The Incentives Created by a Harm Reduction Approach to Smoking Cessation. Maki, J. International Journal of Drug Policy.
The Incentives Created by a Harm Reduction Approach to Smoking Cessation [link]Paper  doi  abstract   bibtex   
AbstractBackground Tobacco harm reduction involves advocating the use of a less harmful alternative to smoking for those users who are unwilling or unable to quit. The net effect of such an approach is unclear as it may create opposing incentives. Although some smokers may substitute toward this less harmful alternative, it may reduce the incentive to quit by undermining public health efforts and may act as a gateway to smoking. This research paper aims to answer the question: Does the availability of a less harmful alternative to smoking lead to cessation? To explore the opposing incentives created by a harm reduction approach to smoking cessation, I focus on the role of snus, a popular smokeless tobacco product in Scandinavia that is widely used in Sweden. Methods This paper exploits a quasi-natural experiment to examine the net effect resulting from these opposing incentives. While two Scandinavian countries, Sweden and Finland, joined the European Union (EU) in 1995, Finland was subject to a pre-existing EU ban on oral tobacco products while Sweden received an exemption. A difference in differences framework is used to estimate the change in the smoking rate in Finland due to the implementation of the ban. A secondary analysis uses Finnish smoking data to test for a structural break in trend. Results In the post-ban period, smoking was 3.47 percentage points higher in Finland relative to what it would have been in the absence of the ban. Conclusion The availability of snus, a less harmful alternative to smoking, appears to have had a positive impact (reduction) on the smoking rate. Offering acceptable alternatives to cigarettes is critical in reducing smoking prevalence.
@article{maki_incentives_????,
	title = {The {Incentives} {Created} by a {Harm} {Reduction} {Approach} to {Smoking} {Cessation}},
	issn = {0955-3959},
	url = {http://www.sciencedirect.com/science/article/pii/S0955395914002175},
	doi = {10.1016/j.drugpo.2014.08.003},
	abstract = {AbstractBackground
Tobacco harm reduction involves advocating the use of a less harmful alternative to smoking for those users who are unwilling or unable to quit. The net effect of such an approach is unclear as it may create opposing incentives. Although some smokers may substitute toward this less harmful alternative, it may reduce the incentive to quit by undermining public health efforts and may act as a gateway to smoking. This research paper aims to answer the question: Does the availability of a less harmful alternative to smoking lead to cessation? To explore the opposing incentives created by a harm reduction approach to smoking cessation, I focus on the role of snus, a popular smokeless tobacco product in Scandinavia that is widely used in Sweden.
Methods
This paper exploits a quasi-natural experiment to examine the net effect resulting from these opposing incentives. While two Scandinavian countries, Sweden and Finland, joined the European Union (EU) in 1995, Finland was subject to a pre-existing EU ban on oral tobacco products while Sweden received an exemption. A difference in differences framework is used to estimate the change in the smoking rate in Finland due to the implementation of the ban. A secondary analysis uses Finnish smoking data to test for a structural break in trend.
Results
In the post-ban period, smoking was 3.47 percentage points higher in Finland relative to what it would have been in the absence of the ban.
Conclusion
The availability of snus, a less harmful alternative to smoking, appears to have had a positive impact (reduction) on the smoking rate. Offering acceptable alternatives to cigarettes is critical in reducing smoking prevalence.},
	urldate = {2014-08-23},
	journal = {International Journal of Drug Policy},
	author = {Maki, Jennifer},
	keywords = {Harm reduction, Incentives, Smoking cessation},
	file = {ScienceDirect Full Text PDF:files/49662/Maki - The Incentives Created by a Harm Reduction Approac.pdf:application/pdf;ScienceDirect Snapshot:files/49663/S0955395914002175.html:text/html}
}

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