Saturday, July 30, 2022

Bridging Walls

How often have you felt angry when someone calls you a name or accuses you of being a troll just because you disagreed with them? Have you been called a bot, accused of having a financial conflict of interest, or some other ad hominem attack against you, derailing the conversation from the issue at hand? Have you had someone make fun of you, belittle you, and put you in the position of having to defend yourself instead of staying on the topic of dissent? How do you react? Should you back away from the "fight" or lash out in an "eye for an eye" fashion? Do you maintain a cool head and steer the discussion back to the topic?
Several people listened to "How the FDA is addressing vaping and e-cigarettes," a live broadcast on WAMU. The guests were Dorian Fuhrman, Mitch Zeller, and Cliff Douglas. The panel represented a concerned parent (a co-founder of PAVe), worried about youth vaping, and 2 veterans in the fields of public health and tobacco control. 

The first thing that struck me was that a perspective was missing from the panel. There wasn't anyone who vaped or the concerned parent of a child who smoked. The voices of people who vape and parents of children who smoke are often missing in these conversations. It frustrates me. Don't their voices matter to the rest of society? I tried to listen to the discussion with an open mind. I must admit, that's very hard to do. I am biased because my son smoked, and smoking harmed him. I smoked for over 40 years. After failing to quit smoking countless times, vapor products helped both of us quit smoking.

I mostly agreed with the things said by Cliff Douglas. I sometimes agreed with the things said by Mitch Zeller, and I strongly disagreed with most of the things said by Dorian Fuhrman. It was hard not to instantly think of her as a liar with evil intentions. However, I know this isn't a fair way to react to someone I disagree with. 
Disagreeing on topics that are important and remaining open-minded and civil is hard. It was interesting watching the comments on Twitter about the show. Very few were in the middle. A vivid reminder of how passionate all sides are about vaping. Some felt the hosts leaned too heavily on the anti-vaping side as they read viewers' remarks. The most significant outrage I heard by people I know was over statements made by Dorian Fuhrman and a viewer comment by another mom from the same organization as Dorian. 

Months ago, I wrote about how we need to change the conversation. I look at how folks disagreeing with the PAVe moms talk about them on Twitter. Calling them "Karen," making fun of them for drinking wine, accusing them of accepting "Bloombucks," ridiculing their lifestyle and their children. 

Is it any wonder that the PAVe moms think we're a bunch of bullies, obnoxious, and rude trolls who don't give a shit about kids? The best some of us have to offer is that "they should learn how to parent their kids and leave the rest of us alone." So many of us are angry because those PAVe moms won't listen to us, look at the science, and don't seem to care that these products are saving adult lives. Why would they? Do any of us listen to people who treat us this way?

I'd bet money I know how some people will react to this. We're going to embrace the "what's good for the goose is good for the gander" mentality. Because they don't listen to us, are wrong in our view, and are trying to ban things we believe save lives. So why the hell should we be nice to them? 

Maybe we need to listen first, acknowledge people's concerns, and then ask to be listened to. No one will hear anyone else while we're all shouting insults!

A few years ago, I was at a city council meeting waiting to testify against a tobacco 21 ordinance. An elderly lady got up to speak. She was a volunteer with one of the health organizations. I'm sure my blood pressure went up 50 points as I listened to her talk. I tossed my speech, got up, and tried to debunk everything she said in the 3 minutes I was allowed to testify. Her blood pressure probably went up an equal amount. She spoke to me outside after the meeting as she was sure I worked for big tobacco and was trying to addict kids. I invited her out for coffee. I asked her to tell me her story. Her husband smoked and died from lung cancer. She started volunteering to spare other people from experiencing her pain. She believed nicotine was the thing that caused harm. I then told her my story. She is still a champion against youth use of any nicotine product. Yet, she understands the importance of safer alternatives for adults who smoke.

