Summary - Department of Health and Ageing

Harm reduction strategies seek to minimise or limit the harms associated with drug use
without necessarily seeking to eliminate use. These strategies are distinct from treatment
approaches that aim to reduce the level of drug use. In their focus on reducing harm
without necessarily reducing drug use, they operate in a similar way to developmental
protective factors although they typically apply at a later stage in the development of drug
use problems. Together with demand reduction and supply reduction, harm reduction is
an integral part of a harm minimisation approach and has been part of Australian national
drug policy since the first policy was developed in the mid 1980s. Although harm
reduction is often thought of mainly in terms of reducing the spread of BBVs among
injecting drug users, it covers a much wider range, with initiatives relating to the use of
tobacco, alcohol, illicit drugs and pharmaceuticals. This chapter discusses initiatives across
all these areas.
In Australia, there are few harm reduction initiatives relating to tobacco as it has been
thought such moves might encourage smokers to continue smoking. This has not been the
view in other countries and some new approaches are emerging, including non-smoking
nicotine delivery systems. Sweden has shown that tobacco that can be nasally ingested can
take significant market share away from cigarettes. Low-tar ‘light’ cigarettes, developed
apparently to persuade smokers that there is a safer way to smoke, have generated
significant international concern as it has been shown that smokers tend to compensate by
inhaling harder. There are also concerns that misleading promotion could lead to increased
use.
The wide range of restrictions to prevent passive smoking are effective and enjoy high
public support, even among smokers.
Australia is a world leader in reducing drink-driving with effective programs. Random
breath testing has been particularly successful in Australia because of the way it is
implemented, including testing of all stopped drivers, high-visibility policing and frequent
public advertising campaigns emphasising the likelihood of being detected. Other drinkdriving
strategies include lower blood alcohol concentration (BAC) limits for
inexperienced drivers, for which the current evidence is inconclusive, and ‘designated
driver’ schemes, which have been widely implemented although some compliance
problems have been noted. Ignition interlocks require drivers to provide a breath sample
before starting their vehicles. They are a promising new intervention although they tend to
be effective only while they are actually fitted and operating, with drivers often reoffending
after the lock is removed.