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Interventions to reduce the harm from continued tobacco use (e.g. smoking reduction or use of 'less risky' products) may decrease long-term health risks of smoking, but less so than quitting.



Possible ways to reduce harm for smokers who are unwilling or unable to quit include reducing the number of cigarettes smoked, or switching to alternative tobacco products. Some smokers can reduce their cigarette consumption substantially and maintain a reduction for an extended period, and the use of NRT has been shown to assist reduction. Some compensatory smoking occurs but reduced exposure to smoke can be achieved. Whether this reduced exposure is sufficient to reduce health risks is unclear, thus long-term reduction or use of 'Potentially Reduced Exposure Products' (PREPs) cannot be recommended as an alternative to quitting. The use of NRT assisted reduction as a precursor to a quit attempt can be supported for smokers unwilling to make an immediate quit attempt.

Switching from cigarettes to noncombustible tobacco or pure nicotine delivery products would be expected to lead to substantial harm reduction but it is not clear at present how far population-level interventions to promote this kind of switching or other forms of harm reduction such as reducing cigarette consumption with or without NRT lead to public health gains.



Hughes JR, Carpenter MJ. The feasibility of smoking reduction: An update. Addiction. 2005; 100: 1074-1089.

Clearing the smoke: The science base for tobacco harm reduction. Institute of Medicine, 2001. Summary and full report.

Hope or Hazard? What research tells us about ‘Potentially Reduced-Exposure’ Tobacco Products. University of Minnesota Transdisciplinary Tobacco Use Research Centre. 2005.

Hughes JR, Carpenter MJ. Does smoking reduction increase future cessation and decrease disease risk? A qualitative review. Nicotine Tob Res. 2006; 8: 739-749.

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