TobaccoHarmReduction.org

Cigarettes kill, but it's not the nicotine or the tobacco. It's the smoke!

Nearly everyone knows that smoking is unhealthy, but a lot of people continue to smoke to get nicotine from tobacco. Few people realize that it is the smoke, not the nicotine or the tobacco that is actually unhealthy. The dominant message to smokers is that they must quit or die; that there are no other options. But this is simply not true. There are other options for people who cannot or will not stop using nicotine.

Reduce the harm from nicotine use: Go smokeless.

Using modern smokeless tobacco products can reduce the risks of tobacco use by about 99% compared to smoking. These products include moist snuff (which is sometimes called by its Swedish name, snus) and chewing tobacco. And you do not have to chew or spit – many modern products require no spitting and are as easy to use as a breath mint. Using pharmaceutical nicotine products would probably work as well, but unfortunately the available nicotine patches and gums are not designed to be good long-term alternatives to tobacco.

Of course, this does not mean that someone who does not use nicotine should start using smokeless tobacco. It is easier, cheaper, and a bit healthier to not use nicotine at all. But if you do use it, the worst possible method is smoking. Switching from cigarettes to smokeless tobacco is almost as good as quitting entirely, and is certainly much better than trying to quit and failing.

Ok, I'm convinced. What do I do next?

What seems to work most of the time for successful switchers is a gradual shift from smoking to using smokeless tobacco. The products are different enough that it takes a little time to feel comfortable with the new product and for it to deliver the same satisfaction as smoking. So be patient with the process.

Allow yourself time to get used to it and gradually shift from one to the other. Of course, in terms of health, the sooner you can give up smoking entirely the better, but take consolation in the fact that even if you cannot do that, every little move in that direction works in your favour. Don't worry if it takes a little longer than you planned. Any major life changes, and quitting smoking is a big one, takes time.

Now that you have the facts about making the switch from smoking to smokeless tobacco, you may be left wondering if quitting is still an option. For our information on quitting smoking, go to Quitting Smoking under our FAQ menu.

Public health is all about harm reduction

Suggesting that nicotine users have an option other than quitting entirely is controversial, but it should not be. Almost all of public health is devoted to reducing risks and harms, not eliminating them entirely. The term "harm reduction" is most often used in the context of clean needles for injection drug users, or using condoms to make sex safer. But we think the best analogy is seatbelts. Instead of telling people that they should just quit driving, we try to make cars and roads as safe as possible. Similarly, we do not tell people to quit playing hockey or bicycling, but we try to get them to wear helmets.

But though we try to reduce the risks to recreational drivers, hockey players, heroin users, and sex workers, most health officials single out tobacco users and tell them they simply must quit. They go so far as to lie to people, to tell them that smokeless tobacco is about as bad as smoking. Anti-smoking advocates have gotten so focused on attacking tobacco that they have forgotten that the goal is to help people. They would rather have tens of millions of people make themselves miserable trying, and usually failing, to quit smoking, rather than to admit that using smokeless tobacco is almost as good as quitting.

This website is operated by university professors and other public health experts who are concerned about improving people's health and well being. We want to reduce the harm from smoking, and we are not so naive to think that everyone is just going to quit using nicotine. We also do not think it is acceptable to lie to manipulate people's behavior, or fair to just punish smokers with new taxes and regulations. By telling the truth about smokeless tobacco we can help nicotine users rather than punishing them.

Nicotine users have choices other than to quit or to die.

Note: Though all the material here is designed for public consumption, it is our property and cannot be reused without our explicit permission. We encourage linking to this page (or to this site) but if you wish to use any parts of this page or the site contact us via email.