1/🧵
I remember how excited I was a year ago when @cdoug Tweeted his statement about how we need to #ChangeTheConversation about #THR and #Smoking. His latest tweet reminds me that his voice is one of many. This gives me hope.
"The debate is heated, driven as much by emotions and philosophies as by facts. One hopes that the debate will move to an evidence-based discussion as research fleshes out the factual basis for evaluating the roles of these novel products."
“We must not focus our efforts so narrowly on preventing tobacco use by youth that we send smokers the message that we have abandoned them -- that their addiction is their own fault and that we don't care about them.”
Decisions made about THR are likely to shape TC policy for decades to come, with potentially profound implications for public health. Clarity in analysis and debate is essential if we are to make the right decisions on these weighty questions.
“...we hope that continued discussion about the promise and perils of e-cigarettes is based on a balanced view of the available science, rather than an ideology that opposes harm reduction..."
“…but to reach that middle ground that you mentioned, that balanced position does require healthy debate where we genuinely engage with the nuances around these arguments..."
…much of the discussion over goals and trade-offs rely on “deeply held values and feelings' ' that “dominate much of our thinking”. @jgitchell
9/
“The use of nicotine-containing electronic- or e-cigarettes has divided the tobacco control community along a spectrum from fervent opponents to enthusiastic supporters.”
“We challenge the public health and scientific community to move away from characterizing scientists as “opponents” or “supporters” of e-cigarettes...”
“Still, the letter is a relatively balanced response, and can be read as a rare olive branch in an ongoing exchange where common ground remains shaky at best.”
“To succeed, participants from all sectors in the ongoing harm reduction debate need to take a step back and work together to reach greater common ground.”
“People of widely differing opinions and views spoke, and the audience was one of the most mixed I have seen at a scientific and policy event like this.”
“Reaching consensus is important because a nicotine policy is integral to the target of reducing tobacco caused disease, and the contentious issues need to be resolved before the necessary political changes can be sought.”
“The harm reduction debate has at times been divisive. There has been no unifying set of principles or goals articulated to guide tobacco control efforts.”
“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."
This thread shows that many recognize the need to unite to end the death and disease caused by smoking. It even shows that some have taken the initial steps in the past. Still, no consensus on goals and trade-offs has been reached.
20/
The harsh reality is that we haven't succeeded in this mission. That means today, like every day, someone will die every 4 seconds from smoking.
Why are we as a society ok with that?
When are we going to be ready to roll up our sleeves and get to work? When will the experts, lawmakers, media, stakeholders, consumers, etc., going to sit down and figure this out? When we fight each other #DeathBySmoking wins. Is that what we want?
PS - I missed at least one example. Please let me know if there are more. I read these when I'm frustrated over people dying from smoking and lose hope.
"The often emotional debate would benefit from dispassionate data-based evaluation of evidence.”
PS #2 -
I'm requesting that the scientific community, along with the media and all of society THINK about the words they use. Some of our language is stigmatizing. Please eliminate "smoker" from your vocabulary. Replace it with people first words. Example: People who smoke (PWS)
24/
Despite continuing ambivalence among some health officials about the wisdom of embracing harm reduction as a public health policy, numerous consumers will be taking steps in this direction...
page 202 nap.edu/catalog/10029/…
25/
Continued dialogue and debate are essential as we enter a new and uncertain era of products purporting to reduce tobacco harm.
A lot of excellent minds are focused on addressing the pressing questions. To date, however, answers have eluded them.
...could be achieved by convening yet another strategic dialogue on harm reduction that is led by one of the governmental agencies, a scientific organization and/or by respected scientists who are not strongly associated with one particular ideology. pubmed.ncbi.nlm.nih.gov/32335031/
27/
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.
Zeller went on to discuss the all-too-familiar argument about the potential pros and cons of e-cigs and vaping, wondering if tobacco-control groups and vaping advocates were “having the wrong debate.”
29/ Common Ground Between the Vaping and
Public Health Community
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. ncbi.nlm.nih.gov/labs/pmc/artic…
30/ Civil Dialogue on Tobacco, Nicotine, and Alternative Products - Harm Reduction
There is a need for greater civil engagement between a growing number of stakeholders and experts...
After all, progress rarely happens without some degree of conflict, but I would argue that it never happens without a willingness to remain civil, to find common ground and compromises.
32/ Over a month ago I was asked to create a thread on the topic of the war between the THR pro and anti groups. As I got engulfed in the project I ended up writing in my blog about this topic. (#21/end) in this thread. I've done a couple of threads on this topic since then.
