What is “harm reduction?” Broadly speaking, harm reduction is a concept aimed at minimizing the consequences of addiction and other behaviors associated with drug use. In the electronic cigarette industry, harm reduction encompasses the idea that individual behaviors employed for the intake of nicotine may be more or less harmful to a person based on a continuum of risk. On this continuum, burning tobacco leaf is the most harmful while zero intake of tobacco and/or nicotine would, quite obviously create no health risk.
The spectrum of behaviors considered to be “less harmful” than burning tobacco but more harmful than zero-level intake includes the use of products such as electronic cigarettes, nicotine gums and patches, and various smokeless tobacco products. While there is no universal definition of harm reduction, prohibiting or restricting access to products such as electronic cigarettes is commonly considered by harm reductionists as the least effective solution to minimizing the impact of nicotine ingesting behaviors.
Research
Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes?
Zachary Cahna,* and Michael Siegel
The issue of harm reduction has long been controversial in the public health practice of tobacco control. Health advocates have been reluctant to endorse a harm reduction approach out of fear that tobacco companies cannot be trusted to produce and market products that will reduce the risks associated with tobacco use. Recently, companies independent of the tobacco industry introduced electronic cigarettes, devices that deliver vaporized nicotine without combusting tobacco. We review the existing evidence on the safety and efficacy of electronic cigarettes. We then revisit the tobacco harm reduction debate, with a focus on these novel products. We conclude that electronic cigarettes show tremendous promise in the fight against tobacco-related morbidity and mortality. By dramatically expanding the potential for harm reduction strategies to achieve substantial health gains, they may fundamentally alter the tobacco harm reduction debate.