Tobacco harm reduction: how rational public policy could transform a pandemic

Int J Drug Policy. 2007 Mar;18(2):70-4. doi: 10.1016/j.drugpo.2006.11.013. Epub 2007 Jan 5.


Nicotine, at the dosage levels smokers seek, is a relatively innocuous drug commonly delivered by a highly harmful device, cigarette smoke. An intensifying pandemic of disease caused or exacerbated by smoking demands more effective policy responses than the current one: demanding that nicotine users abstain. A pragmatic response to the smoking problem is blocked by moralistic campaigns masquerading as public health, by divisions within the community of opponents to present policy, and by the public-health professions antipathy to any tobacco-control endeavours other than smoking cessation. Yet, numerous alternative systems for nicotine delivery exist, many of them far safer than smoking. A pragmatic, public-health approach to tobacco control would recognize a continuum of risk and encourage nicotine users to move themselves down the risk spectrum by choosing safer alternatives to smoking--without demanding abstinence.

Publication types

  • Editorial

MeSH terms

  • Disease Outbreaks
  • Harm Reduction* / ethics
  • Humans
  • Nicotine / adverse effects
  • Policy Making*
  • Public Health
  • Risk Factors
  • Tobacco Industry / legislation & jurisprudence
  • Tobacco Smoke Pollution / adverse effects
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / prevention & control*
  • Tobacco, Smokeless


  • Tobacco Smoke Pollution
  • Nicotine