Then why not simply provide those hopelessly hooked tobacco addicts with the nicotine they must have without all those carcinogens and other nasty toxins?
Great idea. Does that work? Well, it does if the slope of the blood nicotine uptake is steep enough to produce the hard-hitting charge that the nicotine addict must have. How about nicotine gum? It works poorly. How about lozenges? Not good enough. Patches? No, too bland. Intravenous nicotine could work, but there's potential for infections. An inhaler? Now you are getting closer.
Maybe these devices called e-cigarettes? They produce a high nicotine content vapor that's inhaled and is reported to produce a serious nicotine rush, similar to that produced by inhaling smoke from burning tobacco.
Sounds pretty good.
Because tobacco deaths don't come from nicotine, maybe we could rescue some 450,000 Americans a year from premature death secondary to tobacco use by making e-cigarettes available to tobacco addicts.
Yeah. Maybe we could. That would be called harm reduction. It could also be called compassionate therapy. Who could oppose that? A lot of folks are antitobacco zealots and they say to the tobacco addicts, "Quit or die!" Ooh. Huge numbers can't quit, so they die, prematurely.
There are many regulatory hurdles awaiting e-cigarettes on their way toward approval, including success at smoking cessation; potential toxicity for the user; any possible harm to people nearby the user; the potential for developing new nicotine addicts via this method of nicotine delivery; possible destigmatization of tobacco; age limits; and the best ways to advertise, market, sell, and tax this new family of products.
Meanwhile, we the public and we the public-health folks ought to cool it and just let the tobacco addicts, who are going to get their nicotine rush any way they can, use e-cigs rather than burn tobacco and inhale its smoke. It strikes me as immoral to try to prevent them that access. Right? Right.
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