33/ After creating this thread this morning and sending the person the link, they bet I had more info in my notes than what I tweeted and asked me to add to this thread. I have now added several more tweets. (WHEW, I'm surprised you're still with me!)
34/ I wanted to dedicate this project to the person who made the original request, but they prefer I dedicate it to those who are the fuel to my fire.
35/ So, I dedicate this project to my family and friends who have died from smoking. I'm sorry we as a community failed to help you quit smoking.
I promise you we're going to do better for those still here on earth with us.
36/ I promise you that we're going to find a way to stop fighting each other and get back on track and work harder to save more lives.
And I promise you I will do my best to see this happen before I die.
You are loved forever and missed deeply. ❤️
~ Skip
END #2
PS - the thread above is important to me because of people like the ones in this thread.
38/
Since closer collaboration between vape-shop managers and health care professionals might benefit smokers who want to quit...we suggest policy makers and health care professionals look for opportunities for mutual information exchange. ncbi.nlm.nih.gov/pmc/articles/P…
39/ Bob’s story, and the millions of others like it, should be a call to action to shift the debate around the risks and benefits of vaping to include all ages of nonsmokers and smokers. Great story by @akleykamp filtermag.org/older-smokers-…
40/ On one side — the side that has commanded the most widespread support — is the goal of reducing high rates of adolescent e-cigarette use (vaping). On the other is the goal of harnessing vaping’s potential to help smokers quit. #TheSRNTfifteen mentioned nejm.org/doi/full/10.10…
41/ "But permanent belligerence will leave us in a slow-moving stalemate. If there is to be a war, can we please make it a common front against disease and death and not a rerun of the battles of the last century?"
^^^ what @Clive_Bates said. tobaccoreporter.com/2022/05/01/fig…
Last week @CDCTobaccoFree tweeted information about the launch of their 2024 #CDCTips campaign. This program provides tips for people who smoke and would like to quit. The tips come from the personal experience of others who have successfully quit smoking.
1/🧵
2/x Several people who have quit smoking enthusiastically replied with what worked for them to help them quit smoking. I don't own a crystal ball, so I don't know what caused some of those replies to become hidden. A tech glitch or a human hid them.
3/x But I do know that several people who quit smoking by a method that is not included in the #CDCTips felt those tweets were hidden on purpose because they believe that someone @CDCTobaccoFree doesn't agree with the method they used to quit.
Late start to the TPSAC meeting.
It is go time!
Ground rules and committee member introductions.
🧵 👇
Getting all the details out of the way. Reading the Conflict of Interest statement. All participants (except for the industry representatives) have been screened for COI. Industry reps are not voting members of the committee.
2/x
Up next is a presentation (I'm sorry, I'm not going to get all the names of speakers) that is an overview of the TPMP that they will be discussing today. This presentation was compiled by the FDA.
3/x
2/x Opening Keynote Dr. Brian King - FDA, CTP.
Tobacco use - adult, youth
Health Disparities
FDA 4 pillars - Rules, Applications review, Compliance & Enforcement, Public
3/x King
Menthol and flavored cigar standards
Nicotine Standard
Cessation Care Package
* Some people who smoke could benefit from lower risk products.
I have been seeing a therapist for a little over 1.5 years to deal with my mental health issues. It's been very helpful and has sent me on a healing journey. But it hasn't been enough. A few weeks ago, I started this course. 1/x soundstrue.com/products/mindf…
And wow! So many things are changing rapidly. I realize that for most of my life, I have lived in an almost constant state of alert. Knowing shit is going to hit the fan, I was constantly looking over my shoulder to see if it was here yet.
2/x
Add the racing mind of ADHD on top of that and you'll see a picture of someone who suffers from crippling anxiety. Lots of undealt with trauma. Lots of not healing from that trauma. Lots of waiting for more trauma to happen, because you know it's coming, it always does.
3/x
The tweet I'm quoting rocks me to the core. Abortion is not a topic I talk about publicly. It's an issue that has torn me in half ever since I've known what it is. I think today, I'd like to share the stories of 2 abortions that DIDN'T happen. 1/x
My husband was 17 and his first wife was 16 when they got married. She was pregnant and their families forbid an abortion and forced them to marry. They both dropped out of school. They had a little girl named Kathryn.
2/x
Mark was home alone with their daughter when she died from SIDS. Everyone blamed Mark and it tore the families apart, with members of Mark's family turning their backs on him. In a time of unfathomable grief, Mark had to deal with it alone because his wife left him...
3/x