Back to the Basics: Is Nicotine Really the Enemy? Understanding Nicotine Use in Tobacco Harm Reduction

The reality of nicotine in harm reduction and how vaping and nicotine pouches are part of the solution

When approaching tobacco control and smoking cessation, nicotine is often seen as much of a villain as tobacco. This approach immediately invalidates any support for products such as vapes or nicotine pouches, where nicotine is often a major component. However, this is simply not the case. Rather than nicotine, it is the tar that is released from burning tobacco in cigarettes that causes the majority of smoking-related death and diseases – including cancer, COPD and respiratory conditions. Although not wholly risk-free, nicotine does not cause any serious illnesses and has been widely sold medicinally under the name of Nicotine Replacement Therapy (NRT) for decades, of which the nicotine patches are well known as a successful quitting tool. 

A key part of this differentiation is the presence of tobacco and the way it is ingested. In traditional cigarettes, tobacco and other carcinogens go through a process of combustion, which increases their harm. Alternatively, forms of nicotine, when separated from tobacco and the process of combustion, are 99.75% less risky than smoking cigarettes – as seen with vaping and nicotine pouches in a study by Murkett, Rough and Ding. Public Health England also finds vaping to increase the success of quitting by one and a half times. This shows how vital it is to understand the concept of reduced risk and the risk continuum – a scientific method that helps classify the harm of various tobacco and nicotine products. By doing so, it is clear to see that the enemy is not nicotine but the misinformation around it that stands in the way of positive change.