Pragmatism and smoking cessation:  the role of harm reduction in creating healthier smoke-free societies

Medical Word 2021; 2(2): 76–80­

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Krzysztof Filipiak, Nadjib Bouayed


Despite the extensive body of evidence demonstrating the risks of tobacco, many people continue to smoke. Medical science has not yet found a ‘cure’ for this. Instead, healthcare professionals (HCPs) have access to a range of strategies, including pharmacological and psychological interventions, to help support smoking cessation. Yet giving up is not easy and not everyone succeeds. The reasons why are as varied as they are complex, ranging from physical addiction to an emotional dependence on the habit. Barriers include a lack of adequate support from smoking cessation services or HCPs, withdrawal symptoms, and psychosocial factors such as the challenges of adapting to behaviour change.

For those people who are unable or unwilling to quit, harm reduction strategies can help reduce the risks associated with smoking, from cardiovascular disease to cancer. While the evidence base is still relatively immature, some studies have shown that products such as e-cigarettes and heated tobacco systems can deliver the addictive nicotine with significantly fewer toxicants and carcinogens than cigarettes.

In this interview, Krzysztof Filipiak, past President of the Polish Society of Hypertension (PTNT) and former Deputy Rector Magnificus and Dean for Science at the Medical University of Warsaw, Poland, and Nadjib Bouayed, President of the Algerian Association of Vascular Surgery of the University Hospital of Oran, Algeria, share their views on the pragmatic approach. They explain how finding the best intervention for each patient is of utmost importance and why harm reduction strategies have a place in smoking cessation services. They also review the current literature on products such as heat-not-burn (HnB) systems and identify gaps in the evidence base.

Key words: smoking cessation, addiction, harm reduction, heated tobacco products

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