avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-6-405-415avk-1331Research ArticleЛЕКЦИИLECTURESКонцепция снижения вреда от табака: прошлое, настоящее, будущееThe Concept of Harm Reduction from Tobacco: Past, Present, Futurehttps://orcid.org/0000-0002-6571-1220БабакС. Л.BabakS. L.

Москва

sergbabak@mail.ruГорбуноваМ. В.GorbunovaM. V.

Москва

МалявинА. Г.MalyavinA. G.

Москва

ШашенковИ. В.ShashenkovI. V.

Москва

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова», Минздрава РоссииРоссияMoscow State University of Medicine and Den tistry named after A.I. EvdokimovRussian Federation202128112021116405415Copyright © Бабак С.Л., Горбунова М.В., Малявин А.Г., Шашенков И.В., 20212021Бабак С.Л., Горбунова М.В., Малявин А.Г., Шашенков И.В.Babak S.L., Gorbunova M.V., Malyavin A.G., Shashenkov I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1331

Концепция «снижения вреда от табака» (СВОТ) является темой для дискуссии в контексте международной борьбы против употребления любых видов табака. Такая концепция предполагает предоставление потребляющим табак лицам, которые не могут или не желают прекратить табакокурение или потребление других видов табака (нюхательный, жевательный), менее вредную табачную продукцию с модифицированным риском (ТПМР) для дальнейшего употребления. Скептицизм в отношении СВОТ огромен и связан с негативным опытом табачных компаний по выпуску сигарет с низким содержанием табачных смол/никотина, которые должны были иметь существенно более низкие риски для здоровья чем обычные сигареты. Парадоксально, но именно такой опыт послужил трамплином к росту числа табачных изделий, которые потенциально обладают свойствами ТПМР. Более того, некоторые члены антитабачной коалиции, включая ВОЗ, рассматривают переход табакокурильщиков на ТПМР как стратегию с большим потенциалом. Однако, Европейская группа специалистов считает, что стратегия СВОТ не работает и приведёт к привыканию к табаку ещё одного поколения молодых лиц. В этой статье мы подвергли критическому анализу историю прошлого и настоящего табачных изделий, мифы и противоречия вокруг них. Мы постарались максимально объективно оценить современную концепцию СВОТ, обладающую высоким потенциалом к реальному сокращению числа смертей, связанных с табакокурением.

The concept of tobacco harm reduction (THR) is a speculative and controversial topic in the context of the international battle against the use of all types of tobacco. This concept involves providing tobacco users who are unable or unwilling to quit smoking or using other types of tobacco (snuff, chewing), with modified risk tobacco product (MRTP) for continued use. Skepticism about THR is huge and is associated with the negative experience of tobacco companies to produce cigarettes with a low content of tobacco tar/nicotine, which should have had significantly lower health risks than conventional cigarettes. Paradoxically, such an experience served as a springboard to an increase in the number of tobacco products that potentially have the properties of MRTP. Moreover, some members of the anti-smoking coalition, including WHO, consider the transition of tobacco smokers to MRTP as a strategy with great potential. However, the European Group of Experts believes that the MRTP strategy does not work and will lead to another generation of young people getting used to tobacco. In this article, we have critically analyzed the history of the past and present of tobacco products, myths and contradictions around them. We have tried to evaluate the modern concept of S THR as objectively as possible, which has a high potential for a real reduction in the number of deaths associated with smoking.

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The authors declare that there are no conflicts of interest present.