Harm reduction is a respected public health strategy for managing addictive behaviours that pose severe health risks. Such an approach recognises that for people unable to abstain from a certain risky behaviour, public health interventions can be used to mitigate the potential dangers and health risks. For drugs such as heroin, harm reduction applications include needle exchange and supervised injection sites where the provision of sterile injection equipment can minimise the risk of HIV and other infections, naloxone can be administered to manage overdoses and medical staff can arrange treatment referrals. In such instances, harm reduction applications can serve as a gateway to accessing vulnerable and marginalised groups. Harm reduction, which is typically overseen by clinicians, nurse practitioners and outreach workers, represents a movement that tends to be community-based, activism-driven and concerned with human rights. An important question pertains to the multitude of stakeholders involved and who is overseeing the harm reduction intervention. For tobacco harm reduction, the curious involvement and role of the industry prove to be contentious.