Dr. David Abrams, professor of social and behavioral sciences at New York University College of Global Public Health has a new article, “Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives”, published in the forthcoming volume of the Annual Review of Public Health. The article focuses on harm minimization and smoking cessation, with alternative nicotine products like e-cigarettes emerging as a promising avenue for people who want to quit smoking. He contends that, compared with vaping, smoking is much more harmful and prematurely kills over half of lifetime smokers.
Inhalation of the toxic smoke produced by combusting tobacco products, primarily cigarettes, is the overwhelming cause of tobacco-related disease and death in the United States and globally. A diverse class of alternative nicotine delivery systems (ANDS) has recently been developed that do not combust tobacco and are substantially less harmful than cigarettes. ANDS have the potential to disrupt the 120-year dominance of the cigarette and challenge the field on how the tobacco pandemic could be reversed if nicotine is decoupled from lethal inhaled smoke. ANDS may provide a means to compete with, and even replace, combusted cigarette use, saving more lives more rapidly than previously possible.
In July 2017, the Food and Drug Administration announced a major shift in its tobacco strategy, including recognizing the role of less harmful products, such as e-cigarettes, for smokers who want a satisfying alternative to smoking cigarettes. Food and Drug Administration (FDA) commissioner Dr. Scott Gottlieb said, “Nicotine, though not benign, is not directly responsible for the tobacco-caused cancer, lung disease and heart disease that kill hundreds of thousands of Americans each year.”
On the basis of the scientific evidence on ANDS, the authors explore the benefits and harms to public health to guide practice, policy, and regulation. A reframing of societal nicotine use through the lens of harm minimization is an extraordinary opportunity to enhance the impact of tobacco control efforts.