Quitting cigarettes is one of the hardest things to do, as many former and current smokers know from painful personal experience. Public health and politicians must do better to help smokers quit. 700,000 deaths per year in the EU should be enough of an incentive to make us rethink our current approach.

To effectively help smokers quit for good, three conditions must be met:

Firstly, smokers must be able to choose from as many options as possible to find out what smoking cessation method works best for them. People are different, and therefore different ways to give up smoking must be made available and affordable. For very few people (less than 4%), quitting with no help works. For a few, nicotine replacement therapy (such as nicotine gums or patches) works, and it turns out that for many people, new nicotine alternatives help them with quitting smoking once and for all. Those products range from vaping and heat-not-burn products to snus or nicotine pouches. What all these new forms have in common is that they separate nicotine consumption from the combustion of tobacco (which produces the vast majority of the toxicity of smoking), making them far less harmful than smoking cigarettes. Each one is different, each working best for each different person.

62% of smokers in France and 53% in Germany believe anti-smoking policies ignore how difficult it is to stop smoking. Clearly, smokers are not satisfied with traditional cessation methods and therefore look to vaping as a means of quitting

Secondly, we need a modern, open regulatory framework to fit these new alternatives. These new products are not the same as smoking. Hence, they must not be painted with the same regulatory brush. What we need instead is risk-based regulation. Vaping is 95% less harmful than smoking and, therefore, must not be treated the same way. Harm reduction must become a centrepiece of anti-smoking policies, like in the field of pharmaceutical drugs. Harm reduction follows practical strategies and solutions to reduce harmful consequences associated with using certain substances instead of an unrealistic `just quit´ approach. Encouraging smokers who are not able to or don’t want to quit smoking to switch to vaping is a best-case example of harm reduction.

Thirdly, smokers must have accurate information about the potential risks of different products to make decisions. The same applies to medical professionals who are working with those smokers. They need to know the facts to make a lasting difference for smokers.

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The Consumer Choice Center, together with World Vapers’ Alliance, recently presented a new survey conducted with 30 general practitioners and over 800 smokers in Germany and France – with an initial piece of good news: more than half of respondents want to quit smoking!

Awareness of the health effects of smoking tobacco has grown exponentially over the last decades, prompting policy-makers to make rules to curb usage. However, just like any vice that carries risk, prohibitive and strict measures have not yielded the desired results.

Standard nicotine replacement therapy (NRT) is recognised, observed, and covered by social security systems, despite showing very limited effects in the efforts of helping those who choose to quit, do so. Vaping has presented consumers with the opportunity to satisfy the need for nicotine, all while posing a fraction of the harm. Vaping is 95% less harmful than using conventional cigarettes, and is simultaneously the most successful smoking cessation tool.

Knowing all this, we can say that vaping is to nicotine use what seatbelts are to driving or what condoms are to sexual encounters: while it may be safer to not use nicotine at all, not drive a car, or not have sex, it is crucial to apply harm reduction. Since the invention of the first e-cigarette in 2003, vaping has come a long way in offering a choice to smokers who wish to quit, and has done so with far less risks involved than cigarettes.

Unfortunately, accurate reporting on vaping is sometimes hard to find. A lot of readers might recall the spike in EVALI (E-cigarette, or Vaping Product, Use Associated Lung Injury) cases in the United States in 2019, which was blamed on vaping. To this day, these cases have disincentivised smokers from switching, even though it has been shownthat affected users had been consuming THC-containing e-liquids from the illicit market. Unbeknownst to buyers at the time, vitamin E acetate had been added to those liquids, with fatal consequences for those who consumed them. All the story really did was underline the importance of a regulated and legal market for vaping products, which prevents leaving the market to bootleggers.

When advocating for harm reduction, organisations such as ours don’t just run into media scare stories, but also into widespread misconceptions. The CCC/WVA survey showed that 33% of smokers in France and 43% in Germany believe vaping is as harmful or more harmful than cigarettes. The erroneous beliefs on nicotine stretch even further: 69% of smokers in France and 74% of smokers in Germany believe nicotine causes cancer, which is far removed from the scientific evidence. Experts on nicotine have long known this, yet the information has not permeated to the public, to politicians, or to general practitioners.

Doctors are essential change-makers when it comes to the unhealthy habits of their patients. However, our survey has shown that too many doctors share ill-informed views on nicotine, or aren’t even aware of the concept of harm reduction. As a result, most doctors do not recommend vaping as a smoking cessation tool. Their views on nicotine (they often believe it causes lung damage) is also fundamentally incoherent: if nicotine were to cause lung damage, why would doctors recommend NRTs, all of which contain nicotine?

Tobacco harm reduction has a long way to go before reaching the ambitious targets of large-scale smoking cessation. Information is therefore crucial: the demonisation of the most successful harm reduction tool needs to stop, and so do punitive rules and regulations. Vaping ought to be at the core of any upcoming policy changes designed to curb tobacco consumption, instead of being the target of overtaxation.

Originally published here