Skip to main content
Log in

Harm reduction and e-cigarettes: Distorting the approach

  • Viewpoint
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

Abstract

Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply—two elements that are explicitly rejected by many advocates of electronic cigarettes. We contend that, in the absence of all three elements, there is a danger that electronic cigarettes will delay the achievement of a tobacco-free world.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Fernández, E., Lugo, A., Clancy, L., Matsuo, K., La Vecchia, C. and Gallus, S. (2015) Smoking dependence in 18 European countries: Hard to maintain the hardening hypothesis. Preventive Medicine 81: 314–319.

    Article  Google Scholar 

  2. Stimson, G.V., Dorn, D. and Lines, R. (2013) Re: E-cigarettes and the marketing push that surprised everyone. BMJ, http://www.bmj.com/content/347/bmj.f5780/rr/665237.

  3. Branston, J.R. and Sweanor, D. (2016) Big tobacco, E-cigarettes, and a road to the smoking endgame. International Journal of Drug Policy 29: 14–18.

    Article  Google Scholar 

  4. Bammer, G., Douglas, B., Moore, M. and Chappell, D. (1992) Heroin trial for the Australian Capital Territory – An overview of feasibility research. 3rd International Conference on Drug Related Harm, Melbourne, 1992.

  5. Bammer, G. (1995) Report and Recommendations on Stage 2 Feasibility Research into the Controlled Availability of Opioids. National Centre for Epidemiology and Population Health, Australian National University, Australian Institute of Criminology, 1995, http://nceph.anu.edu.au/files/feasibility_research_into_the_controlled_availability_of_opioids_stage_2_report_and_recommendations.pdf.

  6. Stockings, E. et al (2016) Prevention, early intervention, harm reduction, and treatment of substance use in young people. The Lancet Psychiatry 3(3): 280–296. http://www.ncbi.nlm.nih.gov/pubmed/26905481.

  7. Ritter, A. and Cameron, J. (2006) A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs. Drug and Alcohol Review 25: 611–624.

  8. Aspinall, E., Nambiar, D., et al (2014) Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: A systematic review and meta-analysis. International Journal of Epidemiology 43: 235–248.

    Article  Google Scholar 

  9. McNeill, A., Brose, L., Calder, R., Hitchman, S., Hajek, P. and McRobbie, H. (2015) E-cigarettes: An Evidence Update. A Report Commissioned by Public Health England. London: PHE.

    Google Scholar 

  10. McKee, M. and Capewell, S. (2015) Evidence about electronic cigarettes: A foundation built on rock or sand? BMJ 351: h4863.

    Article  Google Scholar 

  11. Schaal, C. and Chellappan, S. P. (2014) Nicotine-mediated cell proliferation and tumor progression in smoking-related cancers. Molecular Cancer Research 12: 14–23.

    Article  Google Scholar 

  12. Pisinger, C. and Døssing, M. (2014) A systematic review of health effects of electronic cigarettes. Preventive Medicine 69: 248–260.

    Article  Google Scholar 

  13. Combes, R.D. and Balls, M. (2015) A critical assessment of the scientific basis, and implementation, of regulations for the safety assessment and marketing of innovative tobacco-related products. ATLA 43: 251–290.

    Google Scholar 

  14. McKee, M., Daube, M. and Chapman, S. (2016) Electronic cigarettes should be regulated. Medical Journal of Australia 204: 331.

    Article  Google Scholar 

  15. Kalkhoran, S. and Glantz, S.A. (2016) E-cigarettes and smoking cessation in real-world and clinical settings: A systematic review and meta-analysis. The Lancet Respiratory Medicine, 4: 116–128.

    Article  Google Scholar 

  16. Smoking in England: Latest Statistics. STS140721 (2016) http://www.smokinginengland.info/latest-statistics/.

  17. Colaianni, C.A., Tapias, L.F., Cauley, R., Sheridan, R., Schulz, J.T. and Goverman, J. (2016) Injuries caused by explosion of electronic cigarette devices. Eplasty 16: ic9.

  18. Chen, B.C., Bright, S.B., Trivedi, A.R., and Valento, M. (2015) Death following intentional ingestion of e-liquid. Clinical Toxicology (Philadelphia, PA), 53: 914–916.

    Article  Google Scholar 

  19. Glantz, S.A., Slade, J., Bero, L.A., Hanauer, P., and Barnes, D.E. (eds) (1998) The Cigarette Papers. Berkeley: University of California Press.

    Google Scholar 

  20. Australian Federal Department of Health (2015) The National Drug Strategy 2015, http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/DB4076D49F13309FCA257854007BAF30/$File/nds2015.pdf.

  21. Morgenstern, M., Stoolmiller, M., Bergamini, E. and Sargent, J.D. (2016) Did limits on payments for tobacco placements in US movies affect how movies are made? Tobacco Control: doi:10.1136/tobaccocontrol-2015-052400.

  22. Tobacco Free Kids. (2013) 7 ways e-cigarette companies are copying Big Tobacco’s playbook, http://www.tobaccofreekids.org/tobacco_unfiltered/post/2013_10_02_ecigarettes.

  23. Stanwick, R. (2015) E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada. Paediatrics & Child Health, 20: 101–105.

    Article  Google Scholar 

  24. Smith, R.F., McDonald, C.G., Bergstrom, H.C., Ehlinger, D.G., and Brielmaier, J.M. (2015) Adolescent nicotine induces persisting changes in development of neural connectivity. Neuroscience and Biobehavioral Reviews, 55: 432–443.

    Article  Google Scholar 

  25. Weishaar, H., Trevisan, F., and Hilton, S. (2016) “Maybe they should regulate them quite strictly until they know the true dangers”: A focus group study exploring UK adolescents’ views on e-cigarette regulation. Addiction,. doi:10.1111/add.13377.

    Google Scholar 

  26. Therapeutic Goods Administration. (2015) Electronic cigarettes, https://www.tga.gov.au/community-qa/electronic-cigarettes.

  27. Godtfredsen, N.S., Holst, C., Prescott, E., et al (2002) Smoking reduction, smoking cessation, and mortality: A 16-year follow-up of 19,732 men and women from the Copenhagen Centre for Prospective Population Studies. American Journal of Epidemiology, 156: 994–1001.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Moore.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moore, M., McKee, M. & Daube, M. Harm reduction and e-cigarettes: Distorting the approach. J Public Health Pol 37, 403–410 (2016). https://doi.org/10.1057/s41271-016-0031-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/s41271-016-0031-2

Keywords

Navigation