Harm Reduction in a Persistent Smoker

By David J. Riley, MD, FCCP

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Conclusion

First, the medical and scientific community should keep an open mind about the feasibility of tobacco harm reduction. It might be that reducing exposure to tobacco toxicants leads to less harm to the population. It will be a long and difficult road to answer this question, but our community should support this effort by promoting a change in public policy and supporting research in this area. Second, there is little to guide the practitioner about how to reduce the risk of tobacco exposure in the persistent smoker. Intuitively, it makes sense that reducing the amount smoked should reduce individual risk, but history has taught us there is no safe cigarette. My recommendation is to get patients to smoke less, but this should not dilute efforts toward the primary goals of smoking cessation and preventing initiation of smoking.

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