Methadone Clinic Abolition Collective (MCAC)

academic.oup.com/ntr/advance… One of the more interesting vaping studies this year looked at smokers who specifically said they were interested in cutting down, but not quitting. That matters, because public health often behaves as though somebody either wants to quit today or has somehow failed the test. In this trial, smokers who managed to reduce their cigarette consumption by at least 50% within the first two weeks had around 6.5 times the adjusted odds of being smoke-free at 24 weeks. The same pattern appeared when reduction was measured objectively using exhaled carbon monoxide rather than simply asking participants how much they smoked. This does not prove that cutting down causes cessation. It was an exploratory analysis and early reducers may differ from other smokers in ways that help explain the result. For some smokers, cutting down may be the beginning of quitting. That is particularly important for people who have no immediate intention of becoming abstinent. Telling them that only complete cessation counts risks ignoring the behavioural pathway that may eventually get them there. Perhaps the question should not always be: “Are you ready to quit?” Sometimes it should be: “What would help you smoke less today?” Because for some people, less smoking today may be the first step toward no smoking tomorrow.

Tobacco harm reduction begins with one uncomfortable truth: People do not have to become perfect before they deserve to become safer. If someone cannot or does not stop using nicotine, we should still celebrate every cigarette they leave behind. Public health should never make abstinence the price of compassion. The goal isn't to win a war against nicotine. The goal is to stop people from dying from smoke.