A friend asked me to speak to a mom with a teenage son who was vaping. He told her he was addicted and couldn't stop. Our first couple of conversations were unpleasant as she mostly yelled at me. After she'd had the opportunity to express her anger, frustration, and fear for the welfare of her son, I finally got to tell her about my son. It took us a few tries before both of us could keep our emotions in check and talk mom to mom. Due to listening to her and asking questions, it became apparent that her son started vaping because his friends were. Later he transitioned to self-medicating with nicotine. I encouraged her to have her son tested for ADHD. They did, and he does have ADHD. He was vaping high nicotine products. I referred her to a quit vaping program designed for youth. He no longer vapes. She still feels strongly about youth vaping. She also understands how important these products can be for people who smoke and the deadly consequences when people don't stop smoking.
Are the PAVe moms evil liars or standing their ground because they believe they are doing a good thing and protecting kids? Did they make up what they say, or do they repeat information received from those they think are trustworthy sources? Are we angry with the right people?  
What will we accomplish if we continue to troll and harass the PAVe moms? Will they ever talk to us? Will they ever listen? I think it's human nature to get defensive when people are rude to us. I believe some of our behavior towards the PAVe moms and our comments are cruel and immature. I don't believe we will ever accomplish changing any minds this way. I think we need to find a way to disagree more respectfully. I think we need to continue to extend an invitation for all of us to sit down at the same table and do our absolute best for kids and for anyone who smokes. 

Sometimes I find myself angry that moms like the ones in PAVe have a stronger voice in society than moms like me. Their wealth and higher status in powerful circles give them an in with the media and policymakers. While they get a seat at the table for Congressional hearings and with the President, consumers who smoked don't (that includes moms like me!). It's not fair, but it's not the fault of the PAVe moms. If any of us had that type of prestige, we'd use it to fight for tobacco harm reduction, just like they use it to fight to protect kids they feel are in danger.

I'll leave you with one final thought for those who think these women are awful parents. My husband and I smoked when our son was born and smoked until he was almost 30. We talked to him about smoking and encouraged him to never start. That's very hypocritical as we're puffing away. He started smoking when he was 18. At 29, he had his first heart attack, and at 35, he had a second one. Smoking has almost killed him twice. When he started smoking, I did nothing to encourage him to quit. When he was broke, I bought cigarettes for him. I failed in my forever duties as his mom to do everything in my power to encourage him to make better choices and to protect him.

I don't think you'll find any PAVe moms buying their kids cigarettes or vapor products. I will never again say that they should learn to parent. It looks to me like maybe I could learn a thing or two from them. It doesn't mean I endorse the prohibitions they are asking for. It does mean I understand wanting to do as much as possible for kids.                                                                                                              People seem to have lost their ability to find balance and seek common ground. It appears to me that we have 2 choices. We can continue to build walls and remain divided, or we can start building bridges to close the gap that divides us. 

Sunday, April 3, 2022

Kindness and Understanding

3 simple words "I don't understand"

I'm guessing for some, it's hard to comprehend why it'd be hard for anyone to say those words. But for me, I'd rather choke than utter them. Or at least that's how I used to feel. It was taking a risk to admit to others when I didn't understand.

Life is full of things that perplex me. I become more confused when dealing with people's reactions to my lack of comprehending something. Some will treat me like I'm stupid. Others will talk down to me like I'm a little kid. Some get annoyed. Some say I'm faking to get attention.

Google is my friend. It often leads me to the information that helps me understand what is confusing me. But sometimes Google leads me to misinformation or doesn't find what I need. At times, I just can't figure out the right search terms to tell Google what I need to know. Then there are the things that are just too abstract to use Google as a tool.

Not understanding leads me to getting stuck, increases my anxiety, prevents me from making decisions, overwhelms me, and hinders my quality of life. I am a person who needs to know. Quite often I need to know why or how. To me, "I don't understand" is as much an emotion as it is a statement. I feel the words and I don't like the feeling.

Somehow all the little pieces that makeup life fell into place and brought me a person who is safe to admit when I don't understand. They've never made me feel judged, belittled, stupid, silly, or an annoyance. When I admit to not understanding they try to help. There are times they help me slow the tornado in my head so I'm not overly bombarded by questions in my brain. When the tornado takes over my brain there's no pause to think of answers. I'm surprised that when the tornado is stopped I'm often able to problem solve on my own. And there are times I just need something spelled out in black and white and this person does so in a kind and compassionate way that clears the fog and lets me walk away feeling respected and with my dignity.

