Nicotine / THR - Change the Conversation: Difference between revisions

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The focus has been lost, and who the "winners" and "losers" will be has changed. It is now Tobacco Control (TC) and Public Health (PH) vs. Tobacco Harm Reduction (THR). Caught in the middle are consumers who smoke, consumers who used to smoke, and industry stakeholders. AS TC/PH fights THR with both sides trying to "win" against the other, the world has forgotten the real "winners" and "losers". '''People who succeed at quitting smoking are the only real winners in this battle. People who die from smoking are the only losers in this fight. This is what we should be concerned about - people who smoke.''' It is time to #ChangeTheConversation. For TC/PH and THR to sit down and talk real solutions. Work on ways to limit initiation of smoking (and all age restricted products) while keeping Safer Nicotine (THR) products on the market for adults who smoke.
The focus has been lost, and who the "winners" and "losers" will be has changed. Caught in the middle are consumers who smoke or who used to smoke. AS warring sides try to "win" against the other, the world has forgotten the real "winners" and "losers". '''People who succeed at quitting smoking are the only real winners in this battle. People who die from smoking are the only losers in this fight. This is what we should be concerned about - people who smoke.''' It is time to #ChangeTheConversation. For all sides to sit down and talk real solutions. Work on ways to limit the initiation of smoking (and all age-restricted products) while keeping Safer Nicotine (THR) products on the market for adults who smoke.


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='''Tobacco Control / Public Health'''= <!--T:17-->
='''Tobacco Control / Public Health'''= <!--T:17-->
===2022: [https://www.sciencedirect.com/science/article/pii/S2667321522001597 Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis]===
*Our findings indicated that the majority of meanings attached to tobacco harm reduction were rooted in values, ideology, politics, and opinions, rather than straightforward disagreements about the scientific evidence. Respondents had different ideological positions on the War on Drugs, the role of the private sector and the tobacco industry, social justice principles, the inevitability of nicotine use, and the acceptability of addiction. Throughout, experts struggled and disagreed with precisely where and how to define “harm reduction."
===2022: [https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.00187 A Proposed Policy Agenda For Electronic Cigarettes In The US: Product, Price, Place, And Promotion]===
*All members of the public health community should unite to pursue a shared commitment to the principle that both youth and adults deserve a future free of tobacco-related disease.
*Our fondest hope is that the public health community will unite again and fight for a set of policies that, through measured compromise, will both reduce the use of e-cigarettes by youth and increase adult smoking cessation.
===2022: [https://www.medpagetoday.com/opinion/second-opinions/99553 A Bold U.K. Plan to End the Smoking Epidemic]===
*In stark contrast with the consensus of government and public health organizations in those nations, the U.S. is mired in a polarized debate pitting concern regarding the risks of e-cigarettes for youth against their potential to help addicted adult smokers stop smoking.




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===2021, Mar 4 - [https://safernicotine.wiki/mediawiki/index.php/Cliff_Douglas Cliff Douglas] Manifesto: [https://drive.google.com/file/d/1C1nk1XEZ8WhnOXtCGTqHdeqomc9HOuko/view It is Time to Act with Integrity and End the Internecine Warfare  Over E-Cigarettes]=== <!--T:20-->
===2021: [https://safernicotine.wiki/mediawiki/index.php/Cliff_Douglas Cliff Douglas] Manifesto: [https://drive.google.com/file/d/1C1nk1XEZ8WhnOXtCGTqHdeqomc9HOuko/view It is Time to Act with Integrity and End the Internecine Warfare  Over E-Cigarettes]=== <!--T:20-->


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===2020 - [https://drive.google.com/file/d/1CBmxmTeclgKWjA-_7P3GQrddeOkEISIt/view E-Cigarettes, Harm Reduction, and Tobacco Control: A Path Forward?]=== <!--T:22-->
===2021: [https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2021.306416 Balancing Consideration of the Risks and Benefits of E-Cigarettes]===
*The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes’ risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public—including most smokers—now consider e-cigarette use as dangerous as or more dangerous than smoking.
*The authors are former presidents of the Society for Research on Nicotine and Tobacco (SRNT), the world’s leading professional organization dedicated to the subject. The opinions expressed in this article are solely those of the authors. They do not represent those of SRNT, which has taken no organizational position on the issues discussed in this article and had no involvement in the preparation of this article.
 
