If you want consistent approaches from the government to society’s many problems, then you’re likely to be disappointed. Nowhere is this clearer than in the responses to the tobacco and opioid epidemics—both of which have proven incredibly deadly. Despite tobacco and opioid-related deaths both being inextricably linked to addiction, many states treat them differently and have adopted different responses at their own peril, but there’s a better way.
Many policy experts and researchers have rightly pointed out that for years, the United States has relied on an abstinence-only approach to tobacco , drugs  and sex , and the results have been embarrassingly bad. For those who took an abstinence-focused sex education in the South, they may recall that it was often followed by a flurry of teen pregnancies. Simply put, while abstinence may be the safest course of action, many just don’t—and will never—practice it.
In light of this, it’s important to consider underused tools: consistent harm reduction strategies. These don’t seek to eliminate harm through abstinence—an approach that’s frequently doomed to failure—but to reduce the dangers of potentially hazardous activities, like smoking, by offering safer alternatives or mitigation strategies.
Several states have pursued a harm reduction approach to the opioid epidemic, and understandably. More than 70,000 Americans  and 1,300 Georgians  die annually due to opioid usage. Both red and blue states alike, including Georgia, have legalized needle exchange programs  so that those coping with addiction aren’t sharing used needles and spreading bloodborne diseases.
Many places have tinkered with the idea of opening safe injection sites where people can ingest drugs under the supervision of medical professionals. The hope is that this would prevent those addicted to opioids from overdosing and dying. Only New York  has officially approved these centers so far, but it would be a very tall order in Georgia in the current environment.
Meanwhile, a host of states have legalized marijuana  for recreational use, while others have done so for only medical purposes, including the Peach State. This is also viewed as a harm reduction approach to opioids, given that it provides people a less harmful pain management alternative, and in fact, legalized cannabis is linked to fewer opioid-related deaths . Beyond this, states like Georgia  have made naloxone—the drug that reverses opioid overdoses—available over-the-counter, and expanded the accessibility  of fentanyl test strips to save lives.
While I am not endorsing all of these opioid harm reduction policies, it’s great to see that states are taking the opioid epidemic seriously and searching for outside-of-the-box methods of addressing it. I just wish they’d also apply a harm reduction philosophy more consistently with tobacco usage, which is sorely needed.
Around 480,000 Americans  and nearly 12,000 Georgians  die per year thanks to tobacco use, and since abstinence-only approaches don’t prevent smoking, states should ensure that reduced-harm products, like e-cigarettes, are available.
While e-cigarettes have come under a tremendous level of scrutiny over years, they provide a promising alternative to combustible cigarettes. Public Health England stated that they are 95 percent less dangerous  than combustibles because they don’t employ the same combustion process that releases thousands of chemicals—some of which are very dangerous. That’s not to say that e-cigarettes are without risk, but research has demonstrated that they are far less dangerous than combustible cigarettes.
What’s more, e-cigarettes have become one of the more popular tools  smokers use to kick the habit. This should be celebrated given the deadly nature of smoking, and according to a recent study, e-cigarettes are a more effective cessation tool  than other nicotine replacement therapies, including the patch.
Despite all of this, governments have been increasingly targeting e-cigarettes in various ways. These include attempts to outlaw all e-cigarettes , ban e-cigarette flavors , which give adult smokers another reason to use them instead, or tax the products into oblivion—a proposal that has been introduced here in Georgia . These endeavors do little other than to put less dangerous alternatives out of reach of current smokers, which encourages them to continue their current deadly habit.
Some regulations of e-cigarettes are absolutely necessary. For instance, it is critically important to keep e-cigarettes out of the hands of youths, and nonsmokers would be better served by never beginning to use such products. However, if policymakers truly care about reducing tobacco’s harm as much as some value opioid harm reduction policies, then they should recognize the value of consistent harm reduction strategies and not work to disincentivize smokers from trying less harmful products. Then again, the government isn’t known for its consistent, principled approaches.
- “tobacco”: https://macdonaldlaurier.ca/preaching-abstinence-doesnt-work-tobacco-either-crowley-sun-papers/
- “drugs”: https://www.aamc.org/news-insights/interest-medication-assisted-treatment-growing-means-curb-opioid-epidemic
- “and sex”: https://www.publichealth.columbia.edu/public-health-now/news/abstinence-only-education-failure
- “70,000 Americans”: https://www.hhs.gov/opioids/about-the-epidemic/index.html
- “1,300 Georgians”: https://dph.georgia.gov/stopopioidaddiction
- “needle exchange programs”: https://opioid.amfar.org/indicator/SSP_legality
- “Only New York”: https://www.nytimes.com/2021/11/30/nyregion/supervised-injection-sites-nyc.html
- “legalized marijuana”: https://disa.com/map-of-marijuana-legality-by-state
- “fewer opioid-related deaths”: https://www.bmj.com/company/newsroom/legal-cannabis-stores-linked-to-fewer-opioid-deaths-in-the-united-states/
- “states like Georgia”: https://gdna.georgia.gov/press-releases/2017-06-26/governor-deal-signs-naloxone-bill-law-expanding-access-emergency-tool
- “expanded the accessibility”: https://www.11alive.com/article/news/health/fentanyl-testing-strips-accessible-georgia-kemp/85-134c5061-2773-44be-969e-adc76eaa610c
- “480,000 Americans”: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/index.htm#:~:text=Cigarettes%20and%20Death,-Cigarette%20smoking%20causes&text=Cigarette%20smoking%20is%20estimated%20to%20cause%20the%20following%3A&text=More%20than%20480%2C000%20deaths%20annually,including%20deaths%20from%20secondhand%20smoke
- “12,000 Georgians”: https://dph.georgia.gov/chronic-disease-prevention/tobacco
- “95 percent less dangerous”: https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review/evidence-review-of-e-cigarettes-and-heated-tobacco-products-2018-executive-summary
- “more popular tools”: https://www.bmj.com/content/358/bmj.j3262
- “more effective cessation tool”: https://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used
- “outlaw all e-cigarettes”: https://www.bbc.com/news/business-48752929
- “ban e-cigarette flavors”: https://fox5sandiego.com/news/politics/city-council-votes-to-ban-sale-of-flavored-tobacco-products/
- “here in Georgia”: https://www.legis.ga.gov/legislation/60147