I'm grateful this person has found their way into my life and I want to say "thank you". The photo of all the thank yous is so appropriate. When I first started communicating with this person, I had a wall full of post-it notes. Things I needed to remember, things to do, appointments, projects, and inspirational sayings, were all on the wall. A collage of brightly colored squares that were meant to help me organize my life but in reality only added to the chaos. Dealing with the person who makes me feel safe has led to reducing a lot of the chaos in my life. I took down all the post-it notes except for one. The one left is a reminder. It says:

"Remember: Angry people are hurting, #BeKind."

Thank you, Joe. Over the last year, you've helped me understand many things. You've helped quiet many storms and brought me peace, understanding, and a feeling of acceptance.

Thank you to all of you who practice kindness. We never know what kind of storm is going on in someone's head. When we are kind we're given the opportunity to shelter someone else from a devasting storm.


Saturday, March 19, 2022

Love and Hate


If You Really Care Please #BeKind!

A little over a year ago I shared with the world a new chapter in my life that involved the addition of some labels to my identity. I have been blessed to receive a lot of support from people all over the world as I learn how to accept and work with these challenges. Each episode of depression has been confronted not only with my own efforts to crawl out of the darkness but the words of so many of you working hard to lift me up. 

There have been a couple of people who aren't comfortable with my public sharing of the challenges I'm facing. I've been asked (TOLD) more than once to keep this part of my story quiet. I have suffered quietly with these challenges all of my life because the challenges did not have a name. Instead, I thought I was a bad person, a failure in the eyes of my father and many others. 

What I'm about to share is painful. This is going to be a lot of reading. If you're going to read this, please read it all the way to the end. I need to ask a favor of all of you. I need people to stand with me on this. I need them to stand for what I believe in and what I'm about.

February 24, 2022, Mark and I learned of the death of a good family friend. He died with a cigarette in his hand. I'm heartbroken he passed away, and I'm angry that he couldn't quit smoking. I'm angry that misinformation kept him from trying things that might have helped him quit smoking. I haven't developed an ability to handle grief or anger very well. It appears that each time I'm confronted with grief I go through another episode of depression. It hit me quickly this time.

That depression increased when a couple of days later, I got this message:

“Skip you’re crossing the line and need to step back. You have no idea what you’re saying or doing. You should stop posting publicly about all your mental problems. 

Autistic people should take special classes so they understand how to act and what to say. People you know online aren’t your friends they are acquaintances. You look like an idiot acting like people on social media are your best friends. 

You send too many messages and none of them are important. You’re being an obnoxious pest and I’m not the only one who says this. Stop. Just stop. It’s rude and selfish to take up my time for stupid shit.

Why do you keep sending me ******* flavor studies? Big tobacco and juul are lobbying to destroy us. Flavors aren’t the issue anymore. Either fight for synthetic or get the **** out of our way. And stop with all the people should get along and talk to each other. Our ******* advocacy groups can’t work together and you expect us to go to bed with the enemy? There’s something wrong with you.”

Those words hurt. Who they came from hurt even more. I have been deep into another round of depression and I have been stuck here. The thoughts and emotions were like a tornado in my head and the tears flowed freely on and off every day for a couple of weeks. I didn't know what to do. I was barely functioning, had trouble sleeping, and was plagued with nightmares when I did sleep. I didn't know what it was that I needed to slow the thoughts so I could deal with them.

What I needed was to be heard. I was given that gift and it helped. That night, I fell asleep and slept peacefully for hours. I had a plan, a direction to go. The tornado was gone. I decided to respond to the person and wrote them a letter.

This is what it said:

"Thank you for reaching out to express your concerns.

I’m sorry that the messages upset you. I didn’t realize that you had discontinued gathering evidence on the value of flavors. I think the best remedy to this situation and the easiest way to respect your time would be to stop messaging as you suggested. If you have a need in the future for more studies, info, or just to chat, please feel free to reach out to me.

We are 2 very passionate people when it comes to THR. I think we both feel threatened over the recent developments pertaining to the FDA, PMTAs, MDOs, and now synthetic nicotine. Add in all the state and local battles over flavors and taxes and it seems like all we do anymore is fight for the industry to survive. I find myself dealing with a lot of fear, frustration, and anger. I know that you’re no stranger to those feelings. It sucks to be feeling this way all the time. Thank you for fighting so hard for the industry. I hold on to hope that your business and all the others survive.

