The scientific foundation for tobacco harm reduction is well established. My comprehensive reviews of the evidence in 2006 (here) and 2011 (here) were based on 279 articles published primarily in medical and scientific journals. Dozens more articles were published in the past year.
Tobacco prohibitionists remain blind to this evidence.
On September 11, the Oklahoma House of Representatives’ Public Health Committee convened a hearing on tobacco harm reduction. Daniel McGoldrick, Vice President for Research at the Campaign for Tobacco-Free Kids, told legislators that “Tobacco harm reduction is a complicated and risky strategy that currently lacks an evidence base…”
A particularly vulnerable target of anti-tobacco forces is the e-cigarette, which has been on the market for less than a decade. Even in that short time-frame, scientific studies have emerged to put the lie to “no evidence” charges. For example, a clinical trial conducted at Italy’s University of Catania and the UK’s University of Southampton (available here) concluded that “…the e-cigarette can help smokers to remain abstinent or reduce their cigarette consumption. By replacing tobacco cigarettes, the e-cigarette can only save lives.”
Lead author Riccardo Polosa and colleagues enrolled 40 healthy adult smokers who were not interested in quitting into a prospective trial where they were invited to use e-cigarettes with 7.4 mg cartridges at no cost over 24 weeks. The authors note that “…no emphasis on encouragement, motivation and reward for the smoking cessation effort were provided…” Twenty-seven participants completed all study visits.
One-third (n=13) of the participants reported a sustained 50% reduction in the number of cigarettes smoked, from 25 per day at enrollment to six per day at completion. Further, nine participants had completely quit smoking, with six still using e-cigarettes at the end of the study.
These reports were confirmed by testing carbon monoxide levels in exhaled air. High levels were measured in all smokers before the study; levels at study’s end confirmed little or no smoking.
Few side effects, including mouth and throat irritation and dry cough, were seen, mostly at the beginning of the study; they were not present at study completion.
In summary, this small clinical trial from Italy demonstrates that use of e-cigarettes resulted in smoking reduction or elimination in 55% of smokers who did not intend to quit. The evidence base is solid and growing.