Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111629

Marc Barbiere and Philip Alcabes, PhD. Program in Urban Public Health, Hunter College, 242-57 61 avenue, Douglaston, NY 11362, (718) 631-5365, mb2497@aol.com

Methods now used to reduce the harmful effects of substance use fall into three categories: Prevalence reduction seeks to reduce the number of people using a substance. Quantity reduction attempts to reduce the individual's amount and frequency of use. Harm reduction tries to reduce the harmful effects of substance use without necessarily requiring a reduction in use at all. The primary harm associated with substance use is often due not to the substance itself, but to its delivery method. Just as the syringe, not heroin, transmits HIV and HCV to the drug user, tobacco smoke - the delivery device for the substance nicotine - is the cause of health problems in smokers. Methods are now available to counter the effects of delivery devices without requiring abstinence from the substance (methadone for heroin users, nicotine replacement for smokers), but few alternatives to abstinence have been offered to smokers. Tobacco kills an estimated 400,000 people annually in the United States. Despite tremendous public health effort, taxation, and statutory regulation, the prevalence of cigarette smoking declines from its level of 46 million by only 0.6 million per year. Methods to deliver nicotine without the adverse health impact of smoking would reduce tobacco-related morbidity and mortality. Although the tobacco industry's attempts at producing less harmful cigarettes might be self-serving, products that reduce smoke exposure while delivering nicotine hold promise and should be assessed. Moralistic opposition to smoking should not impede public-health efforts if harm reduction can be successful at lessening tobacco-related illness and death.

Learning Objectives:

• § List the current methods for reducing the impact of the use of psychoactive substances
• § Define harm reduction and describe current applications to various forms of substance use
• § Recognize methods for reducing the harmful effects of tobacco smoke
• § Discuss next steps in evaluating tobacco harm reduction

Keywords: Tobacco, Smoking

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.