The health impact of smoking overwhelmingly comes from inhaling smoldering organic compounds.[1] There's no evidence that the psychoactive compounds in tobacco, including nicotine, has any impact on mortality[2].

At worst (smokeless) nicotine is no more harmful than caffeine. In fact nicotine appears to be neuroprotective against Alzheimers, Parkinsons, and general age-related cognitive decline[3].

[1]https://www.ncbi.nlm.nih.gov/books/NBK53014/ [2]https://www.gwern.net/Nicotine [3]https://www.tampabay.com/news/health/study-finds-nicotine-sa...

How does that line up with the fact that chewing tobacco is still associated with oral cancer?

Most preparations of chewing tobacco are smoke or fire cured. The process still introduces many of the byproducts that are created during the combustion of dried organic material.

The most prominent example of chewing tobacco that isn't smoke cured would be Scandinavian-style snus. There's pretty compelling evidence that snus is not associated with oral cancer[1], or at the very least the risk is substantially lower than traditional chewing tobacco.

[1] https://onlinelibrary.wiley.com/doi/full/10.1046/j.1360-0443...

There are a few meta-analysis about snus cancer risk. I think generally the opinion [1] is that while lower than other smoke-cured tobaccos, there still exists a non-zero risk for oropharyngeal cancer risk and statistically-valid increase in pancreatic and esophageal cancer risk compared to non-tobacco users. [1](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...)

Unless nicotine gum has a similar association, it's probably the same generic cause.

That may be carcinogenic in another way. It's my impression that nasally ingested dry snuff tobacco is not as strongly associated with cancer as smoked or chewed tobacco. That said, it's hard for me to trust anything I read suggesting that, since I can't rule out the possibility that the tobacco industry has corrupted anything I might read suggesting it.

https://en.wikipedia.org/wiki/Snuff_(tobacco)#Health

I agree with your second point, however, respectfully, your first point is incorrect (I was going to call it absolute bloody bullshit, but that would be the amphetamines talking).

Here's a better breakdown of carcinogens in cigarette smoke (same book, same author)[0]. The most lethal way tobacco smoking impacts health is through carcinogenic by-products created from metabolizing said tobacco.

"PAH, N-nitrosamines, aromatic amines, 1,3-butadiene, benzene, aldehydes, and ethylene oxide are probably the most important carcinogens because of their carcinogenic potency and levels in cigarette smoke."[0]

To elucidate on one of your points: nicotine isn't on any of the "carcinogens in tobacco" lists, because it, nor any of its metabolites, aren't carcinogens at any dosage that is practically applicable to humans.[1]

[0] https://www.ncbi.nlm.nih.gov/books/NBK53010/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/

> The most lethal way tobacco smoking impacts health is through carcinogenic by-products created from metabolizing said tobacco.

Maybe, we're misunderstanding each other. But all those compounds you listed are directly present in smoke itself. I.e. they're not metabolic byproducts.

In fact they're not even related to tobacco specifically. (With the major exception of N-nitrosamine). Cannabis smoke (gram for gram) contains equivalent of higher levels of PAH, benzene, 1,3-butadiene, aldehyde, and aromatic amines.[1] These are all pretty much universal byproducts of burning any type of dried plant material, and the same reason that exposures are similar for wood-burning fireplaces.[2]

[1] https://pubs.acs.org/doi/full/10.1021/tx700275p [2] https://www.epa.gov/burnwise/wood-smoke-and-your-health

You do not actually disagree with dcolkitt.

Right, but there are going to be other compounds released from this heatedtobacco product, most likely. Maybe not combustion products, but more than in (say) vaping.

how is that any different than alcohol? sugar? gambling? standing in the sun? how is that different from work? are you profiting off of the people that put together the building you are sitting in?

watching anyone die is hard. no matter what we do, it will probably have a factor in our death.

This is an incorrect way of understanding phenomena. You're essentially claiming that things are the same so long as certain elements of them intersect, regardless of the magnitude. Therefore we cannot distinguish between them.

