A recent article by Dr. Joanna Cohen published in The Hill, incorrectly villainizes the tobacco harm reduction movement. It is highly telling that in her opinion piece against reduced risk tobacco alternatives (Big tobacco is trying to hide its greed behind ‘harm reduction’, March 15), Dr. Cohen fails to cite medical literature, instead resorting to fear of “big tobacco” and ad hominin attacks. 

It is a simple fact that the medical literature overwhelmingly shows the power of alternative nicotine delivery systems to save lives. Morality from smoking is not caused by nicotine, rather by the thousands of toxic chemicals released by the process of combustion. By removing combustion, this process no longer occurs. As a result, the most comprehensive analysis of hundreds of studies, commissioned by the UK Government, and replicated multiple times shows that they are “at least 95% safer than smoking.”  A comprehensive analysis of nicotine product harm estimates that e-cigarettes expose users to just 4% of the harm of combustible cigarettes. Vaping has been endorsed by over 100 of the world’s leading public health organizations as safer than smoking and an effective way to help smokers quit. These products are a safer nicotine intake alternative then deadly cigarettes. 

Similarly, while Dr. Cohen suggests other nicotine delivery systems exist, the Cochrane review, considered the gold standard of medical metanalysis, found with “high certainty evidence that nicotine e-cigarettes are more effective than traditional nicotine-replacement therapy (NRT) in helping people quit smoking”. This is clear, irrefutable evidence that the nicotine products she prefers are simply not as effective at saving lives compared to e-cigarettes. Georgetown University Medical Center has estimated that if as majority of US smokers made the switch to vaping, up to “6.6 million lives” could be saved.

Meanwhile, the prohibitionist policies supported by Dr. Cohen have only one real world effect – to increase the number of people smoking and dying as a result. As Yale University’s Professor Abigail Friedman’s research shows, vaping flavor bans simply increase youth smoking.

FDA’s Center for Tobacco Products Dr. Brian King recently acknowledged the public health failure  that misinformation about vaping has caused, and the  fact many adults who smoke are unaware of the relative safety of nicotine vapes compared to combustible cigarettes.

While referring to what she considers effective harm reduction strategies Dr. Cohen states, “increasing the price of tobacco products, and establishing 100 percent smoke-free public spaces”. These policy ideas do not work. Smoking prohibitions lead to impactful decreases in tax revenue while encouraging criminal smugglers to infiltrate borders to fill the demand for these products. 

Rather than relying on negative perceptions of tobacco companies, spreading fear through  rhetoric devoid of content, and sharing thoroughly debunked myths about formaldehyde, Dr Cohen should follow the science and embrace proven, data-driven harm reduction policies which include encouraging smokers to switch to reduced risk products.