3: Safer nicotine products and health23
Key points about SNP and health
- Safer nicotine products are exactly that – significantly safer than other ways of consuming nicotine, whether that is by smoking tobacco or chewing SLT. SNP help people reduce their health risks in comparison to continuing to smoke or use their current forms of SLT.
- Burning tobacco causes the release of some 7000 toxins, many of which are responsible for the death and disease toll from smoking, both to smokers and bystanders. When it comes to smoking, it is combustion that is the problem – not nicotine.
- It is the toxins released from tobacco and other ingredients when people chew the SLT products widely used in Asia that are responsible for oral and other cancers – not nicotine. Evidence shows that through its improved manufacturing techniques, the safer smokeless product called snus carries little if any of the cancer (and other risks) of these varieties.
- Even if somebody has been smoking for decades, if they can switch away from smoking to SNP before the age of 40, they not only enjoy an enhanced quality of life, but also can avoid the damage caused by smoking.
- Much older smokers have also switched to SNP and considerably improved their health, although they may still eventually suffer a disease related to previous longterm smoking.
- One argument levied against SNP is that there is insufficient evidence about their safety for long-term use. Vaping products have been available since the early 2000s – and snus for over 200 years – without any significant evidence of ill-effects as yet. By comparison, the long-term harms of smoking are very well evidenced. It should be noted that the globally reported cases of lung damage and deaths in the USA were caused by individuals vaping adulterated cannabis liquid and not nicotine liquid.
- Global attention has also focused on experimental use of SNP, especially vaping, among teenagers. Much of the world’s media, including in Asia region, looks to the USA, where there was a rise in experimental or occasional use. But there is no evidence that this has prompted regular daily use among most USA teens, nor that previous non-smokers have taken up vaping in any great numbers. Moreover, even the numbers experimenting has started to decline.24
- Compared to smoking, SNP reduce the risk to bystanders. Vaping devices do not emit smoke but vapour. There is no evidence that, unlike smoke, vapour presents any risk to bystanders. A UK scientific committee concluded that, in comparison to smoke from cigarettes, bystanders would be at “reduced risk” from exposure to HTP.25
- Nicotine acts on the brain in ways that do promote its repeated use. But the problem with the word ‘addiction’ to refer to nicotine is that it conjures up images of the damage to individuals, families and communities caused by serious illicit drug problems. Regular use of nicotine causes none of these problems. Yet individuals, families and wider society are deeply affected by smoking-related death and disease, because while people smoke or use harmful SLT for the nicotine, they get sick and die from the toxins in the smoke inhaled or compounds released on chewing.
Vaping products have been available since the early 2000s – and snus for over 200 years – without any significant evidence of ill-effects as yet
- Millions of smokers in Asia have no intention to quit smoking. It makes sense to encourage them to switch away from smoking and improve public health. However, for those who do want to quit, the evidence suggests that SNP work better than nicotine replacement therapy and other interventions in switching people away from smoking.26
- For more details and references, go to: Shapiro, H. (2020). Burning Issues: Global State of Tobacco Harm Reduction 2020.
https://gsthr.org/resources/item/burning-issues-global-state-tobacco-harm-reduction-2020, Chapter 4, pages 67–90.
Read the chapter online at: https://gsthr.org/report/2020/burning-issues/chapter-4
- U.S. Food and Drug Administration, Center for Tobacco Products. (2020). Youth Tobacco Use: Results from the National
Youth Tobacco Survey. FDA.
- UK. Committee on Toxicity. Statement on the toxicological evaluation of novel heat-not-burn tobacco products.p.4
- McNeill, A. et al. (2021). Vaping in England: evidence update February 2021: a report commissioned by Public Health
England. Public Health England.