Harm Reduction
Anti-smoking activists give smokers a stark choice: Stop smoking or die! In fact, there is a third path: reduce the harm by shifting to less-hazardous products that provide similar enjoyment. For example, switching from cigarettes to smokeless tobacco products or electronic cigarettes dramatically reduces the health risk.
For many years, Swedes have used a kind of spitless tobacco called snus. At least partly because of the widespread use of snus, Sweden has the lowest rate of cigarette smoking and lung cancer in Europe. Surely there are lessons here for U.S. tobacco policy.
Over the past several years, several millions cigarette smokers worldwide have quit smoking or dramatically reduced their cigarette consumption thanks to the use of smoke-free, tobacco-free, and often nicotine-free electronic cigarettes. In April 2014, the International Journal of Environmental Research and Public Health published a report summarizing a survey of more than 19,000 past and present users of electronic cigarettes the largest survey of its kind to date.
Here is what the survey found:
Electronic cigarettes helped 81% of the survey respondents quit smoking. Among those who had not quit entirely, one-third were non-daily smokers, and the rest had decreased consumption from 20 cigarettes to 4 per day.
Smokers primarily begin using electronic cigarettes for harm reduction and to reduce second-hand smoke exposure to family members.
Electronic cigarettes appear to be effective even in highly-dependent smokers.
Side effects are minor and reported health benefits are substantial.
Here is what this means for public policy:
Electronic cigarettes are reducing smoking rates.
Adult smokers should not be discouraged from using electronic cigarettes.
Over-regulation of electronic cigarettes could make the products less appealing to potential quitters.
In light of their public health benefits, governmental policies should not treat electronic cigarettes the same as traditional tobacco products.
Unfortunately, some public health organizations and lobbying groups have made a business out of opposing smoking. If electronic cigarettes solve many of the problems that come from smoking tobacco, their business may be hurt. This conflict of interest means they will be among the last to admit that electronic cigarettes are a safe alternative for smokers.