Table 3

Potential youth focused harm reduction approaches and their plausible consequences. Arrows indicate that the predicted effect is to either increase or decrease the probability of the effects indicated at the top of each column

Approach or productToxin exposureInitiation use by unintended personsEffect on initiation of tobacco useEffect on cessation of tobacco useEffect on relapse in former tobacco usersRisk of increasing nicotine dependence or graduating to cigarettesMarketplace incentivesRegulatory issues and needs
Comprehensive education/control↓↓↓↑↓↓Reduce tobacco profitsNeed product information
Behavioural guidance added to comprehensive education/control???????Need product information
Increase cost of tobacco↓↓↓↑↓↓Reduce tobacco profits?
Decrease tobacco access↓↓↑↓↓Reduce tobacco profitsNeed regulatory control
Reduce toxicity of all products—no promotion allowed↓?????Increased product manufacturing costRegulatory oversight needed
Reduced toxicity of conventional products, allow promotion? – promo could increase use↑, e.g. snuff in 1970s on↑, e.g. snuff in 1970s on↓, e.g. light cigs↓↑, e.g. gateway snuff effectAttractive to tobacco industryRegulatory oversight needed
Eliminate nicotine in cigarettesNear term ↑ Long term ↑??↑↓↓Not attractive to cigarette companiesRegulatory oversight needed
Novel smoked products?↑↑↓, e.g. light cigs↑ consumer survey↑, e.g. snuffAttractive to some companiesRegulatory oversight needed
Novel non-smoked products?↑↑↓, e.g. light cigs↑ consumer survey↑, e.g. snuffAttractive to some companiesRegulatory oversight needed
Nicotine medications↓Regulate to reduce riskNo predicted effectNo predicted effectNo predicted effectPossible if nicotine dependency establishedYouth: no (Adults possible)Regulatory flexibility needed
Non-nicotine medications↓Regulate to reduce riskNo predicted effectNo predicted effectNo predicted effectNo predicted effectYouth: no (Adults possible)Regulatory flexibility needed