A new approach to smoking, the Italian document that is sparking debate in public health
2026-05-22 19:24:57
TiranaPost
The Italian Society for Addiction Pathologies (SIPaD) has published an official Position Statement on risk reduction in tobacco use disorder, recognizing for the first time in Italy the clinical importance of risk-reduction strategies for adult smokers who fail to quit traditional cigarettes.
The document, titled "Risk reduction in Tobacco Use Disorder (TUD): Critical analysis of the available evidence", analyzes the scientific evidence on non-burn products, such as electronic cigarettes and heated tobacco products (HTPs), considering them as an intermediate alternative for cases where complete abstinence is not immediately achievable.
Focus on patients who fail to quit smoking
According to SIPaD, smoking remains one of the leading causes of preventable morbidity and mortality, with particularly serious consequences for people with addictive disorders and patients with mental health problems. In these categories, attempts to quit smoking often fail, while continued cigarette consumption significantly reduces life expectancy and worsens health conditions.
In a statement to the media, SIPaD president Claudio Leonardi emphasizes that risk reduction is an already consolidated approach in the treatment of addictions and that it can also be applied in cases of smoking, when immediate cessation of consumption proves difficult.
"The ultimate goal always remains quitting smoking, but patients who want to quit and are unable to do so cannot be ignored," he emphasizes.
What does the scientific evidence say?
The document summarizes a series of toxicological and clinical studies on non-burn products. According to SIPaD, heated tobacco products work by heating tobacco without a combustion process, which significantly reduces the creation of toxic substances found in traditional cigarette smoke.
The association cites evidence that the aerosol produced by HTPs contains 92–97% fewer toxic and potentially harmful substances compared to cigarette smoke, as well as a much lower number of chemical components.
In clinical studies, smokers who switched completely to smokeless alternatives showed significant reductions in biomarkers of exposure to toxic substances, including carbon monoxide, nitrosamines, and volatile organic compounds. Improvements were also seen in markers of oxidative stress and inflammation.
SIPaD also points out that several studies have shown improvements in respiratory and cardiovascular parameters in patients who completely replaced cigarettes with non-combustible products, including people with chronic obstructive pulmonary disease (COPD).
"Not without risk" and not for young people
However, the document clearly highlights that alternative products are not risk-free, are not considered medications, and should not be promoted to non-smokers or young people.
SIPaD requires that any public communication on these products be careful, balanced and non-promotional, avoiding any normalization of nicotine use.
The association emphasizes that reduced-risk strategies should be considered temporary, monitored, and part of a structured therapeutic pathway that ultimately aims for complete cessation of tobacco consumption.
A debate that is gaining ground in Europe
The publication of this statement comes at a time when the debate on tobacco harm reduction is gaining increasing attention in Europe and the international public health community.
While health organizations continue to emphasize that the best alternative remains not starting or quitting smoking completely, some experts argue that for adult smokers who are unable to quit cigarettes, reduced-risk strategies may represent a pragmatic option for reducing harm and exposure to toxic substances.