I share your concern over the lobbying by those we’d expect to be our allies. I struggle with this and I know that many of you are angry with me over my support of “gas station products”. I don’t like that some THR companies are pushing for legislation that helps them while hurting all us little guys. I don’t like it one bit. It is hard for me to comprehend that business is business and in that landscape, profits come before people (consumers and competitors). I wonder if some of the big guys ever feel the same way when some of us push for flavors (or all vapor products) to be sold only in age-restricted locations, taking the c-stores completely out of the picture? The most painful lesson I’ve learned from the combo of business and politics is that the fight to survive can mean casualties in our own community. It’s brutal and I hate it.

Both of us used to smoke. Both of us are tired of being stigmatized because of smoking and now vaping. Both of us are frustrated that no one is listening to those of us from the smoking community. We’ve both encouraged people to get involved and to tell their story, that lawmakers need to see what a difference it makes for us, our loved ones, and our kids when we quit smoking. Most of society doesn’t smoke and many of them never have. It’s hard to comprehend that some of the people making decisions about our lives don’t even know anyone who smokes. 

It took the encouragement of many of you to help me become brave enough to go testify in front of a city council and then my state lawmakers. Those early testimonies were a quick version of “just the facts”, citing info from studies. It was where I was most comfortable. Under the mentorship of you and others, you helped me find the words to talk about smoking, the death of my Mom, and my son’s heart attack. It’s incredible to testify and have a lawmaker wipe a tear from their eyes as the words people like you encouraged me to use took the glaze out of their eyes and touched their hearts. 

I never would have gotten so involved in advocacy without the encouragement of you and some of our fellow biz owners and consumers. I have always admired and appreciated your fighting spirit and the fact that you never give up. You have inspired me to do the same. As you know, in 2020 a new chapter was added to my story and my love affair with nicotine. I find myself with a new struggle. The stigmatization over having smoked and vaped is still here, we haven’t fixed that. And as you know, the accusations of being big tobacco shills doesn’t seem to end, either. Your messages made me face the painful reality that I now deal with another stigma. One that is given to me by people who don’t understand neurodiversity.

There are 3 of you who have asked me to silence my voice, to hide my truth, my story. I have spent the last 2 weeks torn over this and that is why it has taken me so long to respond to you. It is important to both of us to continue to try to save the lives of people who smoke. So many of those people belong to my neurodiversity family. They are my people, just like you are my people. We all have smoking as our common denominator. And yet, we’re each different in our own unique ways. If you want to learn more about autism and mental health, I’m trying very hard to be an open book and I am willing to do my best to try to answer your questions and address your concerns. 

It took me my whole life to find my voice. To stand up for what is right. I wouldn’t have gotten here without you and the others. I’m deeply hurt by the stigmatizing language in your message and the request to be quiet about the truth that I and many others face. Every day I have to look in the mirror and make sure that I’m doing things that make me proud of the person looking back. The first time I had to speak at a meeting, I was so afraid that I stood outside in tears, frozen in fear and unable to go in. It was YOU who gave me a hug and told me my voice has value. I probably would have been much less hurt if your messages had come from someone else. Your words took my value away from me. What can I do to help you see that my voice and my truth and my story still have value in our efforts to not only save vaping but to save lives?

I share your concerns about the division among our advocacy groups and advocates. We’ve never been able to get everyone on the same page. I don’t have an issue with multiple strategies, none of us know which one will work. I do object strongly to the various groups publicly attacking each other on social media. I think we can all do better at being supportive of each other. My Tweets to "Change The Conversation" applies to everyone - those on both sides of the THR divide, but not to just the other side, but to each other, meaning people on the same side.  

Support is important. How many times have we felt burnt out and defeated and one of our own comes along to lift us back up? It’s OK to disagree, it’s how we act when we disagree that matters. I appreciate you keeping your concerns about me private and not blasting them all over social media. I feel the need to give people like me - those with invisible disabilities - a voice. I feel with the prevalence of smoking among this population, we need to be seen and heard. I think we deserve a seat at the table. I hope you can understand that and that I’ll be able to count on your support in the future.


