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Tobacco Harm Reduction

Professor Ann McNeill, Professor of Tobacco Addiction and co-director of the NIHR-funded Policy Research Unit in Addictions, has delivered a deep dive into tobacco harm reduction

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Professor Ann McNeill, Professor of Tobacco Addiction and co-director of the NIHR-funded Policy Research Unit in Addictions, has delivered a deep dive into tobacco harm reduction. The coverage was for an episode of Addictions Edited podcast in advance of her Society Lecture at the 2024 Annual Conference of the Society for the Study of Addiction (SSA). The interview covers her career and expertise in tobacco harm reduction.

Nicotine is what causes people to smoke by and large, but it isn’t the nicotine that kills

Professor Ann McNeill

Professor McNeill says: “Tobacco harm reduction has been around quite a long time and there are two aspects to it. One is reducing harm to other people around a smoker and then reducing harm to the smoker themselves. And reducing harm to people around people who smoke isn't controversial. That's what smoke-free policies are predicated on. So that's all been accepted. Where it's more controversial is around reducing the harmfulness of someone's own tobacco use or own smoking behaviour. And that goes right back to the 1960s when the first US Surgeon General, and before that, actually, the Royal College of Physicians Report came out on smoking and health.”

She highlighted how the tobacco industry’s response was to offer up reduced tar in cigarettes, which was “heavily and aggressively marketed” to smokers, but it didn’t deliver the desired impact.

That was because, for example, they would put filters on cigarettes and put little pinprick holes in the filters in the cigarettes, which wouldn't be covered when a machine smoked them, so they would then appear to be low tar. But actually when a smoker smoked them, they covered the little holes in the filter and therefore they didn't make any difference to what the smokers were coming down.”

“They were an industry con.”

Professor Mike Russell’s response was to develop clean nicotine delivery systems, Professor McNeill said, “predicated on the fact that nicotine is what causes people to smoke by and large, but it isn't the nicotine that kills. It's the other 7,000-odd constituents that come along in cigarette smoke.”

Professor McNeill states that although nicotine replacement products performed a role, society really needed a vector that delivered nicotine in a way that competed with cigarettes on the open market.

Mike Russell died as vapes were first bursting onto the scene, he would never get to see the amazing impact they have had on smoking rates.

It wasn’t just vaping that comes in for praise, Professor McNeill also praised Sweden for its use of snus to drive down smoking rates.

The expert also remains pragmatic when it comes to teen use: “Some young people are smokers or would-be smokers. So, the smoking cessation (aspect of vaping) applies to them as well. But also, what we know is that one of the main risk factors for young people taking up smoking is parental or caregiving smoking. So, with caregiver smoking, if we can drive that down, then we'll also drive down young people smoking.”

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  • Photo by nehru Sulejmanovski on Unsplash

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Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.

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