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March 19, 2018

According to a recent survey, a “majority of adults erroneously link nicotine to cancer.” The findings reveal a majority of Americans incorrectly believe that nicotine causes cancer and other health risks. These widely-held, false notions regarding the adverse health effects of nicotine may undermine its presence in tobacco harm reduction (THR) products, such as smokeless tobacco, heat-not-burn products, and electronic cigarettes. Since their introduction, THR products have helped millions quit smoking more-detrimental combustible cigarettes.


Researchers at PinneyAssociates, a pharmaceutical research firm, analyzed data from the 2017 health information national trends survey and found 53 percent of respondents “said they believe nicotine causes most of the cancer related to smoking.” Lead author of the study, Karen Gerlach, urged public health officials to properly educate “the public, especially smokers, that nicotine is not what is causing smoking-related disease.”


Public misperceptions concerning nicotine overlooks overwhelming research on one of the most intensively studied drugs in history. Nicotine, while addictive, is not considered a “highly hazardous drug.” Nicotine neither causes cancer nor plays any significant role in pulmonary or cardiovascular diseases. Nicotine is a mild stimulant, similar to coffee. Both substances are derived from plants and both are addictive and cause unpleasant side effects through abstention.


The negative effects of tobacco use “are caused primarily by exposure to combustion products of tobacco.” It is the combustion process that creates the cancer-causing chemicals linked to cigarette use. More so, evidence suggests “total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers.”


To avoid the health risks of combustible cigarettes, smokers are increasingly turning to THR products because they deliver nicotine with significantly less health hazards compared to combustible cigarettes.


A 2009 BioMed Central study analyzed “the relative risk of cancer and smokeless tobacco users, compared with non-users of tobacco,” finding “very little evidence” of smokeless tobacco producing a greater cancer risk.


Dr. Brad Rodu, a senior fellow at The Heartland Institute, has studied smokeless tobacco for over 20 years. According to his research, smokeless tobacco, such as snus, is “at least 98 percent safer than smoking, even though most Americans are misinformed about the differences in risk.”


Research on e-cigarettes and vaping devices continues to provide evidence that these products are effective tobacco harm reduction tools. In 2016, the Tobacco Advisory Group of the Royal College of Physicians concluded that health risks associated with e-cigarette use were “unlikely to exceed 5% of the harm from smoking.” Public Health England, in 2015, declared that e-cigarette use “is around 95% safer than smoking.”


In January 2018, the National Academies of Sciences, Engineering and Medicine found that e-cigarette use resulted in “reduced short-term adverse health outcomes in several organs.” Further, the American Cancer Society noted in 2018 that the “currently available evidence, using current generation e-cigarettes is less harmful than smoking.”


While THR products have proven to be effective agents for smoking cessation, policy makers still treat smokeless tobacco and e-cigarettes in the same manner as combustible cigarettes. Unfortunately, this adds to THR fearmongering and aids in the public’s ongoing misperception of nicotine use.


Thirteen states and over 700 municipalities classify electronic cigarettes and vaping devices as prohibited products in smoke free laws. All states have “at least some tax on non-cigarette tobacco products.” Such policies help demonize the role of nicotine, even though these products have proven to be effective alternatives to smoking combustible cigarettes.


Law makers should encourage policies that promote, or at a minimum, not discourage the usage of THR products. As the recent PinneyAssociates study indicates, many Americans are ignorant of the health risks associated with nicotine use. Such opinions could hinder the public health rewards e-cigarettes and smokeless tobacco products provide for millions of cigarette smokers.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute or Tobacco Harm Reduction 101.

Centers for Disease Control and Prevention Link Majority of Vaping-Related Hospitalizations to THC: Welcome
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