Tobacco harm reduction: the devil is in the deployment

Abstract

First paragraph: The idea of tobacco harm reduction -- that smokers who cannot wean themselves off nicotine should be encouraged to adopt less harmful ways of consuming it -- has much to recommend it. It avoids the trap of making the excellent (complete cessation) the enemy of the good (reduced harm) and provides a way forward where otherwise there is only a cruel impasse. It also provides a clear focus on disease and premature death -- rather than tobacco addiction or corporate power -- and this enemy, like so many medical problems before it, will be defeated with rigorous evidence, effective medicines, and skilled treatment.