Nicotine / THR - Change the Conversation

The war to end smoking has turned into the war on nicotine.

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 that we all should be concerned about. 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 while keeping Safer Nicotine (THR) products on the market for adults who smoke.

We all need to listen to the people and orgs below, who have put out the call to Change The Conversation.

Educators

2020, Aug 10 - Polarization Within the Field of Tobacco and Nicotine Science and its Potential Impact on Trainees

• Divisive, dominant perspectives on e-cigarettes move the field of nicotine and tobacco science away from scientifically rigorous discourse on this important public health topic, which involves millions of lives at stake. If norms do not change, the polarized climate may pressure trainees to choose or inherit an allegiance towards an uncompromising, one-sided stance. That allegiance can then restrict career development, undermine the credibility of research, and hinder public health progress. There is an urgent need to act to avoid negatively affecting the next generation of nicotine and tobacco research scientists. Though we have suggested some solution-oriented ideas, we are calling for reflection among everyone in the field and particularly among those with influence and power.
• There are important questions that must be addressed, including: (1) as the field continues to conquer a range of research questions on e-cigarettes across a range of disciplines and career levels, how can we work better together toward the shared end goal of eliminating tobacco-related disease and death?; (2) how can scientists who perpetuate polarized viewpoints be incentivized and supported to improve?; (3) to whom can junior scientists turn for help with navigating the polarization in the field?; and (4) how can the academic community avoid contributing to the polarization that seems to pervade the field?

2018 Caught in the middle: early career researchers, public health and the emotional production of research

• In this short report, I discuss how public health research, its assessment, and its dissemination outside the academy are produced, in part, through emotional circumstances. Using current debates on e-cigarettes as an example, I show that researchers find themselves uncomfortably positioned in complicated moral and affective landscapes, often making it difficult to represent the nuance of their research.
• Mair and Kierans (2007, p. 109) warned us some time ago that: ‘adopting any normative stance towards tobacco, whether pro- or anti-, would actually interfere with our capacity to document and interpret the significance of tobacco in the lives of those we study’. This statement transfers to the contemporary e-cigarette situation.

Tobacco Control / Public Health

2021, Mar 4 - Cliff Douglas Manifesto: It is Time to Act with Integrity and End the Internecine Warfare Over E-Cigarettes

• "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."

2020 - E-Cigarettes, Harm Reduction, and Tobacco Control: A Path Forward?

• "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."

2018 - How to Think—Not Feel—about Tobacco Harm Reduction

• Taken literally, tobacco harm reduction—reducing the harms created by tobacco—is what everyone in tobacco control wants to accomplish. But, the term “tobacco harm reduction” (THR) has become the source of one of the most divisive, often acrimonious debates in tobacco control history. Intense emotions, on both sides, have obstructed objective consideration of complicated THR issues.
• Participants on both sides of the divisive THR debate need to examine the complicated issues and evidence more objectively. This entails considering both the potential benefits and costs associated with reduced-risk products like e-cigarettes.
• 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.

2015 - A Proposed Collaboration Against Big Tobacco: Common Ground Between the Vaping and Public Health Community in the United States

• An unfortunate conflict is underway between the public health community and the vaping community over e-cigarettes' harmfulness or lack thereof. This conflict is made worse by an information vacuum that is being filled by vocal members on both sides of the debate. This conflict is avoidable; common ground exists. If both groups rally around what is in their own and the public's best interest-the end of combustible tobacco--all will benefit significantly. If not, the result may be missed opportunities, misguided alliances, and--ultimately-poorer public health.

Tobacco Harm Reduction

2020: ACTIVISTS, HEALTH WORKERS CALL FOR TOBACCO HARM REDUCTION

• "Human rights activists and health workers in Uganda have embarked on a Tobacco Harm Reduction (THR) campaign aimed at reducing or minimizing harm or risks suffered by people and communities as a result of using tobacco products."
• "He stressed that the THR advocacy is not going to fight or conflict with the on going government programs, but to raise an intellectual conversation seeking a deeper understanding of THR and nicotine."

Tobacco Industry

2019: Philip Morris International: time for a new conversation

"By demonising a company that is doing exactly as the Editors demand, we might never know exactly how much of an opportunity a tobacco harm-reduction strategy will bring to public health. The only losers if this happens will be the men and women who continue to smoke."

• Written by: Marian Salzman
• PDF Version