After 20 years of staunch opposition to and misinformation about tobacco harm reduction from anti-tobacco forces, one prominent figure has broken ranks, offering the truth and a cautious endorsement of safer tobacco products.
David B. Abrams, executive director at American Legacy Foundation’s Schroeder Institute for Tobacco Research and Policy Studies, recently acknowledged in a college newspaper that smoke-free tobacco products are vastly safer than smoking. Here is the key passage from that article:
Though he said that there is not much research on e-cigarettes, Abrams said the studies he has seen ‘put e-cigarettes in the category of somewhere between nicotine replacement therapy, which is pharmacy-grade nicotine from a pharmacy, and smokeless tobacco products, which are not harmless but are also much less harmful than cigarettes.’ He said that in terms of risk, he would slot e-cigarettes between snus — a type of powdered tobacco — and dissolvable nicotine products.
Coming from an executive at one of the most anti-harm reduction organizations, this is a revolutionary statement. As readers of this blog know, numerous published epidemiologic studies document that American and Swedish smokeless tobacco products have disease risks so low that they cannot be measured with any precision. Dr. Abrams’ risk assessment for e-cigarettes is therefore accurate.
This was the second time in two weeks that Dr. Abrams acknowledged the substantial risk differential between combusted and smoke-free tobacco. On Nov. 25, he commented at a Wells Fargo e-cigarette forum in New York.
[E-cigarettes are] dramatically less and probably in the order of 10 to 100 times less dangerous than combusted cigarettes. And certainly even less harmful than the data I’ve seen for smokeless tobacco, although they’re also dramatically less harmful than cigarettes. So I’d say they’re somewhere in between the ‘safest nicotine replacement pharmaceuticals’ and smokeless. And I would regard smokeless as a decent harm reduction strategy along with e-cigarettes in the map of harm reduction versus quit or die total abstinence.
Thus far, the campaign to inform smokers about safer products has been led by a handful of tobacco research and policy experts. Dr. Abrams’ statements should pressure harm reduction deniers to abandon their failed quit-or-die mantra and start telling smokers the truth about safer cigarette substitutes. This underscores my view that the tobacco harm reduction revolution is unstoppable.