Setting the agenda for tobacco harm (reduction) research

The scientific agenda for research on reduced risk tobacco products remains splintered and counterproductive. This is because stakeholders have different goals in mind for what research ought to be able to demonstrate and which positions it should support. Tobacco and nicotine companies, naturally, hope to demonstrate that new, alternative products, compared to cigarettes or other combustibles, carry less individual health risks. Regulators more or less are open to harm reduction science, but have not been clear on defining what types of methods and evidence qualify. Regulators are also wary of potential risks because no tobacco or nicotine product is, strictly speaking, risk free. Tobacco control activists’ agenda is to demonstrate irredeemable harms attached to any and all tobacco or nicotine consumer products, or at least to raise sufficient doubts about potential future harms vs benefits. This has resulted in an asymmetric research agenda focused on harms not benefits. This agenda is driven by mythologies that perversely attract scientists’ attention yet cannot be adequately addressed within the scope of current scientific methods (e.g., the “gateway” hypothesis, nicotine-caused brain damage, e-cigarettes don’t help smokers quit). This has led to wheel-spinning and little forward progress. I will discuss ways that the scientific community can address these myths, reassert its scientific authority, and establish a positive research agenda moving forward.

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