Politics of Acceptable Addiction

This book examines one of the most striking inconsistencies in modern public health: why some forms of dependence are normalised while others are condemned, even when the underlying science suggests they should be treated similarly.Drawing on economics, science, history, and real-world observation, the author explores how caffeine became embedded in respectable life while nicotine—particularly in its non-combustible forms—remains stigmatised and heavily regulated. The book traces the collapse of proportional risk reasoning in public health, showing how institutions moved from managing exposure to managing behaviour, often at the expense of clarity and effectiveness.Through case studies ranging from coffeehouses and Prohibition to contemporary vaping markets and global health governance, the author reveals how narratives, incentives, and institutional structures shape the way risk is interpreted and communicated. He argues that current policy frameworks, designed for a world dominated by cigarettes, struggle to adapt to a landscape in which lower-risk alternatives exist.At stake is not simply how nicotine is regulated, but how societies understand risk itself. When distinctions between more and less harmful behaviours are blurred, the consequences are measured not only in policy debates, but in outcomes over time.This book offers a clear and provocative account of how public health lost proportionality—and what it would take to recover it.

Roger Bate is an economist and policy analyst whose work focuses on global health governance, risk, and the relationship between science and policy. He received his PhD in economics from the University of Cambridge, UK, and has spent much of his career examining how institutions interpret evidence and translate it into regulation.Although he has never been a smoker, Bate's interest in nicotine policy began during debates over environmental tobacco smoke in the 1990s, when he became concerned about how scientific evidence was being used in policy arguments. His work has since explored how public health frameworks can drift from proportional reasoning, particularly when managing widely used substances.Alongside this, his own daily reliance on caffeine prompted a broader question: why are some dependencies treated as normal while others are moralised? That question sits at the heart of this book.He lives in Pennsylvania with his wife and two boys and continues to work on global health policy and risk analysis.