bat sustainability report 2007 - Harm reduction

We will strive to bring commercially viable, consumer acceptable reduced-risk products to market

harm reduction

What is the issue?

Definitions of harm reduction

“Tobacco harm reduction is the general term used to describe the scientific, policy, legal and communications issues raised by products designed to continue tobacco use, albeit with products holding out the promise to reduce risk of tobacco-related disease.”
D Hatsukami & M Zeller Psychological Science Agenda (Vol 18, No 4), April 2004

“Tobacco harm reduction refers to decreasing the burden of death and disease, without completely eradicating nicotine and tobacco use…”
R Wallace, Institute of Medicine Testimony to US House of Representatives, June 2003

Tobacco products are addictive and their use poses real and serious risks to health. Working towards the goal of reducing tobacco-related harm caused by tobacco use is something that should be of benefit to society.

The term ‘tobacco harm reduction’ does not have a single meaning which is accepted by all. To one section within the public health and scientific communities, including the World Health Organisation (WHO) and the majority of public health policy makers, tobacco harm reduction means urging people not to start using tobacco products, or to quit if they already do.

Certainly, the only way to avoid the risks associated with tobacco products is to not use them, and public health policies based on prevention and cessation continue to be effective. However, due to population growth, it is likely that millions of adults will continue to consume tobacco products for many years to come.

Considering this, a small but growing number of public health and scientific professionals think that a tobacco harm reduction approach could include a focus on those people ‘who cannot or will not stop using tobacco, and it is to this group that effective programs and products of harm reduction should be directed’ (2001 Institute of Medicine Report; ‘Clearing The Smoke: Assessing the Science Base for Tobacco Harm Reduction’). In this report, the authors defined tobacco harm reduction as ‘minimizing harms and decreasing total morbidity and mortality without completely eliminating tobacco and nicotine use’.

This broader approach to tobacco harm reduction recognises a well-established public policy concept that seeks pragmatic ways to minimise the impact of an activity or behaviour which carries inherent risks. Well known examples of this are the use of seat belts in cars and crash helmets for motorcyclists. For those public health proponents of a broader approach, this could mean that, in addition to a continued emphasis on prevention and cessation efforts, adult tobacco consumers should have the option of choosing less risky products instead of existing more risky products, such as conventional cigarettes.

Understandably, there is considerable debate about what the public health impact of potentially reduced-risk tobacco products might be and whether they would actually contribute to a reduction in total tobacco-related harm on a population basis.

The situation is further complicated by the fact that there is currently no scientifically recognised way of determining whether, for example, one type of cigarette is of potentially lower risk to an individual than another type. However, there is some scientific consensus that certain smokeless tobacco products such as snus are substantially less hazardous to health than cigarettes.

Why is it important?

Our stakeholders have consistently raised how the public health impact of our products can be reduced as a key issue. Consumers have also told us it is one of the most responsible things they believe a tobacco company should try to do. A Core Belief within our Statement of Business Principles is that the health impact of tobacco consumption should be reduced, whilst respecting the right of informed adults to choose the products they prefer. In line with this, we believe that consumers should have access to a range of products, including potentially reduced-risk tobacco products.

We envisage governments and public health authorities taking the lead in providing manufacturers and consumers with practical advice on different product choices and behaviours that might reduce consumers’ risks, in addition to providing quitting advice.

What are we doing about it?

Our approach to tobacco harm reduction is to pursue the research, development and test marketing of innovative tobacco products that will have consumer acceptability and will be recognised by the scientific and public health communities and regulators as posing reduced risks to health.

Today, we have a global programme that focuses on:

© 2008 British American Tobacco