Is nicotine really the primary cause of smoking related disease?

Nicotine is addictive and not risk-free, but – contrary to what many believe – experts agree that nicotine itself is not the primary cause of smoking-related diseases. It is the chronic exposure to the toxic chemicals in cigarette smoke that are generated when tobacco is burned that cause disease.

When a cigarette is lit, the tobacco combusts (burns), generating smoke that contains thousands of chemicals, many of which are toxic and known to cause disease. Once the tobacco is ignited, the combustion is a self-sustaining process that will continue as long as there is tobacco (fuel) and oxygen available.

Public health authorities have classified these toxins in the smoke as the primary cause of smoking-related diseases, such as lung cancer, heart disease, and emphysema.

Despite being aware of the evident health risks, many smokers continue to smoke cigarettes. Currently, there are over one billion smokers worldwide, and almost eleven million in South Africa, while it is estimated that this number will not change significantly in the coming years.

Quitting smoking – or better yet, never starting – is, without doubt, the best option to reduce the risk of smoke-related diseases. However, the inclusion of a third strategy which complements these measures is required, namely tobacco harm reduction – that adults who would otherwise continue smoking should have access to and accurate information about less harmful alternatives, such as heated tobacco products and e-cigarettes.

This approach considers the rights and needs of this population and is a means of reducing smoking rates faster.  Tremendous progress has already been made in moving towards a smoke-free future. 

Since 2008, Philip Morris International (PMI) has invested over $8billion in the science and research of developing and accessing smoke-free products, while not risk-free, they are a much better choice than continuing to smoke cigarettes. In 2020, 76 percent of PMI’s commercial efforts and 98 percent of its R&D expenditures were dedicated to smoke-free products. 

PMI aims to ensure that its smoke-free products meet adult consumer preferences and rigorous regulatory requirements. 

Dr Gizelle S Baker, Vice-President of Global Scientific Engagement at PMI

Dr Gizelle S Baker, Vice-President of Global Scientific Engagement at PMI, explains, “This is a transformation that is happening within each country. We need researchers, healthcare professionals, policy experts, governments, the industry and media to work together to ensure adult smokers have access to accurate information about different products so they can make informed decisions about their health, relative to continued smoking.” 

She adds: “We need to find ways to encourage and incentivise innovation in the development and scientific assessment of less harmful products. It is also important to implement regulatory frameworks that recognise that not all tobacco products are the same.

“This would maximise the number of adult smokers who switch to better alternatives and stop smoking, and at the same time minimise the number of youth and non-smokers exposed to nicotine-containing products.”

Today, a future in which cigarettes are obsolete is within reach. In fact, with the right regulatory encouragement and support from civil society, cigarette sales could even end within 10 to 15 years in many countries. Effective policies and regulation should allow smokers access to scientifically substantiated smoke-free products. They should also enable smokers to make informed choices based on accurate information about these products.

To learn more, head to the Unsmoke South Africa homepage.