 
===2021: [https://www.bmj.com/content/361/bmj.k2282.full Polarising the e-cigarette debate confuses people]===
*We read with interest the article on whether the NHS should recommend e-cigarettes. It struck a polarising tone, which we fear will further confuse the public. In an effort to take a sensible position on this divisive issue Sheffield Tobacco Control Board has published an updated [https://smokefreesheffield.org/app/uploads/2021/02/The-Sheffield-TCB-e-cig-policy-statement-Final_2.4-1.pdf consensus statement]. We aim to be a vape-friendly city …
 
 
===2021: [https://pubmed.ncbi.nlm.nih.gov/33433588/ Tribes of Trust or Distrust, "Attitude Roots" and Encouraging Scientific Participation in the Tobacco Harm-Reduction Debate]===
*[https://sci-hub.se/10.1093/ntr/ntab006 PDF of full paper]
*Trust reassures, while distrust disqualifies. Battle lines between tobacco harm reduction (THR) supporters and abstinence-only supporters provide an example of more or less trusted or distrusted factions in opposition. Some may think of tobacco control science as an evidence-based, objective, rational scientific citadel. The present account of tribal clashes on THR issues, biased by feelings of trust and mistrust, and arising out of values, moral emotions and attitude roots, seems pertinent to me. That attempts at rational thought are subject to many biasing influences has been recognized for decades...
<br>
 
===2020: [https://drive.google.com/file/d/1CBmxmTeclgKWjA-_7P3GQrddeOkEISIt/view E-Cigarettes, Harm Reduction, and Tobacco Control: A Path Forward?]=== <!--T:22-->


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*"Consider that in the few minutes it took to review the points in this Commentary, approximately 25 Americans and 300 people worldwide died of complications arising from their use of combusted tobacco. This is a toll that should be unacceptable to all of us, no matter where one stands on the issues presented here. We should not and can not continue to engage in the divisive and shameful conflict that the e-cigarette era has visited upon the tobacco-control community; the lives of too many people are at stake. We can and must do better and move on to the combusted tobacco endgame."  
*"Consider that in the few minutes it took to review the points in this Commentary, approximately 25 Americans and 300 people worldwide died of complications arising from their use of combusted tobacco. This is a toll that should be unacceptable to all of us, no matter where one stands on the issues presented here. We should not and can not continue to engage in the divisive and shameful conflict that the e-cigarette era has visited upon the tobacco-control community; the lives of too many people are at stake. We can and must do better and move on to the combusted tobacco endgame."


===2019: [https://www.drcherylolson.com/wp-content/uploads/2020/09/Olson_End-the-Tribal-Warfare-12-2019.pdf END THE TRIBAL WARFARE Creating Productive Conversations Between the Vaping Industry and Public Health]===
*The narrative around vaping, initially so full of hope and promise, has taken a wrong turn. Industry and public health people can seem like mistrusting, warring tribes.


===2018 - [https://academic.oup.com/ntr/article/21/10/1299/4990310 How to Think—Not Feel—about Tobacco Harm Reduction]=== <!--T:24-->
===2018: [https://academic.oup.com/ntr/article/21/10/1299/4990310 How to Think—Not Feel—about Tobacco Harm Reduction]=== <!--T:24-->


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===2016 - [https://www.cspdailynews.com/tobacco/4-takeaways-zellers-nato-show-session Mitch Zeller (FDA/CTP) - The E-Cig Debate Has Been Detrimental to Harm Reduction]=== <!--T:26-->
===2016: [https://www.cspdailynews.com/tobacco/4-takeaways-zellers-nato-show-session Mitch Zeller (FDA/CTP) - The E-Cig Debate Has Been Detrimental to Harm Reduction]=== <!--T:26-->


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===2016 - [https://csnews.com/fdas-zeller-lets-reframe-debate-focus-nicotine FDA's Zeller: Let's Reframe Debate to Focus on Nicotine]=== <!--T:28-->
===2016: [https://csnews.com/fdas-zeller-lets-reframe-debate-focus-nicotine FDA's Zeller: Let's Reframe Debate to Focus on Nicotine]=== <!--T:28-->


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===2015 - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959509/pdf/ntv241.pdf A Proposed Collaboration Against Big Tobacco: Common Ground Between the Vaping and Public Health Community in the United States]=== <!--T:30-->
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959509/pdf/ntv241.pdf A Proposed Collaboration Against Big Tobacco: Common Ground Between the Vaping and Public Health Community in the United States]=== <!--T:30-->


