020 if current smoking patterns continue. Tobacco harm reduction approaches are therefore aimed at reducing the adverse effects of tobacco use for those who continue to use the drug. They should be used alongside strategies which aim to help people stop using tobacco, prevent people using tobacco in the first place, and aim to reduce the exposure of non-smokers to tobacco harms (passive smoking etc).
The premise behind tobacco harm reduction is that most tobacco use is underpinned by a dependence on nicotine. However, it is not the nicotine itself that causes most of the harm – it is the other 4000 constituents in cigarette smoke (of which 60 are known carcinogens). Drawing an analogy with illicit drug use, the cigarette is the equivalent of the ‘dirty syringe’. Consideration therefore needs to be given to separating the drug from the delivery system, and this collection examines the rationale and evidence behind less harmful nicotine delivery systems.
It is hoped that, by providing this collection, IHRA will be able to raise international awareness of tobacco harm reduction approaches and some of the issues and debates in this field. Until now, there has been no single, readily accessible and up-to-date source of key documents on this topic. The collection is separated by sub-topics (such as smokeless tobacco and ‘light’ cigarettes), and is fully searchable on the website.
