Hi! My name is Troop. I’m addicted to nicotine, and have been for many years. I finally quit my 20+ year cigarette habit and have been cigarette free for one year as of Jan 19th, 2012 by using ecigs. My big area of concern is the legislation against harm reduction products and mis-information spread by those that should be helping Americans be better informed. We’d like to thank AAPHP for being sensible, and encourage other physicians and MD’s to do the same. Smoking is smoking, vaping is vaping – and harm reduction is harm reduction. Wrap laws around it, but it is what it is. Maybe 2012 is the year that the American Heart Association or American Cancer Society will start caring enough to look into ecigs and harm reduction options too. We can all hope. In the least, let’s support our MD’s and Physicians that keep some common sense when it comes to smoking and harm reduction.
Principles to Guide AAPHP Tobacco Policy
1. AAPHP tobacco policy should be based on the best available scientific evidence.
2. Tobacco use is a major cause of illness and death in the United States.
3. Almost all tobacco-attributable mortality in the USA is due to cigarette smoking.
4. While nicotine is the primary addictive substance in cigarette smoke, other factors substantially enhance the addictiveness of cigarettes. These factors include habituation to the cigarette handling ritual, psychological appeal based on advertising themes, the strength and speed of the nicotine “hit,” and other factors. This set of factors make cigarettes the most addictive of tobacco/nicotine products.
5. Substances in the cigarette smoke, other than the nicotine, inhaled deep into the lung, cause most of the tobacco-attributable illness and death in the United States.
6. Smoke-free tobacco/nicotine products, as available on the American market, while not risk-free, carry substantially less risk of death and may be easier to quit than cigarettes.
7. Since susceptibility to tobacco/nicotine addiction is strongest in adolescence and early adulthood, measures to prohibit sale of tobacco/nicotine products without a physician prescription should be maintained and strengthened.
8. The healthiest option is to never initiate tobacco/nicotine use.
9. For those already using a tobacco/nicotine product, the best option is to quit.
10. Harm Reduction: Smokers who have tried, but failed to quit using medical guidance and pharmaceutical products, and smokers unable or uninterested in quitting should consider switching to a less hazardous smoke-free tobacco/nicotine product for as long as they feel the need for such a product. Such products include pharmaceutical Nicotine Replacement Therapy (NRT) products used, off-label, on a long term basis;, electronic “e” cigarettes, dissolvables (sticks, strips and orbs), snus, other forms of moist snuff, and chewing tobacco.
11. Harm reduction should be considered as an addition to current tobacco control policies and programming and should be done in a way that will minimize initiation of tobacco/nicotine use, maximize quit rates and assure that dual use does not increase potential harm to the user.
12. Mandated health related warnings on tobacco/nicotine products should be periodically reviewed to assure that each warning reflects a real-life hazard posed by the product in question and is not misleading in any way.
13. AAPHP tobacco policy should be intended to reduce the burden of illness, death and property damage attributable to tobacco products in American society. In pursuit of this goal, AAPHP must consider the needs and risks of current tobacco users, those potentially exposed to tobacco smoke, and those at risk of initiating future use of tobacco/nicotine products.
14. The tobacco page of the AAPHP web site should be configured to serve as an informational resource to physicians, other health-related organizations and the general public.
AAPHP Tobacco Documents
AAPHP 2008 Harm Reduction and Resolutions White Paper AAPHP 2008 Harm Reduction and Resolution White Paper
AAPHP 2010 Harm Reduction Update http://www.aaphp.org/special/joelstobac/2010/harmredcnupdatejuly2010.html
AAPHP Statement on the State Regulation of E-cigarettes 20100402AAPHPEcigLegisStatemnt.pdf
American Association of Public Health Physicians, Tobacco Control Task Force (AAPHP) – Citizen Petition Document ID: FDA-2010-P-0095- 0001 Docket ID: FDA-2010-P-0095: available at http://www.regulations.gov/#!documentDetail;D=FDA-2010-P-0095-0001 Also available here 20100207FDAPetition1.pdf . A second related petition is available here: 20100207FDAPetition2.pdf FDA Petition Summary: 20100207FDAPetitionSummary.pdf References to materials included as attachments to FDA Petitions 20100208Petition_TOC.pdf Attachment Set A1-A40 A1-A40.pdf For material from all other attachment sets and for additional information please contact Joel L. Nitzkin, MD at [email protected]
Other Tobacco Related Documents of Potential Interest to Readers
FDA determination to regulate E-Cigarettes and other smokeless tobacco products – http://www.aaphp.org/Determination
2011 Harm Reduction Update 20110729RoduReview.pdf
Legislation H.R. 1256: Family Smoking Prevention and Tobacco
Control Act111th Congress 2009-2010: available at