R Street Policy Study No. 179: Tobacco Harm Reduction: Evidence Update
WASHINGTON (Aug. 7, 2019) – As e-cigarettes and other reduced-risk products are gaining popularity, policy makers—domestically and abroad—are considering excessive restrictions or complete bans aimed to reduce use without regard to scientific evidence that supports their use as a harm reduction and public health tool. In the United States, the recent House Committee on Oversight and Reform hearing examining the production and marketing of e-cigarettes is likely to only further the gap between evidence on favorable outcomes for those who switch to reduced-risk products and excessive restrictions that will prevent their use.
In a new policy study, R Street Director of Harm Reduction Carrie Wade and R Street Research Assistant of Harm Reduction Chelsea Boyd recognize that it has been conclusively shown that the profile of dangerous constituents, including particulate matter, lack of carbon monoxide and HPHCs is much more favorable in e-cigarettes, heat-not-burn and snus products than in cigarettes. Unsurprisingly, the decrease in exposure to these constituents leads to positive health outcomes for smokers who switch.
Wade and Boyd go on to say that while there are valid concerns about poor cessation outcomes for those who switch from combustibles to alternative nicotine delivery systems (ANDS) and e-cigarettes acting as a gateway to combustible use for those who otherwise would not smoke, they are unfounded. The most recent and robust trials indicate that ANDS users are twice as successful in achieving abstinence and that e-cigarettes have not renormalized combustible cigarettes.
The authors conclude that placed in a broader context of comparative risk, e-cigarettes and other reduced-risk products are likely to gain much more support—to the benefit of those who try to quit combustible cigarettes, and perhaps even to those who might have otherwise gone on to smoke.