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0:00 - Intro with Joanna Junak

0:24 - Will Godfrey discusses the importance of language in tobacco harm reduction

2:12 - CDC stokes confusion surrounding EVALI outbreak

4:14 - Maintaining a balance between "ideal" terminology and commonly-known terminology within tobacco harm reduction

4:57 - Closing remarks


Joanna: Hello and welcome. I'm Joanna Junak, and this is GFN News on GFN TV. In today's program Will Godfrey of Filter will be talking about language and tobacco harm reduction. Hi Will. What has brought this to your attention?

Will: Hi, Joanna. So the Johns Hopkins Bloomberg School of Public Health just published a video about this. In it. Joanna Cohen, the Bloomberg Professor of Disease Prevention and director of the school's Institute for Global Tobacco Control, calls for a common language in tobacco control. She notes that the number of terms used to describe nicotine products has expanded significantly as the market has diversified. Often, she says, with word choice that serves tobacco industry interests. The broad problems that she and her colleagues identify are that terms are too broad imply novelty or innovation when such descriptors are time limited or, heaven forbid, suggest reduced harm. One example she gives is that heat not burn, a pretty straightforward description of what those devices do implies safety. We know, of course, that heated tobacco products are safer than cigarettes, which doesn't mean that they're totally without harms. More bizarrely, Cohen says that alternative, as in alternative nicotine products, suggests a choice between two mutually exclusive products and could evoke something you'd look for in a 1990s record store. As someone who used to frequent 1990s record stores, I have my doubts. Her call for clarity concludes with urging people in public health don't do the tobacco industry's dirty work for them. As Alex Norcia, who covered this for Filter, wrote, what's regrettable is that there is an important conversation to be had about terminology in the tobacco and nicotine field. The video is an opportunity well and truly missed.

Joanna: What are some of the points that people in tobacco harm reduction would make about terminology?

Will: There are lots of important examples, but near the top of the list would be Evali, an acronym for Ecigarette or Vaping Product Use Associated Lung Injury. The 2019 outbreak of lung injuries was quickly blamed by the CDC on nicotine vapes. Subsequently, vitamin E acetate in illicitly manufactured THC cartridges was found to be the cause. But the CDC has failed to explicitly correct the record or change the name. Despite the pleas of many experts and with damaging consequences for people's understanding of relative risks, language changes can reduce stigma. For example, there's a growing call in THR to abandon the word smoker. And when we regularly note that people who smoke are marginalized and dismissed, it certainly makes sense to use person first terms. Tobacco products, which the Johns Hopkins video uses along with the FDA and others, is also irritatingly misleading when used to refer to things that contain nicotine but not tobacco. Another one is nicotine addiction, which often represents a sloppy conflation. Modern addiction definitions such as the DSM on substance use disorders focus on harms rather than use per se. So while addiction might apply to cigarette smoking, it's not a fit for regular vaping without significant harms. Some people in THR also dislike the term ecigarette as it suggests another version of a cigarette, which I understand. A personal preference would be to sometimes try to move away from products which emphasizes that things are manufactured and marketed. We don't tend to describe other harm reduction devices and resources like Syringes or Narcan which are also manufactured and marketed by companies in this way. There are many other examples that we don't have time for, but there's always a tension when considering changes in terminology between using ideal terms versus retaining most people's understanding instead of trying to invent new terms to distance themselves from tobacco companies. Danielle Jones of Kazar told Alex the creators of the video should focus on learning the language that exists from people who use the products. Tobacco and nicotine research needs to be more user informed, and terminology is just one example of that. I know that consumer organizations have been working on suggested terminology and that's something we should watch. It's a necessary discussion to which Johns Hopkins has contributed little.

Joanna: Thank you, Will. That's all for today. Tune in next time here on Gfntv or on our Gfntv podcast. You can also find transcriptions of each episode on the Gfntv website. Thanks for watching or listening. See you next time.