Ask any doctor what they would recommend if a patient of theirs who felt compelled to use a drug with proven health risks asked whether it would be better to take another drug which made them feel exactly the same but was a lot safer. Odds are the doctor would suggest switching.
Now ask them about smoking and e-cigarettes and the answer might change.
Though many doctors are coming around the health community as a whole is still experiencing a bizarre disconnect when it comes to nicotine. You can’t even call it cognitive dissonance because they don’t seem to experience any anxiety from endorsing harm reduction in general while rejecting it when it applies to smokers.
A few years ago at a small meeting held at one of the conferences of what used to be called the International Harm Reduction Association I witnessed a similar occurrence which given the context was even more disturbing. The meeting had arisen due to certain influential elements within the organization who wanted to eliminate tobacco harm reduction from their community.
It was very strange to see individuals who had supported safer sex, safer drug injection practices, and safe injection sites, practically foaming at the mouth at the thought of promoting tobacco harm reduction. One of the central objections was that one avenue of harm reduction, smokeless tobacco, was produced by tobacco companies, and these same people who would, if it improved the likelihood of safer practices, collaborate with drug producers and dealers, with difficult anti-democratic bureaucracies, and with pimps, would rather cut off their own hands than join with tobacco companies to find a solution.
When the people who are on the front lines of the battle reject what should be contiguous with their own goals (reducing the harm in risky practices) you have to be concerned about the average public health official.
I don’t want to be entirely negative here. I believe the tide is turning and to a great degree because e-cigarettes arose independently of the tobacco companies. However the companies are buying into the e-cigarette market and you can expect the objections to increase in number.
Most of these objections will be of the “just a way of maintaining nicotine addiction” nature. But guess what – along with the independent e-cigarette companies these “evil” folks are taking pretty well all the harm out of using nicotine. The addiction was never really the issue.
The anti-nicotine forces like to promote the idea that there is something special about smoking, nicotine and tobacco companies.
Smoking is just another popular behavior with some safer satisfying alternatives available. Nicotine is just another drug like caffeine that feels good enough to make a difference but not so good that it disrupts the rest of your life. And tobacco companies are no different from any other large corporations that will do anything to keep customers.