Combustion vs Nicotine: Expert Advocates for Tobacco Harm Reduction

Dr. Diego Verrastro, a physician and co-founder of the Latin American Network for Tobacco Harm Reduction (RELDAT), has urged global health authorities to differentiate between nicotine addiction and the lethal effects of tobacco combustion. Speaking on the Argentine radio program Nada sucede dos veces, Verrastro argued that embracing harm reduction could save millions of lives worldwide.

“People smoke for the nicotine, but they die from the smoke,” Verrastro noted, quoting the famous maxim by tobacco research pioneer Dr. Michael Russell. He clarified that while nicotine is the addictive component, it is not the direct cause of cancer or chronic obstructive pulmonary disease (COPD).

Combustion vs. Non-Combustion

The fundamental difference between traditional smoking and alternative nicotine delivery systems lies in how the substance is consumed. When tobacco is burned, it creates a toxic slurry of chemicals. In contrast, smoke-free alternatives eliminate combustion entirely.

Traditional Cigarettes (Combustion)	Harm Reduction Alternatives (Non-Combustion)
Generates ~6,000 toxic substances and ~1,500 carcinogens.	Eliminates smoke, reducing toxic exposure by up to 95%.
Directly responsible for high rates of cancer, cardiovascular diseases, and COPD.	Utilizes controlled nicotine delivery (vapes, heated tobacco, pouches, patches).
Affects bystanders through secondhand smoke.	Significantly minimizes environmental and secondhand exposure risks.

The UK Model as a Public Health Blueprint

Verrastro highlighted the United Kingdom as a prime example of progressive public health policy. In the UK, stop-smoking clinics within hospitals actively distribute free vapes to smokers, and pregnant women who struggle to quit smoking are encouraged to switch to e-cigarettes to mitigate gestational risks.

However, Verrastro expressed skepticism toward extreme policies, such as lifetime bans on purchasing tobacco for generations born after a certain year. He warned that absolute prohibitions often backfire, fueling illicit black markets and infringing upon individual adult liberties.

Protecting Youth While Preserving Adult Choices

Addressing the rise of youth vaping, Verrastro insisted on clear boundaries. “The message has to be clear: if you don’t smoke, you shouldn’t vape,” he stated. He called for comprehensive training for parents, teachers, and healthcare professionals to address youth curiosity without resorting to outright bans that push products underground.

“The more tools doctors have, the better they can tailor treatments to individual patients,” Verrastro concluded, emphasizing that a smoke-free future requires pragmatic, diverse solutions rather than dogmatic restrictions.

Source: Vapeadores, nicotina y cigarrillos: el debate mundial sobre qué hace más daño

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Matthew Ma

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With over a decade of experience in the e-cigarette industry, Matthew Ma is a seasoned expert in both the manufacturing and usage aspects of vaping products. His extensive background has provided him with a deep understanding of the intricacies and evolving dynamics of e-cigarettes.