What happens when public health loses sight of harm reduction? Evidence should come before stigma. Safer choices should be easier - not harder to access. But when nicotine, regulation, and the tobacco industry enter the conversation, politics and morality can quickly complicate the picture. Can we put the evidence first and focus on reducing harm?
Transcription:
00:00 - 00:06
[Brent Stafford]
You mentioned something about NHRC doing modules around tobacco harm reduction. Tell us more.
00:06 - 00:40
[Gaby Zabala Alemán]
Yes, so we are developing 10 online self-directed modules for peer social workers and nurses and just generally people who smoke on tobacco harm reduction that include understanding nicotine engaging people who use drugs and smoke tobacco and are looking for safer alternatives, and a little bit of more population-specific, culturally humble approaches to tobacco harm reduction.
00:42 - 01:06
[Brent Stafford]
Now, I don't know if this is something that you want to comment on, but often I've been very critical of public health, who on the one hand, no longer, rightly so, create a moral panic around drug use. They learned that lesson. Meanwhile, they're doing a moral panic on nicotine. And I can't parse the two. I see hypocrisy there.
01:06 - 01:33
[Gaby Zabala Alemán]
Yes, and I feel like Public health efforts should make the healthier choice the easier choice. And adding that moral panic to nicotine use alongside smoking tobacco is not actually making people go for the healthier choice or the less risky choice, if you will.
01:33 - 01:50
[Brent Stafford]
When you look at the FDA and the CDC, you know, basically the health regulators in the U.S. that have the responsibility of authorizing these products on the market, and they're doing very little of it. What would your message be to the FDA?
01:52 - 02:46
[Gaby Zabala Alemán]
I would say that the FDA needs to look at the evidence base, which is very robust, and it's very expensive to go through all of this process. So they're doing a disservice to researchers who are putting in their time and effort to gather this data, interpret it, and make it accessible. And they are doing a disservice to smaller businesses that actually could provide healthier options to their communities by making it really, really, really hard to get these safer use products approved. A key takeaway, like if I had to say it in one sentence, I would say just look at the evidence and remove the morality and politics out of it.
02:47 - 02:55
[Brent Stafford]
When you look at your own harm reduction group, the community in harm reduction, they have a problem with big tobacco too, don't they?
02:55 - 03:59
[Gaby Zabala Alemán]
Yes, yes. And it's, you know, it's very understandable. When whole communities that are already vulnerable are being targeted by a billion dollar industry, disregarding health and safety, it is understandable that there is skepticism or, you know, harder feelings, hate or, you know, towards that industry. So, yes, it is not something that is an easy conversation to have, but we need to talk about what they're doing now. And the way that we see it is if they're building safer products, then we view it as reparations. You know, you did all of this harm. We are harm reductionists. So we need to take into account that they are, yes, for profit, but also giving us something that we need that is keeping us healthier.