Last night I finally got brave enough to send it. I tried to be kind and gracious. I was hopeful that my words would help foster an understanding as to why neurodivergent people have voices that are just as important as everyone else's. Unfortunately, my efforts failed and made the person even angrier. They called me in the wee hours of the morning. It wasn't pleasant. I asked them to stop yelling and to stop calling me names. They continued. I did something I don't usually do, I hung up on them. This made them even angrier and they sent me a Facebook message. It was pretty ugly. A little bit ago I blocked them. Also something I try hard not to do - block or get blocked. Once that door is closed, there's no future opportunity for any productive communication.

Exhausted, hurt, and frustrated I laid down and had a good cry. I must have cried myself to sleep. Before today, outside of the 2 of us mentioned in the messages above, only 1 person knows the details of what has been going on, the person who patiently listened as I tearfully talked about this experience. This whole exchange has been private, and I prefer it that way.

Unfortunately, a pile of used tissues beside me and the hurtful words on my computer screen was all that was needed for someone to add 1+1=too much pain. It's human nature to come to the defense of those we care about and that's what happened next. It was put on Twitter. And now, here is where a bunch of you join in on this story. You made me smile rallying around me, wanting to have words with the person who caused me pain. Some of you feel motivated to go beyond words. Thank you to all of you for wanting to come to my defense. I feel stronger standing with you.

One of you knows what's going to come next from me. Thanks, Lindsey, you nailed what I need from everyone.

"Thinking of you Skip. I'm so sorry someone felt the need to hurt you...You've got an army ready to take them on, but knowing you, you'd like us to practice kindness. ❤❤❤"


Go back to the message from the person I'm writing about. Look past the stigma of their words. What do you see? I see anger. Anger that had no place to go and ended up directed at me. Anger is a secondary emotion. It's born from a primary emotion. When I step outside of the hurt caused by that person's words, I see fear. When we feel fear, survival instincts kick in. What is that person afraid of? That is easy to answer! Losing the technology that helped them quit smoking and keeps them from returning to smoking. Losing their business and their means to support their family. If they lose their business they lose their means of helping members of their community quit smoking. Loss of their business means they have to let down their employees, some of who have worked for them for years.

I see someone who has fought long and hard for what they believe in. I see the fear that my voice may hurt instead of helping that cause. I see someone who is hurting as bad as I am. The last thing I want to see is a bunch of us add to their anguish. Thank you to all of you who want to rally to my defense. I've done what I need to do. I tried to show them why my perspective is different than theirs. When that effort failed, I did what I need to do to protect my mental health and have cut off ties with this person. Now, I have 1 thing left to do before I can walk away from this situation. And that's to ask a favor of all of you...

If You Really Care Please #BeKind!

If you believe in prayer, please pray for this person.
If you believe in healing energy, send some their way.
If you believe in hope, I think that person could use some.
If you believe in love, that is what I need you to radiate right now.
If you believe in the power of positive thinking, send some in the direction of this person.

By doing these things you will be demonstrating your love and support for me. Because you will be standing up for what I believe in, for what's important to me. My goal is to someday die a success. To me, success means that when my time is up, I will be known for being a good person, for making the world a better place, and for having a positive impact on others. I can't do that without you. Please don't spend any more time feeling anger towards this person. Love always has been and always will be stronger than hate.

A really good book to read that has had a positive influence on me as I've dealt with this situation is "See No Stranger" by Valarie Kaur. Thanks, Joe, for the recommendation. Her philosophy is something I very much agree with. As we all struggle with how stressful and challenging life is, I hope some of you will read this book.

Quality of life is vastly improved when we put ourselves in a peaceful place filled with love for others.

Sending hugs,
~ Skip

Sunday, February 27, 2022

Change the Conversation (Part 2)


Are we ready to “roll up our sleeves and work together”?

Part 2

On February 18th I added “Change the Conversation (Part 1)” (CTC) to my blog. In the early morning on Saturday the 26th I discovered a message from someone on Twitter (I’m not saying their name to protect their privacy). They found the link to CTC because someone retweeted it. After checking out my Twitter account, they felt compelled to message me. They believe it’s not possible for all sides to get together and discuss the controversy over tobacco harm reduction because pro-vaping people are a bunch of rude trolls not willing to budge an inch or be willing to admit that vaping is dangerous. They felt that I must be one of those people based on my pro-vaping tweets. They looked at my blog quick and saw a bunch of hyperlinks, but didn’t see an actual list of what I was referring to. They assumed I’m biased and said so in their message. I asked if they read my CTC commentary and checked out the links. They said no, they weren’t going to waste their time and said I was probably working for a tobacco company.

