Recently, three researchers from the University of Pittsburgh in the United States pointed out in their research papers that e-cigarettes are far less harmful than cigarettes, and "e-cigarette availability" (ECA) should be used as a tobacco harm reduction strategy.

"Tobacco Harm Reduction Ethics: Analyzing the Usability of Electronic Cigarettes from the Perspectives of Utilitarianism, Bioethics and Public Health Ethics"

"E-cigarette availability" is a group intervention to encourage smokers to switch to e-cigarettes. It has two meanings: to make it clear to smokers that e-cigarettes are less harmful than cigarettes, and to ensure that they can easily get e-cigarettes.

The author of the paper pointed out that "e-cigarette availability" is supported by the two ethical frameworks of public health ethics and biomedical ethics. "E-cigarette availability" can help smokers reduce their health risks and hazards, and allow smokers to make health decisions on their own. This conforms to the principle of respecting individual rights and autonomy, and promotes social fairness and justice. At the same time, the use of "e-cigarette availability" to achieve public health goals is less restrictive than traditional tobacco control practices.

The biomedical ethics framework has proposed four principles, namely, respect for autonomy, benevolence (increasing the welfare of patients), non-maliciousness (avoid harming patients), and justice. E-cigarettes are far less harmful than cigarettes. If smokers switch to e-cigarettes, they can avoid the harm caused by traditional tobacco, so it conforms to the principles of benevolence and non-maliciousness.

More importantly, this program also fully meets the ethical needs of respecting the principle of autonomy.

Respect for autonomy refers to respect for the right of individuals to make informed decisions according to their own wishes. Providing smokers with e-cigarette products and e-cigarette harm reduction information can ensure that smokers make voluntary choices based on their own values and preferences without any coercion and deception, which is a manifestation of respect for the rights of smokers.

The public health ethics framework has always emphasized that the realization of public health goals should minimize violations of individual rights and freedoms. Even smokers who start to quit smoking in their old age have the right and freedom to pursue harm reduction. Their rights and interests also need to be protected.

"Everyone has the right to pursue their own definition of happiness. Regardless of whether a smoker decides to quit smoking or switch to electronic cigarettes, we should show respect." said Rebecca Thomas of the University of Pittsburgh, who is also one of the authors of this paper.

Since the individual rights of smokers should be respected, it is particularly important to provide accurate e-cigarette information to ensure that smokers make wise decisions.

Take the American lung disease reported by the media last year as an example. At that time, research confirmed that the cause of this incident was the use of black market smoke that was illegally added with THC (tetrahydrocannabinol, a high-concentration chemical extracted from industrial hemp). Oil has nothing to do with regular e-cigarettes. The CDC Center for Disease Control and Prevention once ignored the research conclusions and attributed the cause to ordinary e-cigarettes, and did not correct the relevant information until March this year.

The author believes that this approach seems to protect consumers, but in fact it does more harm than good: "Not only does it allow smokers who have switched to e-cigarettes to re-smoker, it also does not allow everyone to avoid the real culprit-black market THC products."

The public health ethics framework states that to achieve public health goals, the least restrictive interventions should be used. As far as the goal of tobacco harm reduction is concerned, the restrictions on the provision of e-cigarettes for smokers are less than the ban on the sale of e-cigarettes and all tobacco products, so they meet their ethical needs.

In addition, providing smokers with e-cigarette products and e-cigarette harm reduction information can also provide cheaper harm reduction programs for disadvantaged groups, reduce social health gaps, and promote social justice.

According to data from the World Health Organization, tobacco causes more than 8 million deaths every year, and tobacco harm reduction is imperative. "A large amount of evidence shows that e-cigarettes are much less harmful than cigarettes. Both the public health ethics framework and the biomedical ethics framework prove that the availability of e-cigarettes is ethical and is a beneficial measure. Therefore, smokers should be encouraged to switch to e-cigarettes." The paper pointed out.

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