The unfortunate paediatrician does not realise just how hypocritical his letter is. His salary is paid entirely by the British government; if a packet of cigarettes costs £7.00, at least £5.47 of it goes to the British government, which is by far the biggest financial beneficiary of smoking, far bigger than the tobacco companies in absolute terms (it has, after all, only to collect the excise, while the tobacco companies actually have to make the product). Moreover, tobacco excise is one of the top ten sources of income of the British government. Thus, by working for the British government, the paediatrician is working for a tobacco trafficker. He should resign at once, and work only in the private sphere. 

The economic interests involved in harm reduction for heroin addicts are no doubt relatively small by contrast, but that it not to say they are unimportant for those who have them, or that they will not fight to retain them. The manufacturers who make substitute drugs and the governmental therapo-bureaucrats who distribute them will defend their interests just as the rest of us do. 

Consistency, no doubt, is the hobgoblin of little minds, but we must make some effort, at least, in its direction, or else deliver ourselves up to our own prejudices.