Electronic Cigarettes As A Harm Reduction Strategy For Smokers

Abstract 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. Harm reduction is a framework for public health policy that focuses on reducing the harmful consequences of recreational drug use without necessarily reducing or eliminating the use itself. They have not found wide support in tobacco control. Many within the tobacco control community have embraced nicotine replacement therapy (NRT) and other pharmaceutical products, but these products are designed as cessation strategies rather than recreational alternatives. Recently, however, a new product that does not fit neatly into any previous category has entered the nicotine market: the electronic cigarette. Electronic cigarettes do not contain tobacco, but they are recreational nicotine devices and the user closely mimics the act of smoking. Thus, they are neither tobacco products nor cessation devices. The novel potential of electronic cigarettes warrants revisiting the harm reduction debate as it applies to these products. In this article, we first explain what electronic cigarettes are and why they are difficult to categorize. Second, we examine the available evidence concerning the safety and efficacy of electronic cigarettes. Then, we review the most common arguments made against harm reduction in the tobacco control literature, followed by an analysis of each of these arguments in light of the recent emergence of electronic cigarettes. Finally, we identify conclusions from this analysis and their implications for the public health practice of tobacco control. Electronic cigarettes are hand-held devices that deliver nicotine to the user through the battery-powered vaporization of a nicotine/propylene-glycol solution. The act of smoking an electronic cigarette is called vaping and it mimics smoking; but, there is no combustion and the user inhales vapor, not smoke. Although the nicotine is derived from tobacco, electronic cigarettes contain no tobacco. Theoretically, we would expect vaping to be less harmful than smoking as it delivers nicotine without the thousands of known and unknown toxicants in tobacco smoke. Moreover, a product that mimics the act of smoking, in addition to delivering nicotine, can address both pharmacologic and behavioral components of cigarette addiction. Electronic cigarettes are not manufactured or distributed by the tobacco industry or by the Cahn and Siegel them over the internet and in shopping mall kiosks. They have been on the market in the United States for more than 3 years and have become increasingly popular. As B5300 of the estimated 10 000100 000 chemicals in cigarette smoke have ever been identified.

by: kevinmaddox

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