November 2, 2009 — Switching to low-risk nicotine products, like smokeless tobacco, electronic cigarettes, and pharmaceutical nicotine, offers smokers a chance to almost completely eliminate their health risks. While these alternative products still pose some very small health risk, a new study at the University of Alberta School of Public Health in Canada shows that in most cases switching is better for reducing lifetime risk than trying to quit. The study by Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives.

For the average smoker, the study finds, smoking for just one more month poses a greater health risk than a lifetime of using one of the increasingly popular low risk products like snuff, snus, the new electronic imitation cigarettes, nicotine lozenges, or some other non-combustion alternative. Switching products is a strategy known as “tobacco harm reduction.” “It has long been known that while no nicotine product is completely harmless, harm reduction products pose only about 1% the risk from smoking,” says Dr. Phillips, “and this difference is so great that for the average smoker, using a smokeless product for the rest of his life poses about the same risk as 30 days of continuing to smoke.” What this means is that most smokers, even those who plan to quit soon, will not quit before damaging their health far more than using low-risk products for a lifetime. Moreover, for some older smokers, smoking for a day or two more poses a greater risk than using a low-risk product for the rest of their life. Since switching products is often much more appealing to smokers than quitting nicotine entirely, this option is more practical than quitting and leaves the former smoker happier and less likely to relapse. Those who switch can still choose to quit entirely later, lowering their risk further still.

Dr. Phillips and his public health research group publish the website www.TobaccoHarmReduction.org, and have worked for years to educate smokers about the advantages of low-risk alternatives. The new study, which also looks at some of the history and politics of tobacco harm reduction, suggests that efforts to promote abstinence as the only healthy choice may be killing thousands of smokers per month. Discouraging switching causes the deaths of far more smokers than could ever die from using low-risk nicotine products for their entire lives.

This study comes on the heels of a major study by Peter Lee, published in another BioMed Central journal, BMC Medicine, that showed that the cancer risk from smokeless tobacco is so small it cannot even be reliably measured. Given the ample evidence about the risks of different products, “there is no scientific basis for denying the benefits of tobacco harm reduction” says Phillips, “and it is time that we offer smokers honest public health interventions rather than the moralizing and deadly ‘abstinence-only’ approach.” The abstinence-only approach leaves many ex-smokers miserable and leaves millions of others no choice but to keep smoking. Some activists object to alternative products because they let smokers stay addicted to nicotine or allow companies to profit from selling the products. But, asks Phillips, “is addiction to a low-risk habit — not much different from drinking coffee — really such a problem, or is the profitability of some companies so terrible that it outweighs the millions of lives that could be saved by harm reduction?”

Contact: Dr. Carl V. Phillips, Associate Professor, University of Alberta School of Public Health: cvphilo(at)gmail(dot)com; +1 651-503-6746.

Professor Phillips is an epidemiologist and health policy researcher, journal editor, popular educator, and consultant. He and his work group are leading advocates of tobacco harm reduction, and he advises and works with many other organizations who are trying to promote it, some of which are companies that hope to profit from selling low-risk nicotine products. The www.TobaccoHarmReduction.org research group at the University of Alberta School of Public Health is partially supported by an unrestricted (completely hands-off) grant from U.S. Smokeless Tobacco Company. No funder, company, or other organization played any role in initiating, designing, or conducting this research.

Source TobbacoHarmReduction.org

Actually, I love smoking. Since mononucleosis infiltrated my body, however, I’ve engaged in the attempt to quit.

My blood pressure, heart rate and carbon monoxide levels have dropped. I’m regaining some circulation, lung capacity and sharpening my senses of taste and smell. Plus, I’m salvaging years of my life and fistfuls of dollars.

It’s hell.

I quit before, for an entire year. Then, through the attrition of one cigarette here and there, I quit quitting. One cigarette at a party turned into one after every coffee, during every walk outside, after every meal and so on. I was chasing the dragon’s breath again before I knew it.

Nothing takes the place of that simple ritual. Not sunflower seeds, not gum and certainly not some mutant bandage that secretes nicotine. Electronic cigarettes come closest to a non-threatening alternative, as they’re basically battery-operated, carcinogen-free metal cigarettes that deliver nicotine in a smokeless vapor. However, the FDA is impeding the sale of these “e-cigarettes” — coincidentally, the federal government recently instituted the largest cigarette tax increase in history.

