Kevin's Watch

A comment in The Lancet for 9 September reports that a world conference on tobacco and health, held in Washington in July, failed to establish a consensus on some key policy issues regarding smoking.

On the subject of harm reduction, the 4000 participants, including advocates, scientists and clinicians, seem to have been evenly divided. A tobacco control programme devised by Californians has had much success in reducing smoking, second-hand exposure and disease, without however incorporating an element of harm reduction. This is defined as any process that reduces harm in continuing users of tobacco by reducing toxins in the smoke, promoting their conversion to smokeless tobacco or introducing longterm replacement therapt with nicotine.

One reason for reservation on harm reduction has been an implication that nicotine addiction itself is virtually harmless. This is contrary to its known pharmacology and to regulatory efforts to ensure that the doses and treatment patterns do not pose significant risk. Another reason is that the earliest attempts to reduce harm by reducing tar did not bring the expected decrease in mortality or persuade young smokers that cigarettes labelled as low tar were safe. Nicotine replacement therapy has the potential for harm reduction but has not generally been approved.

All tobacco products present a risk that depends on how they are used. Altering the way in which tobacco is cured can substantially reduce nicosamines. Reducing toxins in tobacco, restricting smoking and increasing its costs are seen as prudent steps, but promoting certain types of tobacco in place of others may help to undermine attempts at harm reduction.

i guess like making bullets out of a softer metal?