Possibilities of implementing harm reduction program for smokers. Current status and recommendations Recommendations

Abstract

On September 30, 2019, the editorial debate of the quarterly “Neuropsychiatry. Clinical Review” took place in Warsaw, dedicated to the possibilities of implementing the harm reduction programs in nicotine addiction. The scientific organizer was the Polish Neuropsychiatric Association. The publication is the result of this meeting. The debate was to establish the status praesens, to review research analyses and understand controversies, as well as to outline the perspectives of practical implementation of harm reduction programs. In addition, the possibilities of legal changes and new medical standards were indicated. Smoking is the most important, modifiable, cause of many diseases and premature mortality. Tobacco smokers become addicted not only to nicotine, but also to other substances included in cigarette smoke. Addiction is also influenced by cultural and social factors. A number of new tobacco products that do not work by smoking have a 90–95% reduction of toxic ingredients comparing to the composition of cigarette smoke. While lowering level of carcinogens is obviously beneficial, the long-term effects of these new products have not yet been established. The low effectiveness of the available methods of pharmacotherapy for nicotine addiction creates premises for the implementation of harm reduction programs using new products with modified risk. Such concepts are supported by state regulators in developed countries, creating special registration paths, taking into account the fact that the toxicity of new products is reduced. Precedent registrations of the products with reduced risk of harm (FDA, USA) create conditions to replace pragmatically smoking tobacco products – with other, less harmful ones.