Role of Nicotine in Public Health

Author: Muzammil Ferozi

There is clear evidence that smokers of any age can reap significant health benefits from quitting smoking. Surveys show that most smokers want to quit while many have even made multiple attempts to quit. However, traditional smoking cessation methods require smokers to completely abstain from tobacco and nicotine, which can be a difficult task for many, if not most, smokers, who try to quit cold turkey due to increased chances of relapse. As a result, people continue to smoke despite the impending adverse health effects. To counter this situation, science shows that the provision of nicotine, without the harmful components of tobacco smoke, can prevent most of the harm from smoking. This is known as a tobacco harm reduction method, which is a public health strategy to lower the health risks to smokers. It takes out the elements that cause the majority of harm and helps those smokers, who would otherwise continue to smoke, to switch to products that are less harmful than cigarettes.

Nicotine is found in tobacco and is one of the reasons why people smoke cigarettes. While not risk-free, nicotine is not the real culprit behind most smoking-related diseases. Instead, it is the smoke, produced by the burning of tobacco in cigarettes, which causes a majority of health risks, including cardiovascular diseases and lung cancer. Thus, by switching to products that do not burn tobacco and only deliver nicotine, risks to smokers’ health can significantly be reduced.

Provision of nicotine, without the harmful components of tobacco smoke, can prevent most of the harm from smoking.

Given the proven effectiveness of this method in helping smokers cut down on harm to their health otherwise caused by cigarettes, many smokers are advised to switch to nicotine products including nicotine gums and pouches, e-cigarettes, and heated tobacco products that are scientifically substantiated to be less harmful than cigarettes. These smoking alternatives are also called smoke-free products as they do not release toxic smoke as do not involve the burning of tobacco. The strategy has been recognized for its efficacy and adopted as a part of health and tobacco control policies in several countries that aim to reduce smoking and tobacco harm to their citizens. Japan, the UK, and the Philippines–all countries with traditionally high smoking rates–are working to integrate THR and smoke-free alternatives within their tobacco control plans to protect smokers’ health.

The fact to be noted is that these products are scientifically designed to be smoke-free and less harmful for smokers, which is why they are recognized as reduced-risk products – a claim supported by various studies. They are recommended as an aid for adult smokers for whom immediate cessation is not achievable in a bid to reduce harm to their health otherwise inflicted by cigarettes. A study by the American College of Clinical Pharmacology, citing the effectiveness of smoke-free alternatives, mentioned that smokers were able to reduce the number of tobacco cigarettes smoked per day with the help of e-cigarettes. Another research, conducted by King’s College London, concluded that smokers who used NRT or e-cigarettes concurrently had higher probabilities of changing their tobacco and nicotine use patterns and moving away from smoking.

It is always recommended to quit tobacco and nicotine altogether, but it is also to be accepted that it is not easily achievable in every situation. Scientific findings showing how nicotine can prove to be a key component in reducing cigarette harm by reducing and/or eliminating the intake of toxins present in tobacco smoke through NRTs and alternative smoke-free nicotine products have greatly helped smokers. It can prove to be even more beneficial if the potential of alternative products and methods is rightly recognized and implemented as a tobacco control strategy for better health outcomes for smokers around the world.

Writer is a correspondent, Daily Times and tweets at @maferozi)

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