Anti-smoking efforts to date not leading to significant reduction in smoking- which has lead many health advocates to encourage public health initiatives to take a harm reduction approach, also known as a phased approach, to reducing public smoking rates (and deaths!). Recent research points to e-cigarettes as an effective gateway to quitting tobacco all together. See how the UK has successfully deployed a harm reduction public health campaign and how this approach is quickly spreading to other European countries.
Stopober Campaign Public Health England
Stoptober - A Harm Reduction Campaign
Public Health England, the UK Department of Health agency who handles public health initiatives, launched the latest edition of the UK’s biggest public health campaign aimed at reducing smoking, Stoptober. This year’s Stoptober campaign is unique in that it has a greater focus on harm reduction approaches over a traditional “cold turkey” approach to quit smoking. Stoptober’s messaging encourages smokers to begin the process of quitting by leveraging smoking alternatives to wean oneself from their traditional cigarettes and to make their attempt to quit ultimately more successful.
The Stoptober campaign recommends leveraging different tactics, including switching to e-cigarettes. The logic is that e-cigarettes make quitting easier and immediately reduce many of the health hazards associated with smoking traditional cigarettes such as smoke inhalation and carcinogenic- similar to traditional alternatives such as nicotine patches or gums or more innovative cigarette alternatives such as heat-not-burn.
The inclusion of e-cigarettes as a strategy amongst the medical, nicotine replacement options is new for public health campaigns and signifies that recent studies on the health benefits of switching to e-cigarettes are becoming widely accepted.
Stoptober’s campaign specifically addresses the benefits of the e-cigarette strategy, particularly how usage is linked to improved success rates for those attempting to quit smoking. The campaign references a 2017 study that found switching to e-cigarette usage led to higher rates of people successfully quitting smoking.
The Stoptober campaign includes PSA billboards, a free app, daily emails, Facebook Messenger chats, videos, in-person support groups, and a website. Vaping, or the smoking of e-cigarettes, is featured prominently in the campaign’s videos, photos, and website content.
Medical Acceptance of Harm Reduction and E-Cigarettes
Public Health England’s tobacco harm reduction approach to reducing smoking is increasingly viewed as more effective than “cold turkey” public health campaigns by the broader medical community.
Support for a harm reduction approach to improve smoking cessation rates comes from multiple international anti-tobacco associations and health organization including NHS Health Scotland,
Public Health England. Action on Smoking and Health, Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Healthier Futures, Public Health Action (PHA), Royal College of Physicians, Royal Society for Public Health, UK Centre for Tobacco and Alcohol Studies, and the UK Health Forum.
The National Institute for Health and Care Excellence’s latest draft on public health guidelines instructs professionals to recommend e-cigarettes as effective tobacco replacement products.
Recent studies by British health experts have noted that e-cigarettes are around 95% safer than smoked tobacco and are especially effective at phasing smokers away from tobacco usage.
The e-cigarettes process of tobacco and nicotine intake is less harmful to smokers than traditional cigarettes. Phasing more smokers to this smoking device would likely bring immediate improvement to the health of the smoking population by reducing smoke-inhalation and cigarette-related diseases, sores, and deaths.
Additional studies indicate that public health campaigns that focus on the idea of harm reduction in tobacco use are overall more successful than those that call for total abstinence.
E-Cigarettes Compared to Other Harm Reduction Tactics
It’s well-documented that the main driving factor behind smoking addiction is nicotine, and that the tobacco and other carcinogens in cigarettes act merely as a delivery for the nicotine craved by the habitual smoker. Nicotine patches and gums allowed people to get their fix of this highly addictive substance without inhaling any toxic chemicals, and have gone a long way in effectively helping many quit.
In recent years, researchers have also realize that there is a second, strong component of cigarette and smoking addiction- the habit of physically smoking a cigarette, which has a strong psychological and social context. This addiction can be reduced and eventually eliminated by switching to smoking e-cigarettes, while also immediately causing improved health by reducing smoke and carcinogenic inhalation. E-cigarettes deliver the same psychological satisfaction of taking a nice long drag from a cigarette.
The Canadian Institutes of Health Research also noted that smoking cessation efforts have previously failed because of additional behavioral and social benefits to cigarette usage (and addiction). Additional benefits of cigarette smoking include improved alertness, enhanced focus, stress reduction, and increased social opportunities. These benefits do not come with quitting cold turkey and are minimally provided for by medical alternatives. Individuals who are addicted to these additional benefits of smoking have been unable to successfully quit. However, e-cigarettes provide all of these additional benefits and pose an opportunity for successful cessation over time while immediately improving the health of users (compared to traditional cigarette users).
The group of people for whom the behavior or benefits addiction affects is sizable. 53% of those who participated in Stoptober in 2016 used e-cigarettes as part of their strategy.
University College London researchers found 20% of cessation attempts were successful in the first six months of 2017, compared with an average of 16% over the previous 10 years, before e-cigarettes were available.
The government's deputy chief medical officer Professor Gina Radford said e-cigarettes have "95% less harmful products" in them than normal cigarettes. This means that switching from a cigarette to an e-cigarette while going through the process of quitting smoking will dramatically improve one’s health, compared to continuing to smoke traditional cigarettes while attempting to quitting.
In Conclusion
The Stoptober campaign is leading the way and changing the conversation from a puritanical “quit or die” approach to embracing all options that reduce the harmful effects of tobacco, even if they’re smoking adjacent devices like e-cigarettes. This kind of public health campaign is focused on end results and the the most efficient way to achieve them rather than setting unrealistic expectations and seizing the moral high-ground.
E-cigarettes proved the most popular tool for quitting during last year's campaign with over half of all participants selecting them as their strategy for quitting, so their inclusion in the 2017 edition of Stoptober will likely draw increased rates of participation as e-cigarettes are clear an appealing strategy to improve one’s health and attempt at quitting.