Doc. 9867

9 July 2003

Harm reduction and the health benefits of smokeless tobacco

Motion for a recommendation

presented by Mr Flynn and others

Cigarette consumption continues to rise, in spite of the best efforts of all European Union members to stop people from smoking and reduce the number of smoking-related deaths. 4 million people around the world die each year as a result of smoking and it is a leading cause of illness and death. The cost to the National Health Service alone in the UK is £1.500m per annum.¹

Bans on tobacco advertising, public health campaigns and the promotion of nicotine replacement therapy (subject to greater regulation than cigarettes)² have had limited effectiveness. Anti-smoking campaigns rely heavily on the message “quit or die”.

However, it is difficult to quit. 95% of smokers who try to quit, fail.³ This is because nicotine is as addictive as heroin and cocaine. Nicotine is itself pretty harmless; what kills the smoker is the carcinogens contained in the smoke of a lighted cigarette and the smoke itself. Public health policies have largely failed to recognise this significant fact.

Sweden has the lowest lung cancer rates in Europe and is the only country to meet the World Health Organisation target in reducing smoking prevalence to 20% of the population by 2000. Swedish men have the lowest risk of dying from a smoking-related disease: 11% compared to 25% for Europe as a whole.⁴ This success is attributable to the use of a smokeless tobacco (snus) instead of cigarettes and is a prime example of a harm reduction strategy being effective. Snus eliminates passive smoking, has been shown to offer a method for giving up smoking⁵ and can greatly improve the life expectancy of smokers.⁶

The Parliamentary Assembly concludes that it should investigate the possible benefits to be gained from:

      i. harm reduction involving the substitution of safer smoke-free products for cigarette smoking;

      ii. relaxing the regulation of nicotine replacements to allow the substitution of safer alternatives to smoking;

      iii. the legalisation of snus;

      iv. conducting research into developing safer, smoke-free methods of taking nicotine;

      v. considering the establishment of a tobacco regulatory authority, to monitor the toxicity of tobacco products.

Signed ⁷:

Flynn, United Kingdom, SOC

Banks, United Kingdom, SOC

Brînzan, Romania, SOC

Chapman, United Kingdom, EDG

Cox, United Kingdom, SOC

Etherington, United Kingdom, SOC

Gross, Switzerland, SOC

Hancock, United Kingdom, LDR

Lloyd, United Kingdom, SOC

Marty, Switzerland, LDR

McCafferty, United Kingdom, SOC

Schmied, Switzerland, LDR

Taylor, United Kingdom, EDG

Zwerver, Netherlands, SOC

¹ Research by the Centre for Health Economics University of York

² McNeill, A Foulds, J. Bates, B "Regulation of Nicotine Replacement Therapies. A Critique of Current Practice' Addiction 2001

³ According to the 1999 review by England and Wales's Health Education Authority

⁴ Peto, R. Lopez, A.D. Boreham, J Thun, M. Heath, C Jr. 'Mortality from smoking in developed countries 1950-2000' Oxford University Press 1994

⁵ Tilanshalski, K Rodu, B and Cole, P 'A Pilot Study of Smokeless Tobacco in Smoking Cessation' American Journal of Political Science 1998

⁶ Rodu, B. Cole, P. 'The Rewards of Smoking Cessation' Epidemiology Vol. 7. 1996

⁷        SOC: Socialist Group

      EPP/CD: Group of the European People’s Party

      EDG: European Democratic Group

      LDR : Liberal, Democratic and Reformers’ Group

      UEL: Group of the Unified European Left

      NR: not registered in a group