Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis

Abstract

The growing use of e-cigarettes has been condemned as a significant health crisis by some and welcomed as an unprecedented opportunity to eliminate combustible tobacco by others. Seeking to better understand the contestation and range of perspectives on this issue, this article employs an interpretivist approach to identify how experts communicate their perspectives on these issues. This debate is examined through interviews with twenty one tobacco and harm reduction experts. Our findings indicated that the majority of meanings attached to tobacco harm reduction were rooted in values, ideology, politics, and opinions, rather than straightforward disagreements about the scientific evidence. Respondents had different ideological positions on the War on Drugs, the role of the private sector and the tobacco industry, social justice principles, the inevitability of nicotine use, and the acceptability of addiction. Throughout, experts struggled and disagreed with precisely where and how to define “harm reduction." Overall, this study significantly expands on past literature by delving more deeply into the broader ideological contexts in which these policy disagreements occur, and the argumentative strategies employed within them.