Call It Whatever You Want -- Tobacco Harm Reduction Saves Smokers’ Lives

 

The U.S. desperately needs tobacco harm reduction, starting with reducing the harm from the pronouncements of federal officials.  Case in point: FDA Commissioner Robert Califf’s April 11 tobacco testimony before the House Oversight Committee.

Dr. Califf made so many false statements that I penned a response for Real Clear Health. Following are some additional observations related to his testimony.

Readers know that I don’t tolerate doctors who claim they saw many people die from the ravages of tobacco, when those patients actually died from the smoke!  Similarly, I can’t let the federal official in charge of regulating tobacco get away with mislabeling it in the same fashion as the World Health Organization and the National Cancer Institute.

Dr. Califf wrongly claimed that harm reduction is an industry term.  My late colleague Dr. Philip Cole and I used that term in an article published by the American Council on Science and Health in 1995.  The Institute of Medicine, hardly a tobacco industry tool, titled a 2001 report, “Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction (here).”

For 30 years, I’ve been saying, without challenge, “Nicotine, when consumed without the harmful constituents of cigarette smoke, is no more harmful than caffeine.”

Fifteen years ago Britain’s Royal College of Physicians, one of the world’s oldest and most prestigious medical societies, agreed with me, finding, “…that smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

Dr. Califf should stop supporting the cigarette industry by trashing vastly safer cigarette substitutes.  That's called tobacco harm escalation.

 

 

Facts About Safer Smoke-Free Products Are “Somewhere,” But Not at the FDA

 

I recently came upon the FDA website “Nicotine is Why Tobacco Products Are Addictive.”  The section “What Makes Tobacco Use Harmful” starts with partially truthful information: “Nicotine is what keeps people using tobacco products. However, it’s the thousands of chemicals contained in tobacco and tobacco smoke that make tobacco use so deadly.” [emphasis in original].

That’s not too bad, although agency officials know that the thousands of deadly chemicals are present only in smoke, not tobacco.  Then they get more specific. 

“Combustible products, or products that burn tobacco, are the most harmful. An example of a combustible product is cigarettes, which deliver more than 7,000 chemicals along with nicotine that makes it hard to quit.

“FDA-approved nicotine replacement therapies (NRTs), such as gums and lozenges, are the least harmful.”

Then it gets awful, as the guidance turns to noncombustible, or smoke-free tobacco products.

“Noncombustible products, such as heat-not-burn tobacco products, smokeless tobacco, and e-cigarettes, fall somewhere in between combustible products and NRTs.”

Somewhere?

The FDA has hundreds of scientists on staff and has funded research by thousands more at universities across America.  This federal agency is responsible for regulating the entire tobacco industry, and it sets precedents for tobacco regulation worldwide.  It claims to act only on the basis of hard science, yet it feigns ignorance about where the risks fall for smoke-free products.

This farcical position is undermined elsewhere on the webpage where the agency acknowledges that “many studies suggest e-cigarettes and noncombustible tobacco products may be less harmful than combustible cigarettes.” 

Those studies do more than suggest.  Britain’s Royal College of Physicians has stated for years that smoke-free products are at least 95% less hazardous than cigarettes – a fact that anti-tobacco zealots consistently ignore.  The FDA’s response is always “more research is needed,” though for this agency, there will never be enough.  Regulators know the facts, but they refuse to share them with smokers and their loved ones as smoker deaths continue to mount.

 

 

Dear Canadian Smokers: Please Follow Britain’s Guidance

 

I sent the following message to Canadian smokers.  It appeared in a Maclean’s magazine health supplement, with sponsorship by the Canadian Vaping Association (available here).

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You may wonder why an American professor accepted an invitation from the Canadian Vaping Association to author an article about e-cigarettes. In part, it’s because I want to apologize to you for the way my government, which is engaged in a coordinated, expensive campaign to create a tobacco-free society, has wrongfully destroyed the prospect of a smoke-free future for millions. Don’t listen to American health officials, who emphasize only the negatives, untruths, and urban myths. Don’t let their campaign stop you from stepping away from the fire.

Instead, you should follow the lead of Britain’s Royal College of Physicians, one of the world’s oldest and most prestigious medical societies. Nearly 20 years ago, it advised, “as a way of using nicotine, the consumption of non-combustible tobacco is on the order of 10-1,000 times less hazardous than smoking, depending on the product.”1

In 2007, the Royal College published a report2 challenging governments to consider “that smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved. This report makes the case for radical reform to the way that nicotine products are regulated and used in society.” It described its ideas as “controversial and challenge many current and entrenched views in medicine and public health. The principles behind them have the potential to save millions of lives. They deserve consideration.”

Unlike their American counterparts, British authorities have consistently told smokers the truth about vaping since 2011 (here, here, here and here). In fact, their Department of Health helps smokers switch from combustibles to vapour. As a result, the U.K. vaping population ballooned from 700,000 in 2012 to 3.6 million in 2019.

The Royal College (here) provided the perfect reason for you to switch from cigarettes to vape in 2016: “The hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5 percent of the harm from smoking tobacco.”

Nothing has changed the Royal College’s hazard assessment, so don’t be fooled by the tsunami of exaggerated and outright fictitious vaping “dangers” concocted by prohibitionists.

Note: I have restored some links that were removed by the publisher.