As a research psychiatrist who has spent most of my professional life looking for ways to mitigate the harms of addictive drugs, the concept of replacing a very harmful drug such as heroin with a safer one such as buprenorphine (Suboxone/Subutex) makes perfect sense. However when the same logic is applied in the market place, rather than in the consulting room, a different logic seems to apply. Smoked tobacco is the leading cause of premature death in the world today killing around 6 million people per year. Since the discovery of its causing lung cancer and heart attacks in the 1950s the medical profession and many legislative authorities have sought to reduce use. This approach has produced significant progress, but still in the UK tobacco is the leading cause of premature death, with nearly 5 times the risk of the next risk factor – alcohol.
