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Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction
Tobacco has been used by humans for at least a millennium, and its harmful effects have been suspected for at least 200 years. In the last 50 years, convincing and generally accepted evidence has established the fact that exposure to tobacco products is the major single cause of early human mortality and morbidity in developed nations and in many developing nations as well.
Even nonsmokers suffer morbidity and excess mortality from the toxic effects of inhalation of sidestream smoke. Both smokers and their nonsmoking associates are more likely to be injured in fires and automobile accidents. The personal and social price we pay for establishing and sustaining nicotine addiction through exposure to tobacco smoke is our greatest controllable health cost and one of our greatest social burdens.
It has been scientifically established that reduced exposure to tobacco smoke by lifelong abstinence and avoidance of smoke eliminates the added risk and harm and that cessation, even after many years of smoking, reduces risk and harm both immediately and in the long term for many tobacco-related conditions.
Several smoking cessation programs, some aimed at individuals and some at communities, have been shown to be modestly effective in assisting smokers to quit smoking. These programs have been shown to be more effective with the added use of nicotine replacement by patches for absorption through the skin, by nicotine-containing chewing gum or sprays for absorption through oral or nasal mucous membranes, or by the administration of psychotropic drugs to reduce the desire for nicotine.