Absolute Risk vs Relative Risk
We are clear that many of our Smokeless Products have not been on the market long enough to assess the long-term impacts of their use. Some stakeholders maintain that this absence of long-term data means that Smokeless Products have no role to play in THR. For example, the EU's Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) issued an opinion in April 2021 focusing on the potential absolute risk of e-cigarettes.[3] While the SCHEER report reviewed the evidence for an association between a number of risks and e-cigarettes use, classifying the evidence base for each risk as “strong, “moderate”, or “weak”, it did not compare the level of these risks to the well documented risks associated with combustible cigarettes. We believe that this relative perspective is crucial for THR, as the primary goal is to reduce tobacco-related morbidity and mortality for those who would otherwise continue smoking.
Numerous other public health authorities similarly focus on the absolute risks of Smokeless Products compared to cigarettes. These authorities argue that because Smokeless Products are not risk-free, they should not be promoted as part of THR strategies. Such arguments overlook the significant reduction in risk when comparing these alternatives to traditional smoking. For example, studies highlighting the potential carcinogenic or cardiovascular risks of Smokeless Products tend to ignore the actual and substantial risks posed by combustible tobacco products. We believe that this narrow focus on absolute risk fails to acknowledge the public health benefits of switching to Smokeless Products for adult smokers, who would otherwise continue to smoke.
