Can Endgame Tobacco radically reduce cigarette smoking?


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4 comments

  1. Gerald Evans

    A worthy goal. Having said that, somewhat ironic when over this same time we, as a society, are about to drive up rates of cannabis consumption with legalizing the latter’s recreational use. Good evidence that carcinogenic compounds are by-products of marijuana smoke not just tobacco.

  2. Frederick Weston

    Greetings: Fiore et al “Methods to Quit Smoking”-JAMA/1990 reported; 20% at 12 months and 42% of smokers at 5 years will end their habit/addiction; if they are equipped with behavior change training that empowers and enables them to ‘unlearn’ their psychological, habitual and emotional dependencies. The “choice is yours” introductory seminar has ‘engaged’ virtually every smoker (98%) at 4,000 work sites in the above mentioned training. As you are aware, smokers’ ‘engagement’ in fully-funded traditional cessation programs at the workplace has been +/- 3% since 1997. Why 100,000+ smokers ‘chose’ the AMS Training is easy to explain. I would be pleased to do so.

  3. Joel L. Nitzkin, MD

    I think we need to consider what our “end game” hopes to end. In Western society, almost all the deaths and most of the addiction is to cigarettes. Combustible cigarettes are, by far, the the most hazardous and most addictive of tobacco-related products. Deaths from all other tobacco-related products, combined, are so low that, at least in the United States, they are not estimated on a regular basis and not tracked by any federal agency.
    If our goal is to end tobacco-related addiction, illness and death, as we now know it, much is to be said to change our goal from a “tobacco” end game to a “smoking” or “cigarette” end game. Most of this can probably be done by simply informing current and potential future smokers of the differences in risk posed by e-cigarettes and smokeless tobacco options, and enabling and empowering consumers to switch to these both far less hazardous and less addictive products. The evidence to date clearly shows that the risk of potentially fatal tobacco-related illness posed by smokeless tobacco is close to zero, and the same can be said for nicotine, as an isolated substance. The idea that the smokeless tobacco products widely available on the north American and European markets cause mouth and throat cancer is a myth. Evidence gathered to date, largely dismissed by tobacco control authorities also shows e-cigs to be a gateway AWAY from cigarettes for both smoking and non-smoking teens who may be prone to experiment with such products.

    Such an approach would mean adding a tobacco harm reduction component to current tobacco control programming and redefining (at least in the USA, for regulatory purposes) smoking as a behavior as opposed to a disease. Once that is done, we could harness the power of the marketplace, at little or no cost to the public sector to maintain and accelerate current enhanced trends for reduction in smoking prevalence by both teens and adults, and so in a non-coercive manner.

    I know that what I am saying conflicts with the deeply held beliefs of those reading this proposal and comments. If any of you are, in fact, interested in learning more about the potential for tobacco harm reduction and e-cigarette related products securing public health benefits not likely readily achievable by other means, please write me and I will supply some key references. Joel L. Nitzkin, MD jlnitzkin@gmail.com

  4. Bill Godshall

    If tobacco end gamers truly wanted to sharply reduce cigarette smoking, they:
    – would truthfully inform Canadians that smokeless tobacco and vapor products are far less harmful than cigarettes,
    – would truthfully inform Canadians that millions of smokers have quit smoking by switching to vaping or smokeless tobacco,
    – would encourage all Canadian smokers to switch to vaping or to using smokeless tobacco,
    – wouldn’t have lobbied Health Canada to ban the sale of lifesaving nicotine vapor products in 2009,
    – wouldn’t have lobbied to ban tobacco advertisements and retailer displays for smokeless tobacco,
    – wouldn’t have lobbied to ban smokefree vaping in workplaces,
    – wouldn’t have lobbied to ban the sale of flavored smokeless tobacco products,
    – wouldn’t be lobbying for S-5 provision to severely restrict/ban vapor advertising and truthful claims.

    Also, the term End Game is code word for Prohibition. But since tobacco/nicotine prohibitionists have lobbied to deny smokers legal access to and truthful information about low risk smokefree alternatives, don’t expect them to admit the End Game is synonymous with Prohibition.

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