I got angry. The response I started typing was not kind. I didn’t send it. Instead, I told them if watching loved ones die from smoking and then watching others - including myself - finally quit smoking thanks to vaping makes me biased, then yes I am biased. I went on to explain I don’t mean the CTC entry to be pro-vaping, that I’m concerned about how many people die from smoking and I think we could save more lives sooner if the pro/con people would stop fighting and try to work together. I asked them to please read my commentary on the subject.

They were surprised I’d admit to being biased but weren’t ready to agree to read my blog. They commented again on there’s no list at the end of what I used for links. They were sure that everything I used would be pro-vaping and that garbage is a waste of time. 

I put a lot of thought and time into writing that piece so once again I found myself angry. I sat and thought about this over a cup of coffee. How do any of us ever change the conversation if someone won’t listen to us (or read the words we wrote)? I started to doubt myself based on that person’s accusations. Did my personal beliefs motivate the writing of that piece and if yes, is that a bad thing? 

The answer is yes, my personal beliefs motivated me to write my commentary on CTC. And no, that’s not a bad thing. The reason it’s not a bad thing is because of WHY I wrote it. I wrote it because I’ve seen many people who in the past couldn’t quit smoking and thanks to tobacco harm reduction products, including vaping, they have finally quit. I wrote it because I want the needless deaths to stop. I wrote it because I care.

I started another reply to the person. Again, my anger and frustration got the better of me and luckily I paused and didn’t send it. I was going to tell them off. I’m tired. I’m tired of being judged. I’m tired of seeing people die. I’m tired of being thought of as evil. I’m tired, tired, tired. It shouldn’t be so hard to save lives. Why can’t this be easy? Is my head even in the right place to try to reply to this person?

My heart is heavy. My husband’s best friend, Jim Constenius, died last week. Dropped 

dead from a heart attack. He smoked from his teen years until the day he died. He’s only a year older than my husband. Another painful loss. Would this have happened at his age if he didn’t smoke? We’ll never know. Thanks to isolating because of COVID, my husband and I can’t go to the funeral. Our smiling Finnish friend is gone. We haven’t made the trip back to my husband’s childhood home for a couple of years, so it’s been a while since we’ve spent time with Jim and his family. Now, we’ll never get to.

It would be so easy to tell someone off. To give my sadness, anger, and frustration a release from my brain. It might even feel good for a little while until I get around to feeling like a jerk for being a dick. I want to do the wrong thing but am stuck on my mission to do the right thing and to always #BeKind. Reminding others to be kind is something I Tweet about daily.

Now lost in self-doubt and stuck on how to respond to the person I’ve been messaging back and forth with I had to decide what to do. If I wasn’t going to tell them off, the next option that I thought of was to just not reply to them anymore. I’m grinning because it crossed my mind that if I walk away, they’ve won. So here I am, preaching “Change the Conversation” and encouraging people to stop fighting and start talking while I’m thinking about winners and losers! ARGH, it is hard to drag myself out of fight mode! 

After a lot of deliberation in my head, I went back to what the person mentioned twice. There’s no list at the end of my blog of what I used to make my case for wanting people to CTC. Is that really a big deal? Well to the person I’m exchanging messages with it is, or it’s an excuse not to read my blog. There’s really only one way to find out. So, I messaged them back and asked them if I made a list of where my information came from and an indication of why I used it, would they read my blog.

I was thrilled when they said yes!

I went through my CTC commentary and made the list. I put it in a google doc and sent them the link this morning (it’s below if you want to see it). I’d been waiting hours for a response. While I waited I thought about what was on that list. There are several people and organizations I usually don’t agree with on that list. Yet, if I dig deep enough I can see where we do have common ground or the potential to find some. I have spent the last few days having private conversations with people who don’t share my views about tobacco harm reduction. Sometimes it takes a lot more effort to be kind and respectful, but I think it’s worth it.

The wait for the reply from this latest person has felt like days instead of hours. In the end, it wasn’t what I expected. I thought they'd tell me to go jump in a lake. Instead, they were surprised that my commentary on the need to CTC wasn’t more pro-vaping than it was. They didn’t know people had tried to reach some kind of understanding in the past. They still don’t think it will happen in the future and they don’t think if it did it would do any good. They were disappointed that I didn’t make a point of how dangerous vaping is and how it’s addicting kids. They think that all nicotine products should be illegal. They were surprised I'd use WHO, Cancer Society people, and the Truth Initiative as forms of information.

