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The rationale for establishing low-toxicity smokeless nicotine product policies: Why are the pros stronger than the cons?
- 1. Reducing the toll of smoking-related disease and death: The case for tobacco harm reduction The rationale for establishing low-toxicity smokeless nicotine product policies: Why are the pros stronger than the cons? Lars Ramstrom Institute for Tobacco Studies, Sweden 6th July 2010
- 2. Reduction of harm from tobacco use is a top priority in public health. But, ”Tobacco Harm Reduction” is a controversial issue.
- 3. Tobacco Harm Reduction is mainly a matter of replacing cigarettes by a less harmful tobacco product. ” Low-tar” cigarettes are no candidates for harm reduction, but some ”low-toxicity” smokeless tobacco products are. One such product, Swedish SNUS , is dominating the debate on Tobacco Harm Reduction.
- 6. What can we learn by the evidence from Swedish population studies?
- 8. 5.4% of all cases of onset of daily tobacco use Remaining ”secondary” smokers: 0.7% of all men Starting to smoke after onset of snus use is a very rare option − and most of those cases, 76%, end up by quitting smoking.
- 10. Continuing daily dual users are a minority (12%) of all dual initiators and constitute just 1.8% of all men.
- 12. About a third of smokers who start snus use do subsequently quit all daily use of nicotine. This is not compatible with the idea that snus use were strengthening nicotine addiction.
- 15. Will snus use weaken smokers’ efforts to quit smoking?
- 17. Smokers who have started subsequent snus use appear to make more efforts to quit smoking than those who have not.
Editor's Notes
- The primary smokers WITH secondary snus use are the most successful quitters. They end up with a very small fraction continuing smoking (13%). The primary smokers WITHOUT secondary snus use end up with a much higher fraction continuing smoking (43%). Next question: Have all these general patterns of tobacco use been static, or has there been a development with large changes over time?
- The primary smokers WITH secondary snus use are the most successful quitters. They end up with a very small fraction continuing smoking (13%). The primary smokers WITHOUT secondary snus use end up with a much higher fraction continuing smoking (43%). Next question: Have all these general patterns of tobacco use been static, or has there been a development with large changes over time?
- In this diagram on primary initiation each bar represents a 10 year birth cohort of Swedish men. Over time there has been an increasing initiation of primary snus use (sectors at the top), associated with decreasing initiation of primary smoking (sectors in the middle). Total initiation of tobacco use has been decreasing across all cohorts from the next oldest one.
- The primary smokers WITH secondary snus use are the most successful quitters. They end up with a very small fraction continuing smoking (13%). The primary smokers WITHOUT secondary snus use end up with a much higher fraction continuing smoking (43%). Next question: Have all these general patterns of tobacco use been static, or has there been a development with large changes over time?
- The primary smokers WITH secondary snus use are the most successful quitters. They end up with a very small fraction continuing smoking (13%). The primary smokers WITHOUT secondary snus use end up with a much higher fraction continuing smoking (43%). Next question: Have all these general patterns of tobacco use been static, or has there been a development with large changes over time?
- The primary smokers WITH secondary snus use are the most successful quitters. They end up with a very small fraction continuing smoking (13%). The primary smokers WITHOUT secondary snus use end up with a much higher fraction continuing smoking (43%). Next question: Have all these general patterns of tobacco use been static, or has there been a development with large changes over time?
- The outcome of latest quit attempt shows similar patterns for men and women. Use of snus as cessation aid yields the highest proportion of ”quitting completely” and the lowest proportion of ”continuing daily smoking”. The Swedish experiences of reducing smoking and related diseases have raised a lot of international interest. A recent example is the October 2007 report by the Royal College of Physicians.