Bill Godshall – The UK NHS Supports Tobacco Harm Reduction

EDITOR’s NOTE:  Bill Godshall checked in with some (amazingly) positive news on  Reduced Harm Tobacco as a way to cut cigarette smoking.  If only the rest of the EU would start thinking rationally…

We are off to a positive start in 2010 on cigarette replacement solutions in the EU.  In an historic first for public health, the National Institute for Health and Clinical Excellence (NICE) of the UK’s National Health Service overwhelming approved tobacco harm reduction as a key component in England’s ten year plan to reduce cigarette smoking by half. The US FDA should follow the UK’s lead. The announcement and a news excerpt are below and you can read the full report “A Smokefree Future”.

Bill Godshall

Citizens Council vote in favor of harm reduction in smoking

On February 1st, 2010: The Citizens Council, a group which brings the views of the public to NICE’s decision-making, has voted overwhelmingly in favor of the use of harm reduction as a way to reduce the dangers of smoking.

The 30 members of the Citizens Council met in October last year for three days to discuss the pros and cons of harm reduction. Whereas smoking cessation aims to help smokers quit smoking and break their reliance on nicotine completely, the idea of harm reduction involves reducing the harm associated with cigarettes for smokers who find it too hard to quit. This could include replacing cigarettes with a clean form of nicotine, or with cigarettes which intend to deliver lower levels of toxins.

Overall, the Citizens Council supported the use of harm reduction in smoking but the idea of considering harm reduction as a way to provide a less harmful alternative to smoking – while accepting that nicotine addiction continues – proved relatively unpopular.

Sir Michael Rawlins, Chair of NICE, said: “The concept of harm reduction conflicts with traditional smoking cessation as it does not necessarily seek to help people stop smoking altogether, nor does it treat nicotine addiction. What would this approach mean for the goal of having a smoke free society?

“The Citizens Council’s view will help guide our independent advisory committees, should they be required in the future to make recommendations about harm reduction in smoking.”

The findings from the Citizens Council come as the Department of Health launches a Tobacco Control Strategy for England which aims to halve the number of smokers, from 21 to 10 per cent of the population by 2020.

This latest strategy, A Smokefree Future, builds on the previous 1998 strategy and sets out to ensure that every smoker will be able to get help from the NHS to suit them if they want to give up. This includes introducing new approaches to reducing smoking such as harm reduction.

The Department of Health will also work with NICE to encourage alignment of the Quality and Outcomes Framework (QOF), so as to encourage more smokers to use the NHS Stop Smoking Services.

The 30 members of the public that make up the Citizens Council are drawn from all walks of life, and provide NICE with insights into the public’s views on challenging issues that often involve values such as fairness and need. It meets twice a year and reports directly to NICE’s Board. Its recommendations inform a wide programme of work. When the Council was set up in 2002 it was the UK’s first advisory body made up entirely of members of the public.

The public is now invited to comment on the Citizens Council members’ views on the use of harm reduction in smoking, before the report is presented to the NICE Board. The report on the Council’s views is available for public comment, at www.nice.org.uk .  Your Comments must be sent in by 5pm on Wednesday, March 31, 2010.

1 February 2010

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A Shift in status for anti-smoking aids

February 1 2010

By Public Policy Editor, Nicholas Timmins,

The Financial Times

A major shift in the government’s anti-smoking policy has been quietly announced, allowing nicotine products to be sold as a long-term substitute for smoking, not just as an aid to quitting. The announcement acknowledges that some smokers are nicotine junkies, who find it close to impossible to give up the addictive element in cigarettes.

(excerpt)