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CHAPMAN: Should the Health Community Promote Smokeless Tobacco (Snus): Author's Reply 

As someone who has researched and advocated for harm reduction in the HIV/AIDS [1] and narcotics areas [2], I am highly supportive of the general principle of reducing harm in public health. My recently released book [3] features a 29,000 word chapter examining the application of the term in tobacco control. My current position is that there is an overly seductive simplicity in drawing neat analogies with other areas of harm reduction when it comes to tobacco. It is obvious that there is immediate benefit to health and society from encouraging condom use and clean needle use. However, the putative benefits of population experiments with harm reduction will not be assessable for 30–40 years.

Behind most calls for harm reduction in tobacco control policy lie under-examined assumptions that there is a large intractable smoking population for whom cessation is “an impossible goal,” . . .

While a case may exist for carefully controlled access to snus by such a relatively small group, the case for allowing the foxes in the tobacco industry into the chicken coop of open sales and marketing should alarm anyone with their eyes open to the industry's bottom line. Recent insights confirm our caution that Big Tobacco sees snus as a way of arresting declines in smoking by promoting dual use.

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