Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
-
Harm reduction for continuing smokers has been suggested as a public health priority. We evaluated whether tobacco control programs might reduce cigarette consumption among current smokers through strategies aimed primarily at protecting nonsmokers from secondhand smoke (SHS). Data were from adult (18+ years) respondents to multiple (1990, 1992, 1996, 1999), large, cross-sectional, population-based surveys of smoking behavior, conducted to evaluate the California Tobacco Control Program. ⋯ In 1999, nearly 30% of current smokers did not smoke daily, and more than 60% said they now smoked less than previously. In 1999, self-reported cigarette consumption was inversely related to believing SHS is harmful to nonsmokers, having a smoke-free workplace, and living in a smoke-free home. In California, tobacco control strategies that educated the population about SHS and resulted in smoking restrictions may have led continuing smokers to smoke less, which should reduce the harm from smoking to the public health in the long term.
-
The 2001 Institute of Medicine report Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction has helped to focus attention on the scientific basis for assessing tobacco harm reduction products. As the tobacco research and policy communities tackle the challenges of evaluating harm reduction, there are ethical issues that must also be addressed. ⋯ First we outline three overarching topics in tobacco harm reduction that would particularly lend themselves to study: (a) Is the pursuit of tobacco harm reduction an ethical goal? (b) What are the ethical considerations of tobacco harm reduction vis-à-vis pharmaceutical companies? and (c) What are the ethical considerations for harm reduction vis-à-vis tobacco companies? We then present one possible framework for analyzing the ethical issues that accompany particular tobacco harm reduction strategies. By considering the ethical dilemmas attendant to tobacco harm reduction in a prospective and thoughtful manner, we will be better prepared to handle the challenges that face us individually as researchers and collectively as a tobacco control community.