PubMed · 14660753
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S Chapman. 2003. Harm reduction.. https://doi.org/10.1136/tc.12.4.341
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To decrease the health consequences of tabagism pandemic, quitting is still the only goal. The size of the problem leads to question if harm reduction is possible. Today, this concept, which was successful with illegal drugs, cannot be applied to tobacco because of a lack of proof. There is no safe cigarette and all brands have the same toxicity. Arguments in favor of smokeless tobacco are still insufficient for a public health decision. A voluntary decrease of tobacco consumption does not decrease morbidity and mortality of heavy smokers. A long-term use of nicotine replacement therapy is acceptable to reduce the daily smoking under medical supervision in smokers with chronic tobacco related disease who have previously failed in attempts to quit smoking.
The concept of harm reduction is controversial, as it brings to mind the failures, public misconceptions, and undermining of prevention associated with the low-tar cigarette campaign. Modern cigarettes are, however, unnecessarily carcinogenic and toxic, a situation that could be improved by sensible and serious regulation of the contents of tobacco smoke. The risks potentially associated with reducing levels of known toxicants in cigarettes are tiny in comparison with the acceptance of the status quo, which is disastrous. Failure to act in these circumstances is negligence.
This article provides information on harm reduction, a recent development in substance abuse services in response to the HIV/AIDS epidemic. The author outlines abstinence and harm reduction perspectives and the stages of change model and discusses how these perspectives can be integrated in social work practice. He proposes using harm reduction strategies for individuals for whom the abstinence perspective may not be appropriate. Together, the traditional abstinence and harm reduction perspectives provide a basis for a more comprehensive continuum of care for individuals experiencing problems related to their substance use.