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='''Tobacco Control / Public Health'''= <!--T:17--> | ='''Tobacco Control / Public Health'''= <!--T:17--> | ||
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*Another possible consensus antismoking strategy might not raise any significant conflicts, even if it were extended to e-cigarettes (or to all tobacco products). That is requiring that all tobacco products be sold only in adult-only sales outlets. | *Another possible consensus antismoking strategy might not raise any significant conflicts, even if it were extended to e-cigarettes (or to all tobacco products). That is requiring that all tobacco products be sold only in adult-only sales outlets. | ||
*To promote switching from smoking to vaping (without any downside risks), even those opposing an e-cigarette harm-reduction approach should also be able to agree that all sales outlets that sell smoked tobacco products should be required to offer e-cigarettes, as well (but not vice versa). | *To promote switching from smoking to vaping (without any downside risks), even those opposing an e-cigarette harm-reduction approach should also be able to agree that all sales outlets that sell smoked tobacco products should be required to offer e-cigarettes, as well (but not vice versa). | ||
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*"I urge all of us in the tobacco control community to climb out of the bunker, come to the table, and try to genuinely work together. Stop skirting the truth when it feels inconvenient and open your minds and ears to all of the science that is before us. But the same goes for my other community, with whom I agree regarding the evidence-based promise of THR, but which also bears some responsibility for the adversarial nature of the relationship and for not consistently acknowledging areas of ambiguity or concern, including significant rates of experimentation with vaping by youth and youth-oriented marketing by some segments of the vaping industry. We won’t come together if we don’t come together." | *"I urge all of us in the tobacco control community to climb out of the bunker, come to the table, and try to genuinely work together. Stop skirting the truth when it feels inconvenient and open your minds and ears to all of the science that is before us. But the same goes for my other community, with whom I agree regarding the evidence-based promise of THR, but which also bears some responsibility for the adversarial nature of the relationship and for not consistently acknowledging areas of ambiguity or concern, including significant rates of experimentation with vaping by youth and youth-oriented marketing by some segments of the vaping industry. We won’t come together if we don’t come together." | ||
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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." | ||
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*THR can be a complement to, not a substitute for, evidenced-based tobacco control interventions. Tobacco control professionals need to focus on objective assessment of and discussion about the potential costs and benefits of THR. | *THR can be a complement to, not a substitute for, evidenced-based tobacco control interventions. Tobacco control professionals need to focus on objective assessment of and discussion about the potential costs and benefits of THR. | ||
*Importantly, we need to assess that evidence in a fair and objective manner, and to move forward together toward the elimination of tobacco’s harms. That, after all, is the THR goal shared by every single tobacco control professional. | *Importantly, we need to assess that evidence in a fair and objective manner, and to move forward together toward the elimination of tobacco’s harms. That, after all, is the THR goal shared by every single tobacco control professional. | ||
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*“The e-cig debate has been emotional, divisive and is not advancing common ground on harm reduction,” he said. “Where and how can we apply the principle of harm reduction to this debate and find common ground? It’s been horribly ineffective to date. | *“The e-cig debate has been emotional, divisive and is not advancing common ground on harm reduction,” he said. “Where and how can we apply the principle of harm reduction to this debate and find common ground? It’s been horribly ineffective to date. | ||
*“Part of the challenge with tobacco-control groups and public-health advocates is a historic distrust of the tobacco industry,” he continued. “Every sector has a role to play (in finding common ground).” | *“Part of the challenge with tobacco-control groups and public-health advocates is a historic distrust of the tobacco industry,” he continued. “Every sector has a role to play (in finding common ground).” | ||
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**Acknowledge the public health opportunity to move tobacco users down the risk spectrum. | **Acknowledge the public health opportunity to move tobacco users down the risk spectrum. | ||
*"Are we having the wrong debate? For me, yes. The debate has been about e-cigarettes. It should be about nicotine," he said, adding that "someone needs to step up to the plate" and reframe the debate. Once that is successfully done, the nicotine debate needs to center on some critical questions, according to Zeller. These include: What is the longer-term use for those who need it? Is there a potential need for a period of dual use and, if so, for how long? What are the unintended consequences? Where does the principle of harm reduction come in? | *"Are we having the wrong debate? For me, yes. The debate has been about e-cigarettes. It should be about nicotine," he said, adding that "someone needs to step up to the plate" and reframe the debate. Once that is successfully done, the nicotine debate needs to center on some critical questions, according to Zeller. These include: What is the longer-term use for those who need it? Is there a potential need for a period of dual use and, if so, for how long? What are the unintended consequences? Where does the principle of harm reduction come in? | ||
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==='''[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915216/ The Strategic Dialogue on Tobacco Harm Reduction: a vision and blueprint for action in the US]'''=== | |||
*The issues related to tobacco harm reduction continue to challenge the tobacco control research and policy communities. | |||
*For more than 2 years a group of tobacco control researchers, policy and communications experts participated in a process called the Strategic Dialogue on Tobacco Harm Reduction | |||
*The topic of tobacco harm reduction is complex and, at times, contentious. No unified vision or strategy has guided research and policy. No opportunities have existed for individuals with diverse perspectives, such as researchers, policy experts, communications experts and advocates to come together to produce a strategic vision on issues related to this area. Instead, while there is broad support for the need to regulate tobacco products, there has been a fractured and sometimes divisive debate over issues such as the appropriate role of regulation as it relates to harm reduction and, particularly, the roles of smokeless tobacco and nicotine replacement therapy (NRT) in harm reduction. | |||
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='''Tobacco Harm Reduction / Other Harm Reduction Backgrounds'''= <!--T:32--> | ='''Tobacco Harm Reduction / Other Harm Reduction Backgrounds'''= <!--T:32--> | ||
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