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='''Tobacco Industry'''= <!--T:39-->
='''Tobacco Industry'''= <!--T:39-->


===2022: [https://tobaccoreporter.com/2022/10/03/transformation-and-its-enemies/ Transformation and Its Enemies]===
*But what if there are policies, practices and messages that are good for the tobacco industry and public health? Or bad for both? One of the accusations frequently thrown at public health advocates who favor tobacco harm reduction is that they are doing the bidding of Big Tobacco. No one likes to be accused of that. But implicit in that accusation is either the assumption that tobacco harm reduction cannot be good for both or worse, that it is more important to hurt the tobacco industry than to serve public health.
*In public health, we need to stop our warrior rhetoric and think harder about the world as it really works and what will change it for the better.




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*Written by: Marian Salzman
*Written by: Marian Salzman
*[https://www.thelancet.com/action/showPdf?pii=S0140-6736%2819%2932126-9 PDF Version]
*[https://www.thelancet.com/action/showPdf?pii=S0140-6736%2819%2932126-9 PDF Version]


='''The Science of Disputes and Negotiations'''= <!--T:44-->
='''The Science of Disputes and Negotiations'''= <!--T:44-->
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='''Goals & Tradeoffs'''=
='''Goals & Tradeoffs'''=


='''Suggestions to add to this page'''= <!--T:49-->
='''Derogatory, Stigmatizing and Racist Language Adds Fuel to the Fire, Doesn't Encourage Meaningful Conversations'''=
*[https://safernicotine.wiki/mediawiki/index.php?title=Nicotine_-_Stigma See Also: Nicotine - Stigma]
 
==Black Words - Example: Black Market==
 
===Studies, Papers, Reports===
 
====2019: [https://www.canada.ca/en/public-health/services/publications/healthy-living/communicating-about-substance-use-compassionate-safe-non-stigmatizing-ways-2019.html Communicating about Substance Use in Compassionate, Safe and Non-Stigmatizing Ways]====
*Instead of "Black Market," use alternative terms such as "illegal supply," "unregulated market," "illegally obtained," "illegally produced," or "diverted."
*“Black” is often used as an adjective to convey that something is illegal or otherwise “bad” (e.g., black market, blacklist, black sheep, blackmail, etc.), which has clear racist underpinnings.
 
====2018: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148600/ “Blacklists” and “whitelists”: a salutary warning concerning the prevalence of racist language in discussions of predatory publishing]====
*This commentary addresses the widespread use of racist language in discussions concerning predatory publishing. Examples include terminology such as blacklists, whitelists, and black sheep. The use of such terms does not merely reflect a racist culture, but also serves to legitimize and perpetuate it.
*The racism in such “black is bad, white is good” metaphors is inappropriate and needs to cease.
*...the word WHITENESS has 134 synonyms; 44 of which are favorable and pleasing to contemplate…Only ten synonyms for WHITENESS appear to me have negative implications—and these only in the mildest sense… The word BLACKNESS has 120 synonyms, 60 of which are distinctly unfavorable, and none of them even mildly positive…
 
===Articles, Blogs, Websites===
 
====2023: [https://filtermag.org/black-market-cannabis/ Why We Should Abandon the Term “Black Market”]=====
 
====2021: [https://practicalesg.com/2021/09/say-this-instead-blacklist-blackball-blackmail-black-market-etc/ Say This Instead: “Blacklist,” “Blackball,” “Blackmail,” “Black market,” etc.]====
*"In a continuation of the “Say This Instead” series, let’s look at the pervasive symbolism of “white” as positive and “black” as negative in the English language. Words like “blackmail” (related to extortion), “blackball” (rejection), “blacklist” (banishment), and “black market” (illicitness) are so woven into the fabric of our language that we often don’t reflect on their racist overtones. The meaning of these phrases is always something undesirable. It perpetuates a systemic stigma caused by using the same terms that describe the color of our skin as a delineation between good and bad.  Based on our use of these words, “black” is bad and “white” is good."
 
====2020: [https://www.jdsupra.com/legalnews/racist-language-and-origins-i-didn-t-35616/ Racist Language and Origins I Didn’t Always Know]====
*The symbolism of white as positive and black as negative is pervasive in our culture. ...color is related to extortion (blackmail), disrepute (black mark), rejection (blackball), banishment (blacklist), and illicitness (black market).
*"To be an antiracist means taking action to change inherit bias, implicit bias, systemic racism, covert bias, and micro-aggressions. While we may say things without malice or racist intent, we can do better by learning how to recognize and stop using language with racist origins, meanings, or connotations."
 
