Transforming Tobacco Use: The Potential of Tobacco Harm Reduction

Tobacco was brought to Europe by Columbus in 1492; within 100 years its use had spread throughout the globe. Its rapid uptake is a profound testament to the affinity of the human brain for nicotine. But tobacco use became a global health problem only in the 20th century, with the nearly universal adoption of the cigarette, a highly efficient but highly toxic nicotine delivery system. In the past 100 years cigarette smoking resulted in the deaths of roughly 100 million people. We can reduce tobacco related death far more rapidly than we can reduce nicotine use by focusing on the fact that people smoke for the nicotine but die from the smoke. At its core, tobacco harm reduction educates and empowers smokers to replace cigarettes with vastly safer smoke-free substitutes. Applying harm reduction principles to public health policies on tobacco/nicotine is more than simply a rational and humane policy. It is more than a pragmatic response to a global nicotine market. It has the potential to lead to one of the greatest public health breakthroughs in human history by fundamentally changing the forecast of a billion cigarette-caused deaths this century. This symposium will describe the growing scientific foundation for and policy implications of a transformation of tobacco use from combustible to smoke-free forms.