Reduced Harm Report

Posted 3rd May 2018 by Dave Cross
Substantial steps forward have been made in the understanding of the role vaping can play in reducing harm for tobacco smokers according to the latest review by public health academics. The paper addresses all of the criticisms of electronic cigarettes and cites useful resources to combat the negativity.

A quick glance at The Truth Initiative’s social media accounts is enough to convince the reader that the organisation is pretty anti-vaping. It has been very quick to join in with the anti-Juul hysteria, and so it is easy to understand how Brad Rodu once wrote about them: “Imprecision, hyperbole and cherry-picked data are the hallmarks of the well-funded and often taxpayer-supported tobacco prohibition movement. In the absence of truth and transparency, public health only suffers.”

Therefore, it is surprising to discover that two members of The Truth Initiative worked as part of a team to produce a report advocating an “evidence-based approach to tobacco control”, and one that recommended embracing “a harm minimization approach”.

The team included:

  • David Abrams, College of Global Public Health, New York University
  • Allison Glasser, Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative
  • Jennifer Pearson, School of Community Health Sciences, University of Nevada
  • Andrea Villanti, Vermont Center on Behavior and Health, University of Vermont
  • Lauren Collins, Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative
  • Raymond Niaura, College of Global Public Health, New York University

 “It is past time to add new and even radical approaches”

Referencing a 2016 paper by Britton, Bogdanovica, McNeill, and Bauld, they write that it is long gone time to think outside the traditional public health box – something Britain has been leading the way in for years – and they call for their peers to carry out a “re-examination of nicotine's role in society”, that “requires reconsidering the harm minimisation perspective within tobacco control”.

They begin by demanding that the Centre for Tobacco Products begins by honestly informing smokers about the relative harms of smoking and nicotine replacement products.

They also call for public health official to revisit what they think about nicotine: “Although nicotine use poses some risk for vulnerable groups, this risk is substantially lower than the risk posed by continuing to smoke cigarettes - Evidence also indicates that nicotine itself is relatively safe when obtained from FDA-approved NRT, which is widely used for smoking cessation.”

Commentary on vaping is positive and welcome. Even reference to formaldehyde is framed in the correct way: “Lab studies have documented some potentially toxic constituents in some devices, e-liquids, and flavours, especially when overheated to produce aldehydes (such as acrolein and formaldehyde),” but they correctly note that this comes about from “an acrid ‘dry puff condition’ unlikely to be tolerated by actual users.”

Section 3 deals with the gateway effect (“Existing studies show that current e-cigarette use by youth consists largely of experimentation, not long-term adoption”) and how the research is focussed on trying to find a link from vaping to smoking. The paper notes the opposite: “Recent data show that 87% of past 30-day e-cigarette users have previously used a tobacco product.”

It goes on to ask if vaping works – and the simple answer is ‘yes’: “Four randomised controlled trials (RCTs) and well-designed observational studies show that e-cigarettes are effective in helping some adult smokers successfully quit smoking.”


They conclude: “Harm minimisation is a pragmatic approach that can complement proven current tobacco control efforts of prevention and cessation.”

The paper uses a wealth of positive research and is easily navigable though a bar menu system here. It is also available as a free PDF download.


 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker