People who use nicotine have earned a reputation for pushing back against flavor bans, new taxes, registry bills and other restrictions on access. To people outside that community, the resistance seems irrational. After all, over a billion people worldwide still smoke, and up to half of them will die early from smoking-related causes. Why would anyone fight measures meant to save lives? The answer is simple: Many measures are no longer about saving lives; they are about abstinence.
For some harm reduction advocates, it’s about personal freedom—the simple belief that what people choose to do with their own bodies is no one else’s business. But for most of us, the story runs deeper.
Millions of people who once smoked have already achieved the public health goal of quitting combustible cigarettes. They’ve done it not by quitting nicotine, but by substituting vapes, pouches or other smoke-free nicotine alternatives. They shouldn’t be required to give up the very thing that helped them first to quit smoking, and then to stay quit.
Tobacco control, however, has moved the goalposts. The mission that once centered on ending the death and disease caused by smoking tobacco has shifted toward eradicating nicotine itself. Nearly every product containing nicotine—even those that contain no tobacco, indeed even those in which the nicotine is synthetic, not tobacco-derived—is now classified by regulators like the United States Food and Drug Administration as a “tobacco product.”
The message is clear: Quitting smoking isn’t enough, unless you also quit nicotine.
Tobacco control has moved the goalposts. To those who’ve switched, this shift feels like betrayal.
Public discourse primarily focuses on youth initiation of vapes and pouches. The word “epidemic” is tossed around like New Year’s Eve confetti. Little or no concern is shown for the young people who smoke (though their numbers have plummeted since the advent of vaping), nor for the older people in their lives who still smoke in large numbers. The broader picture of a continuum of risk, from lethal cigarettes to much safer smoke-free options, is barely acknowledged.
To those who’ve switched, this shift feels like betrayal. They watch the spread of regulations that make it easier to buy cigarettes than to access safer alternatives, and they can’t make sense of it. If the goal is saving lives, why target what reduces harm? For them, resisting these policies isn’t defiance, it’s survival.
And when the goal keeps moving, compromise becomes impossible. There’s no agreed-upon endgame, no shared destination. Every concession to the tobacco control lobby, such as raising the purchase age, banning specific devices and restricting flavors, has been met with new demands. Those who hoped that one more regulation would calm the panic around vaping now see that each new restriction only strengthens the drive for prohibition.
This loss of trust goes beyond policy; it’s personal. People who use nicotine are outnumbered and outspent by the well-funded campaigns to eliminate the products they rely on. But they don’t give up. They know what switching has meant for their health and their families. They want others who still smoke to have that same chance.
What they face instead is stigma. They’re accused of being “shills for Big Tobacco,” of trying to “hook kids,” of spreading misinformation. The irony, of course, is that much of what they hear said about themselves and about harm reduction products, whether through ignorance or malice, is factually wrong. But stigma is powerful. Once it takes hold, facts rarely matter.
The social cost of that stigma is steep. Many describe losing job opportunities, facing higher insurance premiums, or receiving inferior medical care once providers learn they use nicotine. Online, they are moralized at, and mocked. In 2014, advocate Michael McFadden created The Wall of Hate, a poster composed entirely of real online comments about people who smoke, lines dripping with contempt and ridicule. That hostility has since expanded to anyone who uses nicotine at all.
For those in harm reduction, the most discouraging part is exclusion. People with lived experience rarely have a seat at the table. They’re absent from World Health Organization discussions, from FDA hearings, and even from academic conferences about nicotine policy. Decisions about their health are made without them in the room.
Some of us know that if the products we rely on are banned, we will go back to smoking, and we refuse to accept that risk quietly.
That’s beginning to change. Several conferences that are neutral or supportive of harm reduction have started inviting people with lived experience to speak. On October 28, I’ll join the Food and Drug Law Institute’s Tobacco and Nicotine Products Regulation and Policy Conference in Washington, DC, and participate on a panel dedicated to people who use nicotine. I’ll be honored to represent the millions whose voices are seldom heard.
I plan to talk about why we resist—why flavor bans, tax hikes and access restrictions are punitive, not protective. I’ll show what stigma looks like in real life and why seeing people, not just numbers, matters. My hope is that attendees leave with empathy and perhaps a renewed commitment to the original mission: ending death and disease caused by smoking.
What appears as resistance is, for many, self-preservation. Some of us know that if the products we rely on are banned, we will go back to smoking, and we refuse to accept that risk quietly. When policies make it easier to keep smoking than to stay smoke-free, we have no choice but to fight them.
We’re not fighting against public health; we’re fighting for it. We want sensible regulation, not prohibition. We want truth, not fear. And we want to return to that once-shared goal that everyone in tobacco control, public health and harm reduction can and should agree on: saving lives.
Image via the Change.org petition “Stop the Vape Ban in Mississippi”