I disagree they are claiming they are the same. They are instead claiming that these personal vices are not different enough to treat so different. It becomes difficult to discuss general vice freedoms when comparisons always devolve to complaints about the comparison meaning exact equality. This is especially true when it is in response to emotionally charged comments that are used to buttress the original argument.

I purpose the argument that our similarity function is ill equipped to differentiate those intersections in a meaningful way. I think this matters because it calls into question if our differential treatment is really, or is solely, based off of the results of the similarity function.

For example, while we can attempt to justify our reaction to weed by the harms it does, in light of the harms alcohol does and the treatment it gets, one wouldn't be wrong to wonder if our treatment of weed was tied to some other factor that we aren't willing to admit.

It's different because tobacco products were engineered for maximal chemical addiction.

So is fast food. So is Junk food. Casino's were designed with no windows or clocks so patrons would lose track of time while giving out free alcohol.

Casinos are regulated where permitted, and often flat out banned. "Sin taxes" for junk food (particularly soda pop) are becoming increasingly common.

Vice industries often point to each other when trying to justify themselves, which I suppose demonstrates that there is safety in numbers. The strategy of tackling one problem at a time is countered by demands for all-or-nothing tactics, with "all" being obviously and conveniently impractical.

Funny aside, you know what else is considered a "Sin Industry" by the US tax code? Golf Courses.

In some climates, environmentally, that might be a reasonable classification.

you mean like candy?

Or crack, heroin, meth?

The argument that anything can be bad so therefore nothing is bad is a meaningless slippery slope. Clearly there are differences and you have to draw the line somewhere.

The prevailing sentiment in my circle of friends is that substance addiction should be treated as a health, not a moral, issue. That lets us neatly draw the line at 'the user sought it out'. Health outcomes tend to improve under that kind of paradigm as well, so it's not just libertarian ideology either.

What's the rationale for drawing the line at a particular substance?

Do we also allow people to seek rotten meat, ineffective medications, or not wearing seatbelts?

There are known things we can do to substantially reduce harm to the public. It’s always a balancing act between a “parental gov” and individual liberty: there is no universal answer. But over time we learn as humans what we think those trade offs should be.

Note I’m not necessarily for making sins illegal personally, but I am for finding ways to regulate the hell out of them.

> Do we also allow people to seek rotten meat, ineffective medications, or not wearing seatbelts?

For the first two, we definitely do. No one says you can't let your meat rot before you eat it, and certain forms of rotten food are cultural delicacies. Most groceries have aisles full of ineffective junk medicine. Not wearing seatbelts I will grant you, although enforcement of those laws is generally very lax in my experience.

I strongly disagree with regulating them. Consumers should be given information to make a well informed decision, and then we should butt out. You don't want to wear a seat belt? It increases your risk of dying as a result of a crash by XX%. Go for it if you are willing to take that risk.

I don't feel right imposing my own personal values on someone else when their actions aren't harming others (which I know is somewhat debatable with seatbelts). Nothing makes me feel that my own values and morals are superior enough to force them on someone else.

This. Not to mention the public costs of dealing with the ill.

IMO the middle ground is to restrict the marketing, not the sale.

> "Do we also allow people to seek [...] ineffective medications,"

Not that I think we should, but we do. Grocery stores like Whole Foods have entire aisles dedicated to snake-oil.

FWIW those aren’t “medications,” they’re “supplements.” Regardless of the lack of regulating supplements being good or bad, it wasn’t what I meant in this case.

It seems to me that's just wordplay used to avoid regulation. These products are marketed in a way that suggests they might be used in lieu of regulated medicines.

What's unclear to me is if you are advocating for releasing addicts from jail (ideally compensating them for the misery caused by their incarceration), or throwing more people in jail?

If it's the former, I'm with you.

They profit because some people like to relax and have a smoke. With everyone knowing the health trade off now is there anything wrong with that?

I was at a tobacco company hq once. It surprised me to learn that almost everyone there smoked. A lot.