Pennsylvania already imposes a $1.35 per pack tax. Now, the federal government levies $1.01 per pack, up from 39 cents, and some members of the Senate Finance Committee support raising it another dollar per pack to fund a national health care program.

Ay, there’s the rub. State and federal governments use cigarette taxes to fund programs including SCHIP, government-sponsored health insurance for children, so health care revenue becomes dependent upon smoking. Maybe the United States should just adopt a policy like the Hubei Province in China. There, the government recently instituted a smoking quota for local officials, forcing locally produced cigarettes on some people to bolster the economy.

The public needs a healthy cigarette. Scientists have genetically engineered dwarf wheat. Acne-riddled youth can apply specially formulated acid to their faces. An astronaut just sent a Tweet while he was in outer space fixing a telescope that photographs the Crab Nebula. If it’s going to help a poor kid go to the doctor, why can’t I get a cigarette that doesn’t contain arsenic, urea and polonium?

People throughout history have burnt plants and inhaled the vapors since mankind invented stupidity. Cigarettes actually have some benefits, however petty. Smoking can reduce stress, even if it’s just taking those few minutes to block out the world and decompress. It also acts like a social stimulant — you’ll meet some great random people over a cigarette. Some studies even suggest that smoking prevents Parkinson’s disease.

Hecklers can say, “Smoking will kill you,” but non-smokers die every day. Don’t tell smokers they’re going to die — that’s hypocritical. Nobody’s immortal. For all the talk of shortened life spans, there’s always some unaffected octogenarian who picked up his first unfiltered Lucky Strike behind a tool shed at age 11 and smoked ever since with no problems.

Most people, though, don’t have that 80-year-old’s genes, and smoking doesn’t just cleanly cut off some otherwise senile years. It poisons almost every organ in the body, unnaturally aging smokers all the way to chronic diseases and terminal cancers. You don’t go gentle into that good night.

So a lot of people think they can smoke for a few years and then quit. Oh, to be a doe-eyed youth again.

Quitting cigarette smoking isn’t like kicking heroin — who started that gross exaggeration? — but it isn’t easy. Smokers know they’ll end up with rusted bodies. The skin leathers itself in a tar brine. Mouths turn to rotted wood. The throat becomes gnarled, sometimes requiring a surgically implanted blowhole. If you’re lucky enough to escape the mechanical larynx, your gruff voice will only sound clear in comparison to the pull-start of a carbureted lawnmower.

Yet, people still light up.

The addiction is powerful. Harvard studies found that cigarette companies increased nicotine content by about 11 percent from 1997 to 2005. Those companies will likely continue this practice to retain their indentured servants, I mean, customers. Most nicotine leaves the body within four days, according to the American Cancer Society, but furious physical and psychological factors linger. Smokers are addicts, and addicts need to be addicted to something — anyone considering quitting should find a “healthy” addiction like exercise or competitive celery-eating.

Smoking is more than an addiction, too. The stress relief, socialization and even a certain counterculture allure genuinely make it enjoyable — non-smokers should understand that.

Also, quitting has its own detriments. Your lungs and body have to purge themselves of the damage you’ve already done. This sounds fantastic in theory, but reality isn’t so rosy. It’s like having a bad cold — coughing, aching and almost everything else listed on the NyQuil bottle — just with salubrious effects.

You’re getting better in the long term, but feel worse in the short. A reverse logic hits you that if you smoke again, you can make the sickness disappear. It will, but it just suppresses this baneful healing process.

If you quit, you’ll gain weight, lose sleep and suddenly your entire world orbits perpetually recommitting to quitting — you might even find yourself writing about it in some pathetic attempt at catharsis. You’ll want to smoke just one cigarette to regain some sense of normalcy in your life, or at least to stop thinking about it. Just one. Then you spend $6 on a pack, and you’re not going to let the other 19 cigarettes go to waste for that price. And the samsara starts anew.

It’s lame. It’s the smokeless Inferno sequel that Dante never chronicled.

Don’t quit smoking. Avoid this ambivalent struggle and never start. Let some other sucker fund health care.

Bum Dave a smoke at drb34@pitt.edu.

By Dave Beitzel, for the original article and comments go to The Pit News.