Globally, tobacco use is the leading preventable cause of premature death. There are approximately 3.9 million self-reported smokers in Canada and roughly 40,000 Canadians per year die of smoking-related diseases. Smoking increases the risk of heart disease, stroke, and many forms of cancer. The vast majority of the health risks are caused by smoke inhalation as opposed to nicotine intake per se.
Harm reduction approaches are critically important given the high failure rate of smoking cessation, issues of human rights and knowledge on nicotine dependence. These approaches focus on the health risks arising from smoke inhalation and focus on alternative delivery methods that avoid the inhalation of the products of combustion, such as pharmaceutical nicotine products, snus, products that heat rather than burn tobacco and e-cigarettes.
Tobacco is one of the sacred medicines in Indigenous cultures and has been used traditionally for thousands of years for ceremonial and medicinal purposes. Yet the use of cigarettes has taken a tremendous and disproportionate toll on the health of Indigenous populations. Smoking prevalence among Indigenous populations in Canada, including for Indigenous youth, is almost three times that of non-Indigenous Canadians.
Differential taxes for differential risks—Toward reduced harm from nicotine-yielding products
(Frank J. Chaloupka, David Sweanor & Kenneth E. Warner. N Engl J Med. 2015)
Rethinking nicotine: The role of public health law in ending an epidemic
(Sweanor & Houston. Ottawa Law Review. 2016)
Harm minimization and tobacco control: Reframing societal views of nicotine use to rapidly save lives
(Abrams et al. Annual Review of Public Health. 2018)
Nicotine without smoke: Tobacco harm reduction
(Royal College of Physicians London. 2016)