Tobacco Asia

14 tobaccoasia Issue 3, 2026 May / June TA: Those studies you mentioned, they are not just fringe findings, but they are mainstream established findings, right? CG: Yes, absolutely. They have nothing to do with tobacco control. It's really just looking at the psychoactive effects of nicotine patches on people with some neurodiversity conditions. There are other potential positive benefits, including weight loss and ulcerative colitis, which is an extremely painful disease, where nicotine can help reduce symptoms. We've known that for decades. And the reason is that nicotine is -- among other things -- an immunomodulator. It reduces inflammation. Nicotine is also helpful for some people with rheumatoid arthritis. The list goes on, but all of these things have been swept under the rug because we've decided to demonize nicotine. TA: Nicotine also seems to help people to focus better and be more alert… CG: This goes back to the foundational research on nicotine. There is no argument that nicotine, first of all, is psychoactive. It's dependence-form- ing – for some people more than others – and it has psychoactive effects. Like caffeine, it increas- es focus, attention, and memory. But unlike caffeine, it also reduces stress and anxiety and possibly depression as well. And so, not surpris- ingly, some people find those effects pleasurable. TA: And still, there are the critics who continue warning about nicotine. How do we achieve de-demonizing this substance? CG: I think we maybe should take some hints from the field of cannabis activism, which helped tilt the needle of public opinion by getting testimonies from people recovering from chemotherapy, who said that cannabis helped them. Well, we have even more people – tens of millions – who have quit smoking with safer nicotine alternatives like vapes and nicotine pouches. There is no shortage of older people in their 40s, 50s, and 60s who will be able to tell the public: "I tried everything to quit smoking. I tried patches. I tried gum. I tried counseling. I tried acupuncture. And nothing worked until I used a nicotine vape." We need to get their voices and their faces in front of the public so they can see that it's not just teens that are using these products. In the United States, there are 21 million adults vaping nicotine right now -- versus 1.4 million teens. TA: But what about "protecting the children?" CG: Well, anti-tobacco organizations like the Campaign for Tobacco Free Kids and Truth Initiative, they always hire teenagers to get their message to state legislators to beg for the prohibition of safer nicotine alternatives. But it must be getting harder and harder for them to find kids who can honestly say they're addicted to nicotine because of vaping. The numbers don't add up. Teen nicotine vaping in the United States has dropped 74% over the past 6 years, and it's at a 12-year low now. And the use of any nicotine product in the United States is now at a 50-year low. TA: Nicotine alternatives are valuable tools for harm reduction. We have established that. So why is harm reduction by using nicotine delivery alternatives such an important lens here? CG: We deal with risks in life all the time. Driving a car can be dangerous, so we use harm reduction products called seat belts and airbags. These don't prevent death, they don't prevent all harm, but they reduce the risk of harm. If you ride a bicycle, it's potentially risky, as you could be involved in a traffic accident or a fall. So we have a consumer harm reduction device called a bicycle helmet. We don't prohibit sex to prevent HIV and other STDs. We promote condoms to reduce the risk of transmission. This is harm reduction. It's not meant to be 100% safe. But it is safer. Almost nothing in life is 100% percent safe. Keeping nicotine demonized undermines harm reduction and it keeps smokers trapped in the most dangerous form of nicotine delivery, combustible tobacco products. The demonization of nicotine sort of makes logic fly out the window. TA: Tobacco control doesn't seem to see it that way, given all those bans on reduced risk products around the world… CG: If you are part of what I call "old school tobacco control," you are "on the side of good and light," and anything the tobacco industry does and says is "evil and a lie." The world just doesn't work that way. It's not all black and white. There are nuances. The whole industry of nicotine and tobacco is changing dramatically, but "old school tobacco control" isn't ready for the paradigm shift yet. It's still stuck back in the 1990s or earlier. It's almost a cult-like condition, where products that are not tobacco products are called tobacco products, where liquid aerosol is called smoke, and where preventing nicotine now has a higher priority than preventing death. Nicotine is not the enemy. Cigarettes are. "We don't prohibit sex to prevent HIV and other STDs. We promote condoms to reduce the risk of transmission. This is harm reduction." —Gardner

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