Smokeless tobacco, ENDS and harm reduction: ¿trick or treat?
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Head Tobacco Unit, Asturias IV Health Area, Tobacco Group SEMFYC, Oviedo, Spain
Zaragoza University School of Medicine, Coordinator Health Education and Promotion Group of SEMFYC, Spain
Tobacco Group SEMFYC, Cadiz, Spain
Publication date: 2018-06-13
Tob. Prev. Cessation 2018;4(Supplement):A195
The harm reduction arises to reduce diseases related to tobacco or previous step to the abstinence. Historically, faced with the concern of its customers, the tobacco industry exploited this concept to promote cigarettes with filters, light cigarettes, etc. with the results already known. Old and new forms of not burn tobacco (snuss, e-cigs, iQOS, Ploom, IFUSE) are presented as "almost innocuous".They offer a treat for health and aims to obtain a "scientific" endorsement for its promotion. Recent literature review of smokeless tobacco and nicotine delivery devices (ENDS) and harm reduction.

The snuss increased the risk of diabetes, OR 1.42 (95% CI: 1.07-1.87) deaths due to myocardial infarction (MI), OR: 1.5 (95% CI: 1.01-1.30) and CVA, OR: 1.39 (95% CI: 1.29-1.49). In relation to e-cigs, the following has been observed: Users have fewer cessations, OR 0.72 (95% CI: 0.58-0.90). Gateway to cigarettes in youth is founded; OR = 6.31 (95% CI 5.38-7.39). Increase risk of MI, OR = 1.79 (95% CI: 1.20-2.66). Increase risk of asthma in youth OR = 2.74 (95% CI 1.30 - 5.78). IQOS generates 84% concentration of nicotine found in tobacco. All them contain carcinogenic substances without knowing the future risk. The promotion of these products may cause cigarettes to become socially acceptable again, thus undermining decades of tobacco control. Therefore, the precautionary principle must be invoked.

Smokeless tobacco and ENDS are toxic products, cause addiction and serve as a gateway to smoking. It could reduce the risks in some smokers at the expense of increasing the use of tobacco in the population. The scientific evidence on its usefulness for smoking cessation and on its safety is very weak. Probably, the concept of tobacco harm reduction is a great trick to hide the interests of tobacco industry.

This study has been founded by Tobacco Group of Spanish Society of Family and Community Medicine (SPAIN)

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