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Extreme solutions for those who do not succeed to quit smoking. About smokeless tobacco and harm reduction

Antigona Trofor1, Valentina Eşanu2, Elena-Iuliana Frăsilă3

1 Clinica Pneumologică Iaşi
2 Ambulatoriul Clinicii Pneumologice Iaşi
3 Spitalul "Sf. Spiridon Iaşi"



Although in the last two decades, intensified tobacco control measures have increased access to smoking cessation services worldwide and pharmacological therapy in the field had enlarged spectrum and has higher efficiency, yet, long term abstinence rate is no more than 20-25%. Only 70% of smokers are willing to quit and only 10% succeed for good. The rest of 60% plus 30% not even willing to quit will balance between new attempts to quit, new failures to quit and continuing smoking, mainly cigarettes. Among them, many heavy smokers, highly nicotine addicted, unable to quit, even if strongly motivated too. Harm reduction concept is proposing alternatives to classic cigarettes smoking, which is the most dangerous modality of tobacco products consumption. Such alternatives try to minimize as much as possible harm induced by tobacco smoking, by reducing carcinogenic and toxic compunds in tobacco products. Overview of smokeless tobacco types is given, with health risks and consumption particularities in each case. Scientific community in the field's opinions are presented from the perspective of finding ways to save as many lives as possible of smokers unable to quit and to change actual status quo. As part of experts predict continuous increasing smoking prevalence in the future unless competitive alternatives to cigarettes smoking are arising, such alternatives can be temporarily helpful, in order to assist all categories of smokers to avoid tobacco smoke (most dangerous form of smoking) exposure.

Key-words: smoking, nicotine dependence, harm reduction, smokeless tobacco, smoking cessation.