Harm reduction approaches
There are several approaches to harm reduction:
Stopping smoking
- Stopping smoking and using one or more licensed nicotinecontaining products as long as needed to prevent relapse.
Cutting down before stopping smoking (cutting down to quit)
- With the help of one or more licensed nicotine-containing products for as long as needed to prevent relapse l Without using licensed nicotine-containing products.
Smoking reduction
- With the help of one or more licensed nicotine-containing products for as long as needed to prevent relapse
- Without using licensed nicotine-containing products.
Temporary abstinence from smoking
- With the help of one or more licensed nicotine-containing products
- Without using licensed nicotine-containing products.
In their daily practice, pharmacies should continue to identify people who smoke, advise them to stop smoking and explain that stopping in one step is the best approach. However, if a person indicates that they are unable to, do not want to, or are not ready to stop in one step, they can be asked if they would consider a harm reduction approach.
Key points about reducing harm from smoking
- Smoking causes a range of diseases and conditions, including cancer, chronic obstructive pulmonary disease and cardiovascular disease
- Most health problems are caused by other components in tobacco smoke, rather than nicotine
- Smoking is highly addictive largely because it delivers nicotine very quickly to the brain and this makes stopping smoking difficult
- Nicotine levels in licensed nicotine-containing products are much lower than in tobacco, and the way these products deliver nicotine makes them less addictive than smoking
- Licensed nicotine-containing products are an effective way of reducing the harm from tobacco for both the person smoking and those around them
- It is safer to use licensed nicotine-containing products than to smoke
- Licensed nicotine replacement therapy (NRT) products have been shown in trials to be safe to use for at least five years
- There is reason to believe that lifetime use of licensed nicotinecontaining products will be considerably less harmful than smoking
- There is little direct evidence available on the effectiveness, quality and efficacy of nicotine-containing products that are not regulated by the MHRA (e.g. e-cigarettes). However, they are expected to be less harmful than tobacco.