The SCOHRE Congress emphasised that strategies to reduce the harms caused by smoking must be an integral part of public health policy. Experts presented scientific evidence supporting the use of alternative nicotine products and called for their inclusion in control and prevention strategies.
Report from the SCOHRE Congress: Mitigating the Harmful Effects of Smoking as Part of Public Health Policy
The SCOHRE Congress focused on current issues in tobacco control and the role of harm reduction strategies in public health. Discussions concentrated particularly on how innovative, evidence-based approaches can complement traditional preventive and therapeutic measures.
The Framework Convention on Tobacco Control and Its Limits
One of the topics addressed was the Framework Convention on Tobacco Control (FCTC), adopted in 2003 to address the health, social, environmental and economic impacts of smoking. Clive Bates, a UK tobacco control policy expert, compared initial expectations with current practice in his presentation. He described the FCTC as “a good idea gone awry,” arguing that the current focus on nicotine and dependence diverts attention from the main goal – reducing the harms caused by smoking.
He also highlighted the problems of incorrectly comparing risks between conventional cigarettes and new alternative products, a one-sided focus on youth, orientation towards the tobacco industry, and efforts to ban lower-risk products. According to him, it is necessary to return to the original goal and support the transition to less harmful forms of nicotine use.
Unifying Perspectives on Harm Reduction Strategy
A significant portion of the programme was dedicated to unifying approaches to tobacco harm reduction (THR). Although scientific evidence of the benefits of alternative nicotine products – electronic cigarettes, nicotine pouches and heated tobacco products – is steadily increasing, their acceptance remains limited, and some institutions, including the WHO, still reject them.
Some countries, such as the United Kingdom and New Zealand, actively support these strategies. Experts from Italy and the Czech Republic also shared specific experiences. Professor Petruželka and Docent Votruba presented the first Czech consensus on harm reduction in cancer prevention, adopted on 31 January 2025 during the PragueOnco Congress. The document is based on the assumption that complete elimination of risk factors is not always possible; therefore, it is appropriate to minimise harm through innovative and accessible evidence-based approaches.
Harm Reduction as Part of Cancer Prevention
According to experts, the harm reduction concept should be an integral part of primary prevention, especially given the rising incidence of malignant tumours. Risk factors often potentiate each other, making it appropriate to apply harm reduction strategies wherever they can provide benefit.
In the area of tobacco use, harm reduction focuses on nicotine replacement therapy (e.g., patches, gums) and other therapeutic measures supporting cessation. It also includes innovative smokeless forms of tobacco and nicotine, which can significantly reduce individual health risks as well as overall smoking prevalence. Available scientific evidence shows that these products can reduce exposure to harmful substances by up to 95% or more compared with cigarette smoke. Experts therefore consider it unnecessary to wait for the results of long-term epidemiological studies.
International professional societies, such as ASCO and the Royal College of Physicians, support the integration of innovative alternatives into the cessation process. In addition, the U.S. FDA has granted some products the status of Modified Risk Tobacco Products (MRTP).
The Need to Integrate Harm Reduction into Public Health Policy
Professor Ignatios Ikonomidis, Chair of SCOHRE, emphasised that harm reduction must be a pillar of public health policy, alongside prevention and cessation. Increasing the knowledge of healthcare professionals, regulatory bodies, policymakers and the public is crucial. Transitioning from cigarettes to less harmful nicotine products can demonstrably save lives, but progress is hampered by misconceptions, resistance and misinformation.
According to the congress conclusions, tobacco control policy must be based on scientific evidence rather than ideology. Harm reduction strategies should be part of care for smokers who cannot or do not want to quit. While cessation remains the gold standard, alternative products – electronic cigarettes, heated tobacco, or oral nicotine products – offer a pragmatic and scientifically supported option.
Scientific Presentations and Research Findings
The congress featured thirty scientific papers focused on aerosol toxicology and chemistry, epidemiology, social aspects, innovations and new products, preclinical and clinical research, biomarkers, smoking cessation, and regulatory issues.
