harm reduction

There is a stunning lack of practicality in modern-day America. This is reflected not only by our hyperpartisan politics -- in which politicians refuse to endorse good ideas if they come from the "other side" -- but in the never-ending culture wars.

Previously, the culture wars focused on topics such as gay marriage and abortion, but recently, it has shifted to things like sugar, "chemicals," obesity, and smoking. There is a large contingent of Americans who believe they have the right to dictate what you put into your body. Worse, some pass moral judgment on people who do not share their lifestyle. Smokers aren't simply engaging in harmful behavior; instead, they're fundamentally bad people.

Such beliefs appear to be gaining popularity. A...

There's no doubt about it. E-cigarettes have the potential to save millions of lives.

What makes smoking so dangerous isn't the nicotine, per se. Nicotine is an addictive alkaloid, just like caffeine. (Believe it or not, plants produce both compounds because they are insecticides.) The addiction makes people want more tobacco, but the molecule itself isn't all that harmful.

Tobacco is lethal because of the smoke. A lit cigarette releases known chemical carcinogens and tiny bits of particulate matter, which are incredibly damaging to the lungs. Setting anything on fire, not just tobacco, and inhaling the fumes is a bad idea. That's why innovative ways to get...

Philadelphia, the city with one of the highest incidences of drug overdoses, announced yesterday support for “comprehensive user engagement sites”– a facility where drug-addicted individuals can use their drugs under the nominal supervision of nurses. Referrals can be made for addiction services.

While the media outlets have all widely broadcast their decision, a closer look indicates that Philadelphia has “yet to announce a framework for overseeing the program, potential locations, or a timeline for when sites could open.” I found no information on funding at all, so the announcement is perhaps at best a trial balloon and signal of intent. City officials are clear that this is just part rather than a complete solution; it is a harm-reduction strategy. Philadelphia’s decision is...

Scientific Reports published a paper on reducing medical radiation dosages, CT dose reduction factors in the thousands using X-ray phase contrast by Marcus Kitchen et. al. It is fairly technical -- more about physics and algorithms -- but it could be a very big deal. 

One of the difficulties in producing readable CT studies is that our soft tissue (everything except the bones) has similar density, so X-rays penetrate these tissues pretty much equally, and it is hard to distinguish one from another. There are a variety of techniques to improve differentiating these tissues and their anatomic relationships. The breakthrough reported here is that using a new algorithm defining edges, densities, and the like,...

Like most topics in America these days, e-cigarettes are controversial. The reason stems largely from the fact that the debate is driven less by science and more by religious zealotry.

On the one side is the pro-vaping lobby, who seems to believe that e-cigarettes are the greatest invention since the wheel. Not only are e-cigarettes effective for quitting smoking, they are safe and fun.

On the other side is the prohibitionists, who believe that the mere thought of vaping is blasphemous. According to them, e-cigarettes are just as bad as tobacco, and therefore the only acceptable public health policy is total abstention.

Both sides are wrong. While the vapers are right that e-cigarettes can help smokers quit, it is unlikely that they are as safe as breathing fresh...

As a physician, I can unequivocally say that about 70 percent of the illnesses I have encountered has been either directly or indirectly related to cigarette smoking.  It is without a doubt an awful habit, and one whose psychological grip on the user is frighteningly powerful.   

At the American Council on Science and Health, we have always championed measures that improve public health outcomes – chief among them, advocating the use of electronic cigarettes.  We have written countless articles on the utility of e-cigarette use and its role in harm reduction.  This is why it was with great excitement when I read the new ...

E-cigarettes are "effective in helping people quit smoking" and "95% safer than smoking."* Additionally, there are "no health risks to bystanders."

What evil, conniving, greedy, Big Tobacco-loving, propaganda-spewing group of shills says that? The UK's National Health Service (NHS).

On its website, the NHS discusses a report issued by Public Health England (another UK government agency) that examined the available evidence on e-cigarettes. The report is unambiguous in...

The King County Health Department, which serves mostly the city of Seattle and its suburbs, has recently earned a reputation for being driven by politics rather than by evidence-based medicine or common sense.

Last month, the county decided that crisis pregnancy centers that don't perform abortions aren't "real healthcare." According to its website, Care Net -- a crisis pregnancy center in the Puget Sound region -- performs pregnancy tests, STD screens, and ultrasounds and provides prenatal education. Because such crisis centers are often faith-based, what they don't do is perform or encourage abortions.

That's anathema to Seattle, a city whose residents and politicians have little use for religion or...

Under the new director, Dr. Scott Gottlieb, the Food and Drug Administration just announced a new "comprehensive regulatory plan" to decrease the plague of tobacco-related deaths. While we're pleased to see the FDA continue to pay attention to this totally preventable cause of death, we're not sure that the steps they've outlined will all be effective in doing so.

One of the more questionable aspects of the new plan is the possible encouragement of producing cigarettes with lower nicotine levels as a way to make them less addictive. While we certainly agree that nicotine is highly...

Nicotine is one of the most addictive and widely used drugs in the world, bar none. And that's a big part of why it's so difficult for smokers to quit cigarettes. Of course, that's not the whole story, since there are replacement products that supply the drug without the damaging effects of inhaling smoke. However, these don't seem to be as satisfying since they don't mimic the movements and mode of nicotine delivery that accompany cigarette smoking.

Enter the electronic cigarette, or e-cig. The device can look like a cigarette (or cigar or pipe), but instead of burning tobacco, it provides a nicotine-containing vapor that the user inhales, thus getting a "hit" in the same way one would get from smoking. So, as a harm-reduction tool — to get smokers away from the deleterious...