Smoking, No, Nicotine, Maybe Smoking, No, Nicotine, Maybe

The diminishing returns of the anti-tobacco ­campaign. 
FEB 27, 2012, VOL. 17, NO. 23 • BY ELI LEHRER • The Weekly Standard

If there’s one perfectly safe conclusion to draw from nearly a century of public health research, it’s this: Cigarette smoking is really, really bad for your health. An unusually complete, if rather obvious, 2010 Surgeon General’s Report on the topic shows that inhaling tobacco smoke not only causes lung disease but also leads to increased risks of stroke, heart attack, and dozens of other maladies. As a result, it’s not surprising that 38 states (sin-happy Nevada among them) and countless localities have enacted various smoking bans while advertisements, public health campaigns, and tax policies send a simple message: Smokers must quit all tobacco use or die early, painful deaths.

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But public health crusaders haven’t stopped at fighting smoking: Bans on smokeless tobacco use, e-cigarettes, and outdoor smoking have gone into force in locations ranging from the University of Texas’s Arlington Campus (all tobacco), to Boston (e-cigarettes). A growing body of research, however, reveals that the shun-tobacco-or-die dichotomy is an oversimplification. In fact, there’s significant evidence that the act of inhaling burning plant matter does much of the harm while the addictive substance in question (nicotine) and the plant itself (tobacco) are a mixed bag. Public health policy may be better served by a harm reduction strategy that continues efforts to discourage smoking while trying to steer tobacco and nicotine users towards safer forms of the substances.

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