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The controversial principles behind harm reduction should extend to tobacco, argues one anti-smoking advocate.

We’ve got harm reduction for heroin, so why not tobacco? That’s the controversial argument from one Canadian researcher, who says abstinence-only quit-smoking policies just aren’t working for everyone.

David Sweanor, an adjunct professor of law and medicine at the University of Ottawa, says some smokers should consider smokeless tobacco products like snuff or chewing tobacco, even if those alternatives aren’t healthy either.

It’s a big jump from current health policy, which Sweanor describes as a “moralistic” agenda, in which the “likelihood of success is very very low.”

“The essence of harm reduction is not necessarily to eliminate harm, but to reduce harm,” Sweanor said in an interview.

He compares the idea to heroin harm reduction initiatives like needle exchanges or prescribed drug programs, which seek to lower rates of disease transmission rather than force drug users to quit.

What could we accomplish if we have a far less hazardous form of nicotine available to consumers?

“What we have with cigarettes is an incredibly dirty drug delivery system,” Sweanor said. “What could we accomplish if we have a far less hazardous form of nicotine available to consumers?”

Sweanor wants the government to approve more medicinal tobacco and make smokeless tobacco products more readily available than cigarettes, taxing the products differently as well.

“Different tax levels for relative harm,” he explained. “Generally we want to make the safest option the easiest option.”

But the idea hasn’t impressed many anti-smoking advocates.

“The evidence shows that smokeless tobacco products are highly addictive and cause cancer,” said Cathy Adair, VP of strategic initiatives with the Canadian Cancer Society. “Clearly for us smokeless tobacco has carcinogens in there and we would not support their use.”

Instead, Adair suggested the government subsidize the cost of quit-smoking products like Nicorette. These products differ from smokeless tobacco in that they are meant to be consumed for only a limited period of time, containing gradually smaller doses of nicotine, with the end-goal of total cessation.

Health Canada isn’t big on spit tobacco, which includes chew and snuff. It says:

“Spit tobacco has over 3,000 chemicals, including 28 known carcinogens. Spit tobacco is not a safe substitute for cigarettes and can harm your health.”

Among the consequences:

- Throat and mouth cancer, including cancer in the lip, tongue, cheek, floor and roof of the mouth
- Leukoplakia – white leathery sores, which can lead to cancer
- Increased heart rate, high blood pressure, irregular heartbeats
- Addiction
- Tooth and gum disease

Source: Health Canada

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Tags: vancouver, harm reduction, four pillars, drug policy, smoking, tobacco