Smokers should be treated like drug addicts, say doctors

Smokers should be treated the same as heroin addicts and offered tobacco substitutes that deliver the same hit of nicotine without the harm, doctors say today.

The number of people smoking is declining by only 0.4 per cent a year and a new approach is needed to protect those who continue to smoke from the lethal effects of their habit.

Half of all smokers will die prematurely if they do not give up, 150 million of them worldwide in the next 20 years. One hundred million died last century and one billion are projected to die in the 21st. Yet the only response is to warn people not to start smoking or to tell them to stop.

The Royal College of Physicians today calls for a middle way in the approach to smoking, based on "harm reduction," which it says holds real potential for saving lives. By getting smokers to switch to safer forms of nicotine, they would avoid the damaging effects of the burning tobacco that delivers the drug.

Professor John Britton, a lung specialist at the University of Nottingham and chair of the RCPs Tobacco Advisory Group, said: "Smokers smoke because they are addicted to nicotine but it isn't nicotine in cigarette smoke that kills – it's the hundreds of other toxic chemicals that come with it. There are millions of smokers who can't quit and those people need nicotine products that can satisfy their addiction without killing them."

Existing products, such as nicotine chewing gum and patches, were unsatisfactory because they were designed as aids to stopping smoking rather than as substitutes for it. They delivered a steady, low level of the drug, rather than the hit of nicotine that smokers craved.

Tobacco companies had tried for decades to develop a safer cigarette but their efforts had been "pretty pathetic," Professor Britton said. The medicinal market for nicotine gums and patches was so tightly regulated that it prevented innovation.

"We need to liberalise the medicinal market and introduce a decent cigarette substitute. We may end up with millions of people addicted to nicotine inhalers, but so what? Millions are addicted to caffeine," he said.

A national Nicotine Regulatory Authority should be set up to monitor the developments and control the market in order to prevent exploitation by the tobacco companies, he said.

Harm reduction is an established principle in the treatment of drug addiction, where addicts who cannot give up their habit are encouraged to switch to a safer drug. In Sweden, an oral tobacco product called snus that is chewed instead of smoked has been available for decades, and the country has the lowest smoking rates in the world among men at 13 per cent, half the rate in the UK.

Snus is banned in the European Union but Professor Britton said it was an example of the kind of product that needed to be developed. "It would be premature to lift the ban but we need to research a whole range of other products. If there is something in there of benefit to public health then let's have it."

Critics attacked the proposal yesterday, warning it could increase smoking. Professor Martin McKee of the London School of Hygiene said in The Lancet there was a danger tobacco companies would promote cigarette substitutes as an extension of smoking – in public places where tobacco is banned, for example – rather than as a substitute for it.

Ash, the anti-smoking pressure group, however, has backed the Royal College of Physicians report and called for a review "to allow safer nicotine products to be made available while ever stricter measures are applied to tobacco products to deter their use."

Nicotine substitutes

* Snuff – ground tobacco that delivers nicotine via the lining of the nose.

* Snus – popular in Sweden. Ground tobacco in muslin that is sucked.

* Eclipse and Accord – safer cigarettes launched in the 1990s designed to deliver nicotine with less tobacco. Not popular.

* Nicotine inhaler – delivers the drug direct to the mouth and reproduces the feeling of smoking.

* Nicotine nasal spray – delivers nicotine to the nose

* Nicotine gum – chewable nicotine

* Nicotine patch – stuck on the skin, delivers a steady low dose of nicotine over several hours.

News
people'It can last and it's terrifying'
News
people Emma Watson addresses celebrity nude photo leak
News
Katie Hopkins appearing on 'This Morning' after she purposefully put on 4 stone.
peopleKatie Hopkins breaks down in tears over weight gain challenge
Sport
Alexis Sanchez, Radamel Falcao, Diego Costa and Mario Balotelli
football
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Sport
Danny Welbeck's Manchester United future is in doubt
footballGunners confirm signing from Manchester United
News
i100
Arts and Entertainment
Olivia Colman topped the list of the 30 most influential females in broadcasting
tv
Life and Style
techIf those brochure kitchens look a little too perfect to be true, well, that’s probably because they are
News
Kelly Brook
peopleA spokesperson said the support group was 'extremely disappointed'
Sport
Andy Murray celebrates a shot while playing Jo-Wilfried Tsonga
TennisWin sets up blockbuster US Open quarter-final against Djokovic
Arts and Entertainment
Hare’s a riddle: Kit Williams with the treasure linked to Masquerade
booksRiddling trilogy could net you $3m
Arts and Entertainment
Alex Kapranos of Franz Ferdinand performs live
music Pro-independence show to take place four days before vote
News
news Video - hailed as 'most original' since Benedict Cumberbatch's
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    SAP Assessor

    £26000 Per Annum: The Green Recruitment Company: Job Title: SAP Assessor Job T...

    Year 6 Teacher needed for 1 Term- Worthing!

    £100 - £120 per day: Randstad Education Crawley: Year 6 larger then life teach...

    SEN Teacher

    Negotiable: Randstad Education Plymouth: SEN Jobs Available Devon

    Infrastructure Lead, (Trading, VCE, Converged, Hyper V)

    £600 - £900 per day: Harrington Starr: Infrastructure Lead, (Trading infrastru...

    Day In a Page

    'I’ll tell you what I would not serve - lamb and potatoes': US ambassador hits out at stodgy British food served at diplomatic dinners

    'I’ll tell you what I would not serve - lamb and potatoes'

    US ambassador hits out at stodgy British food
    Radio Times female powerlist: A 'revolution' in TV gender roles

    A 'revolution' in TV gender roles

    Inside the Radio Times female powerlist
    Endgame: James Frey's literary treasure hunt

    James Frey's literary treasure hunt

    Riddling trilogy could net you $3m
    Fitbit: Because the tingle feels so good

    Fitbit: Because the tingle feels so good

    What David Sedaris learnt about the world from his fitness tracker
    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Second-holiest site in Islam attracts millions of pilgrims each year
    Alexander Fury: The designer names to look for at fashion week this season

    The big names to look for this fashion week

    This week, designers begin to show their spring 2015 collections in New York
    Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

    'I like Orwell's writing as much as the next talented mediocrity'

    Will Self takes aim at Orwell's rules for writing plain English
    Meet Afghanistan's middle-class paint-ballers

    Meet Afghanistan's middle-class paint-ballers

    Toy guns proving a popular diversion in a country flooded with the real thing
    Al Pacino wows Venice

    Al Pacino wows Venice

    Ham among the brilliance as actor premieres two films at festival
    Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

    Neil Lawson Baker interview

    ‘I’ve gained so much from art. It’s only right to give something back’.
    The other Mugabe who is lining up for the Zimbabwean presidency

    The other Mugabe who is lining up for the Zimbabwean presidency

    Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
    The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

    The model for a gadget launch

    Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
    Alice Roberts: She's done pretty well, for a boffin without a beard

    She's done pretty well, for a boffin without a beard

    Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
    Get well soon, Joan Rivers - an inspiration, whether she likes it or not

    Get well soon, Joan Rivers

    She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
    Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

    A fresh take on an old foe

    Doctor Who Into the Dalek more than compensated for last week's nonsensical offering