==Grandfathered==
 
===Articles, Websites, Blogs===
 
====2022: [https://www.fda.gov/tobacco-products/ctp-newsroom/ctp-updates-grandfathered-tobacco-product-term-pre-existing-tobacco-product CTP Updates “Grandfathered Tobacco Product” Term to “Pre-Existing Tobacco Product”]====
*On Aug. 19, FDA’s Center for Tobacco Products (CTP) updated the term “grandfathered tobacco product” to “pre-existing tobacco product” on all the Center’s systems.
*Additionally, the term “grandfathered” – when used to describe someone or something exempt from a new law or regulation – has its roots in 19th century racist voting laws. Therefore, this terminology has been updated in accordance with CTP’s commitment to diversity, equity, inclusion, and accessibility.
 
====2013: [https://www.npr.org/sections/codeswitch/2013/10/21/239081586/the-racial-history-of-the-grandfather-clause The Racial History Of The 'Grandfather Clause']====
*"Because of the 15th Amendment, you can't pass laws saying blacks can't vote, which is what they wanted to do," says Eric Foner, a Columbia University historian. "But the 15th Amendment allowed restrictions that were nonracial. This was pretty prima facie a way to allow whites to vote, and not blacks."
 
==Derogatory Terminology==
*Comment from Skip, the creator of this wiki page:
**Those of us who believe there is a place in the world for alternative nicotine products have witnessed years of stigmatization for people's nicotine use. I encourage all of us to think twice about our own use of stigmatizing words, especially when directed at those we don't agree with. We must remember that we sometimes seem like "zealots" to them, too. Name-calling, disrespectful attitudes, and hurtful words will never open the dialogue between opposing viewpoints. Don't be a PANTZ (pro-alternative nicotine and tobacco zealot).
**Be kind - millions of people are dying from smoking. It is one thing to be enthusiastic, it is another thing to be a rude troll. Show your mission's credibility by treating others respectfully, even if they've come across as rude. We should teach by example.
**Stick with issues, not personal attacks. Many of us did things when we were teens that our parents didn't know about. When it comes to the teen vaping issue, why are we attacking parents? How are they supposed to know what their kids are doing 24/7? With all the misinformation out there, why are we angry at their panic over their child's use of vapor products? Many falsely believe that vaping can kill their kids or turn them into "addicts" (with all the stigma attached to that word). We shouldn't stigmatize parents, call them names, crack jokes about them drinking wine, etc. We should show compassion for their fear and keep offering to have a conversation and work towards solutions.
 
===Labeling Opponents===
*[https://twitter.com/abraverway/status/1724870868386672868 Video on Twitter]
 
===ANTZ===
*Anti Nicotine and Tobacco Zealots
*A derogatory label applied to individuals and groups focused on eliminating all nicotine and tobacco products without taking the continuum of risk into consideration. Some of those individuals believe that all forms of nicotine are harmful, and society would experience improved public health without the use of nicotine. Some of those individuals are hyper-focused on concerns about youth initiating nicotine use and struggle to include concerns for anyone who smokes. Much of this debate is focused on e-cigarettes. A good discussion on the lack of balance is in this paper: [https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2021.306416 Balancing Consideration of the Risks and Benefits of E-Cigarettes]
 
===Bloombuck===
*Term used when referencing Michael Bloomberg, his money, the organizations he financially supports, and his followers.
 
===Karen===
*A pejorative term for a (most often white) woman (or rarely a man) perceived as entitled or [https://en.wikipedia.org/wiki/Karen_(slang) demanding] beyond the scope of what is reasonable.
*Sometimes called "soccer moms."
 
===Mass Murderers - Nazi - Homicide===
*Terms used by some pro-tobacco harm reduction advocates aimed towards those whom they don't agree with. Claiming that people who don't support tobacco harm reduction are purposely causing the deaths of people who smoke vs the unintended consequences of certain policies.
 
