To most people’s judgement, the balance of harms against benefits from smoking is totally unequal, with a high risk of disease and death for a drug that delivers only rather mild pleasures which decrease over time. This is not just the opinion of health experts; the majority of smokers themselves want to quit. The most important elements of harm reduction for nicotine are therefore;-
• Avoiding addiction to smoking tobacco in the first place,
• If addicted already, quitting as soon as possible
• If quitting is not feasible or desired, transferring to less harmful forms of nicotine product.
Historical attempts to develop ways for people to continue smoking cigarettes whilst reducing overall harm, for example by using low-tar varieties, have proved ineffective.
Quitting smoking permanently can be really hard, and many people do not succeed on their first attempt. It is possible for motivated people to quit smoking without any help, either by cutting down gradually or just deciding to never smoke again, called ‘going cold turkey’. There is some evidence that ‘going cold turkey’ is the most likely to work overall, though different methods will work best for different people.
Depending on where you live, there are a range of sources of support to help you quit, from doctors to other community services. The support of family and friends is also helpful.
Nicotine replacement therapies, like patches and nicotine gum, are proven to help some people quit. They may help get out of the habits involved in smoking, allowing you to overcome the nicotine addiction separately.
Switching to smokeless nicotine
Quitting tobacco is the way to minimise harm, but in reality, many people struggle and fail to quit, or do not want to. These people may benefit from switching to a form of long-term nicotine addiction which is less likely to cause disease and death. There is very little evidence yet to rank the forms of smokeless tobacco in order of harmfulness, but it is likely that they all offer far less risk than smoking cigarettes.