Journal
EUROPEAN ADDICTION RESEARCH
Volume 20, Issue 5, Pages 218-225Publisher
KARGER
DOI: 10.1159/000360220
Keywords
Smoked tobacco products; Oral tobacco products; Electronic cigarettes; Multi criteria decision analysis; Harm assessment; ENDS (electronic nicotine delivery systems)
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Funding
- Euroswiss Health (Switzerland)
- LIAF (Lega Italiana Anti Fumo)
- Medical Research Council [G1000018] Funding Source: researchfish
- NATIONAL INSTITUTE ON DRUG ABUSE [P50DA036107] Funding Source: NIH RePORTER
- MRC [G1000018] Funding Source: UKRI
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Background: An international expert panel convened by the Independent Scientific Committee on Drugs developed a multi-criteria decision analysis model of the relative importance of different types of harm related to the use of nicotine-containing products. Method: The group defined 12 products and 14 harm criteria. Seven criteria represented harms to the user, and the other seven indicated harms to others. The group scored all the products on each criterion for their average harm worldwide using a scale with 100 defined as the most harmful product on a given criterion, and a score of zero defined as no harm. The group also assessed relative weights for all the criteria to indicate their relative importance. Findings: Weighted averages of the scores provided a single, overall score for each product. Cigarettes (overall weighted score of 100) emerged as the most harmful product, with small cigars in second place (overall weighted score of 64). After a substantial gap to the third-place product, pipes (scoring 21), all remaining products scored 15 points or less. Interpretation: Cigarettes are the nicotine product causing by far the most harm to users and others in the world today. Attempts to switch to non-combusted sources of nicotine should be encouraged as the harms from these products are much lower. (c) 2014 S. Karger AG, Basel
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