===Nanny State or Nanny Stater===
*Nanny State is sexist and pejorative--trying to say that the govt thinks we're all babies in need of a "nanny."
*The term is [https://www.thehindu.com/opinion/op-ed/what-is-nanny-state-in-political-science/article19747473.ece attributed] to British Conservative politician, Iain Macleod, who used it in a derogatory sense to criticize government intervention in people’s lives.
*Example of better terminology: "supporter of state intervention to influence behavior"
 
===Shill===
*A shill is someone who [https://en.wikipedia.org/wiki/Shill publicly helps] or gives credibility to a person, company, industry, or organization without disclosing their close relationship or employment. In online discussion media, shills make posts expressing opinions that further interests of an organization in which they have a vested interest, such as a commercial vendor or special interest group, while posing as unrelated innocent parties.
*Both sides of the debate tend to aim this slur (without proof) at people they disagree with. Often to accuse someone of working in the tobacco industry or accuse someone of having their pockets lined by a wealthy funder who pushes a specific agenda. It is an attempt to discredit another person.
 
===Snowflake===
*The phrase is used in a [https://www.bbc.co.uk/programmes/articles/16fXgQp7ymRHF4x8qcrrSq3/from-patriarchy-to-snowflake-five-keywords-you-need-to-know derogatory] way to deride those particularly on the left of the political spectrum, and those with progressive liberal views. The author Chuck Palahniuk used the term 'snowflake' as an insult in his 1996 novel Fight Club. But way back in early 1860s in Missouri, USA, a 'snowflake' was a person who was opposed to the abolition of slavery.
 
===Tobacco Control =/= People Control===
 
===Troll===


===2022: [https://www.sciencedirect.com/science/article/pii/S2667321522001597 Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis]===
===Twitterati===
*Califf (FDA)


===2022: [https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.00187 A Proposed Policy Agenda For Electronic Cigarettes In The US: Product, Price, Place, And Promotion]===
===Mom's Basement===
*All members of the public health community should unite to pursue a shared commitment to the principle that both youth and adults deserve a future free of tobacco-related disease.
*Brian King (FDA CTP)
*Our fondest hope is that the public health community will unite again and fight for a set of policies that, through measured compromise, will both reduce the use of e-cigarettes by youth and increase adult smoking cessation.
*[https://twitter.com/bentollphd/status/1631023717688934406 Tweet by SRNT 2023 Atendee]
*“It’s easy to criticize from a twitter handle in your mother’s basement”


===2022: [https://tobaccoreporter.com/2022/10/03/transformation-and-its-enemies/ Transformation and Its Enemies]===
='''Suggestions to add to this page'''= <!--T:49-->


===2022: [https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2022.00187 A Proposed Policy Agenda For Electronic Cigarettes In The US: Product, Price, Place, And Promotion]===
===2023: [https://www.youtube.com/watch?v=ryTT1ehHnFM 15 Common Logical Fallacies]===


===2022: [https://www.medpagetoday.com/opinion/second-opinions/99553 A Bold U.K. Plan to End the Smoking Epidemic]===
===2023: [https://bigthink.com/the-learning-curve/rapoports-rules-arguments/ Rapoport’s rules: A 4-step strategy to de-escalate tense arguments]===
*In stark contrast with the consensus of government and public health organizations in those nations, the U.S. is mired in a polarized debate pitting concern regarding the risks of e-cigarettes for youth against their potential to help addicted adult smokers stop smoking.


===2021: [https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2021.306416 Balancing Consideration of the Risks and Benefits of E-Cigarettes]===
===2023: [https://link.springer.com/chapter/10.1007/978-3-031-23658-7_4  E-Cigarettes and the Burdens of History: Children, Bystanders and the American War on Nicotine]===


===2021: [https://www.bmj.com/content/361/bmj.k2282.full Polarising the e-cigarette debate confuses people]===
===2023: [https://www.politico.eu/article/aggression-ridicule-bullying-inside-the-world-of-e-cigarette-scientists/ Inside the toxic world of vaping scientists ]===


===2021: [https://pubmed.ncbi.nlm.nih.gov/33433588/ Tribes of Trust or Distrust, "Attitude Roots" and Encouraging Scientific Participation in the Tobacco Harm-Reduction Debate]===
===2022: [https://www.sciencedirect.com/science/article/pii/S2667321522001597?via%3Dihub Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis]===
*[https://sci-hub.se/10.1093/ntr/ntab006 Sci-Hub]


===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680276/ The Past Is Not the Future in Tobacco Control]===
===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680276/ The Past Is Not the Future in Tobacco Control]===