It’s time to make room for vaping in the harm reduction tent

It’s taken a long time but when it comes to drug and alcohol addiction, the concept of harm reduction is increasingly accepted as both humane and an effective approach to addressing addiction by public health authorities and the general public.

Safe needle distribution. Condoms. Methadone maintenance programs. Naloxone kits. Managed alcohol programs. These are all examples of harm reduction initiatives that have been steered by dedicated front-line practitioners and gained the support of public health advocates and some governments, although there is still much work to do. But when applied to smoking, the concept of harm reduction has not yet broken through.

Today, we can confidently say that there is a product on the market that not only is less harmful than cigarettes but is appealing to smokers and helps them quit smoking. We are talking about vapour products or electronic cigarettes.

Public Health England’s 2015 e-cigarette evidence review (updated in 2018) stated: “Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95 per cent less harmful, and of negligible risk to bystanders.”

On this basis, public health authorities in England embraced these alternatives, going so far as to allow vape shops within hospitals and providing starter kits to help impoverished smokers cut back or reduce their smoking. A study in the journal Addiction estimated that the progressive vaping policies the UK has implemented over the years has helped over 50,000 people quit smoking in 2017 alone.

But instead of embracing these products to help improve the health of adult smokers, Canadian public health authorities and tobacco control advocates demonize and dismiss vapour products and the people who use them. In fact, in Canada the government is considering a ban on flavours and nicotine strengths, despite the fact that an overwhelming number of adult vapers report relying on these features to remain smoke free.

Why is Canada so hostile to tobacco harm reduction?

It probably boils down to a well-funded tobacco control lobby that is partially funded by pharmaceutical companies. Companies like Johnson and Johnson and Pfizer, to name a few, are heavily invested in the multi-billiondollar nicotine replacement therapy industry. Vaping takes aim at their dominance within the smoking alternatives market.

The media has also had a role by amplifying and exaggerating youth vaping numbers, billing the youth vaping problem as an epidemic. Youth vaping rates have doubled over the past few years, but pale in comparison to the regular rate of use of alcohol or cannabis and are certainly not in epidemic proportions. The best way to tackle youth vaping is to educate on its risks to the developing brain (although still a tenuous claim) and to enforce those laws that already exist which prevent access to the products. Instead, the government has introduced policies that threaten to make the product unsatisfying and unappealing to adult smokers.

It’s time to see tobacco harm in the same way as other harm reduction initiatives — as an opportunity to save lives. It’s time that the public empathize with adult smokers who are desperately trying to quit. Harm reduction is based on values in which all Canadians believe: respect, dignity, and above all, compassion.

Smokers deserve a choice of less harmful alternatives and should be encouraged to make a better decision.