And then the strangest thing happened. They wanted to know why this is such a big deal to me and wanted to know more about how smoking has affected my life. They just opened to door for me to tell my story and have a more open conversation.

It’s a good thing I was sitting down when I read their message. 


Here’s the list;

Don't Forget the Smokers - 1998 Washington Post by C. Everett Koop (United States Surgeon General 1981 - 1989)

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.”

The Truth Initiative - Citing 2015 data from the World Health Organization (WHO)

“Every 6 seconds, someone in the world dies from a smoking-related disease”

Pan American Health Organization (PAHO) - 2019 Tobacco kills one person every 34 seconds in the Americas

Tobacco use has a major impact on health, killing one person every 4 seconds globally, 

and one person every 34 seconds in the Americas. This accounts for a total of 8 million deaths worldwide each year, with almost 1 million in the Region. Over half of lung cancer cases are related to tobacco, as are almost half of the cases of chronic obstructive pulmonary disease (COPD).”

World Health Organization (WHO) - 2021 Tobacco

Tobacco kills more than 8 million people each year. More than 7 million of those deaths 

are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.”

Tobacco harm reduction: conceptual structure and nomenclature for analysis and research - 2002 Shiffman S, Gitchell JG, Warner KE, Slade J, Henningfield JE, Pinney JM. - Nicotine Tob Res.

“Decisions made about THR are likely to shape tobacco control 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.”

The stigma system: How sociopolitical domination, scapegoating, and stigma shape public health - 2022 Friedman SR, Williams LD, Guarino H, Mateu-Gelabert P, Krawczyk N, Hamilton L, Walters SM, Ezell JM, Khan M, Di Iorio J, Yang LH, Earnshaw VA - J Community Psychol

“Stigma is a fundamental driver of adverse health outcomes. Although stigma is often 

studied at the individual level to focus on how stigma influences the mental and physical health of the stigmatized, considerable research has shown that stigma is multilevel and structural.”

Words Matter: Preferred Language for Talking About Addiction - 2021 National Institute on Drug Abuse (NIDA)

Stigma is a discrimination against an identifiable group of people, a place, or a nation. 

Stigma about people with substance use disorders might include inaccurate or unfounded thoughts like: they are dangerous, incapable of managing treatment, or at fault for their condition.”

Depression Causes Vaping! - 2021 Professor Caitlyn Notley, E-Cigarette Summit UK

Epidemic discussed from 5:57-6:44 

Addiction Center - 2021 Addiction vs Dependence 

The difference between addiction and dependence can be difficult to understand. Some 

organizations have different definitions, use the words interchangeably or even abandon both terms altogether. (Substance use disorder, or SUD, is a preferred term in the scientific community.) Because of this lack of consistency, some ground rules can help differentiate between the two terms.”

National Harm Reduction Coalition - 2020 Principles of Harm Reduction

Harm reduction is a set of practical strategies and ideas aimed at reducing negative 

consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”

Tobacco Harm Reduction: Past History, Current Controversies and a Proposed Approach for the Future -2020 Hatsukami, D. K., & Carroll, D. M. - Preventive Medicine

Tobacco harm reduction has been defined as minimizing harms and decreasing total 

mortality and morbidity, without completely eliminating tobacco and nicotine use”

Truth Initiative - 2021 Truth Initiative Statement on Harm Reduction

“There is a contentious and ongoing debate regarding what role the concept of “harm 

reduction” should play for smokers who have rejected FDA approved cessation methods, 

who find those alternatives unattractive, or simply wish to continue using nicotine”.

Who or what is the World Health Organization at war with? - 2016 Clive Bates - The Counterfactual - Section 3, The wrong war: the confusion of tobacco policy aims

Possible goals for tobacco control. This is why we have to be precise about goals. Is the 

overarching goal to:...”

Electronic cigarettes: achieving a balanced perspective - 2012 Wagener TL, Siegel M, Borrelli B - Addiction

...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 without consideration of both sides of the issue, including potential public health benefits.”

Inside Health - 2019 Professor Marcus Munafo - Why vaping is dividing public health experts causing a polarised split

…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 and accept the possibility that we might be wrong. And when you bring very strong feelings to those discussions, it can be difficult to move your position.”

How to feel AND think about nicotine and those who use it - 2018 Joe Gitchell - Global Forum on Nicotine 

much of the discussion over goals and trade-offs rely on “deeply held values and 

feelings' ' that “dominate much of our thinking”.

It is Time to Act with Integrity and End the Internecine Warfare  Over E-Cigarettes - 2021 Clifford E. Douglas, J.D. - Commentary

“Throughout the 33 years that I have devoted to combating the epidemic of 

Smoking-related illness and death in the United States and globally, I have embodied the 

mainstream American tobacco control community. …1988 as the associate director of the National Coalition on Smoking or Health …I was for five years a member of the senior leadership of the American Cancer Society, where I served as the vice president for tobacco control and founded and directed the organization’s Center for Tobacco Control. …as well as Americans for Nonsmokers’ Rights and the Public Health Law Center, in addition to serving as a special counsel on tobacco issues in the U.S. House of Representatives, as a tobacco control policy advisor for the U.S. Assistant Secretary for Health and the U.S. Surgeon General in the Obama administration,”

New Evidence of Smoking Disparities Underlines That Tobacco Harm Reduction Is Social Justice - 2019 Sessi Kuwabara Blanchard - Filter Magazine

Irrefutable evidence of the disproportionate impact of smoking harms on marginalized 

populations underlines that tobacco harm reduction is a social justice issue.”

Balancing Consideration of the Risks and Benefits of E-Cigarettes - 2021 Balfour DJK, Benowitz NL, Colby SM, Hatsukami DK, Lando HA, Leischow SJ, Lerman C, Mermelstein RJ, Niaura R, Perkins KA, Pomerleau OF, Rigotti NA, Swan GE, Warner KE, West R (15 past Presidents of the Society for Reasearch on Nicotine & Tobacco - Please see Acknowledgements and Conflicts of Interest sections) - American Journal of Public Health

“The use of nicotine-containing electronic- or e-cigarettes has divided the tobacco control 

community along a spectrum from fervent opponents to enthusiastic supporters.”

Balancing Risks and Benefits of E-Cigarettes in the Real World - 2022 Cohen JE, Krishnan-Sarin S, Eissenberg T, Gould TJ, Berman ML, Bhatnagar A, Barnett TE, Soule E, Popova L, Tan ASL, Blank MD, Ling PM, O’Connor R (13 Experts in Tobacco Control - Please see Acknowledgements and Conflicts of Interest sections) - American Journal of Public Health

“We challenge the public health and scientific community to move away from 

characterizing scientists as “opponents” or “supporters” of e-cigarettes for three primary reasons.”

Are We Seeing Early Signs of Common Ground in US Tobacco Control? - 2022 Alex Norcia - Filter Magazine

“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.”

Protecting American Families: Comprehensive Approach to Nicotine and Tobacco - 2017 Scott Gottlieb, M.D., Commissioner of Food and Drug Administration (FDA) (No longer holding that position)

“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.” “Reframing shared objectives around the need to rethink nicotine is a start.  It could help all of us achieve the one public health goal I know we all share, and that’s to save the lives of current and future cigarette smokers.”

How and why I changed my mind on e-cigarettes - 2015 Jim McManus 

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.”

Toward a comprehensive long term nicotine policy - 2005 Gray, N., Henningfield, J. E., Benowitz, N. L., Connolly, G. N., Dresler, C., Fagerstrom, K., Jarvis, M. J., Boyle, P. - Tobacco Control Vol. 14(3)

“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 Strategic Dialogue on Tobacco Harm Reduction: a vision and blueprint for action in the US - 2016 Zeller, M., Hatsukami, D., & Strategic Dialogue on Tobacco Harm Reduction Group (Please see list of funders and participants) - Tobacco Control Vol. 18(4) 

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.” “This paper discusses recommendations from a strategic dialogue held with key, mostly US-based tobacco control researchers and policy makers to develop a strategic vision and blueprint for research, policy and communications to reduce the harm from tobacco for the US. Short-term and long-term objectives are described.”

Polarization Within the Field of Tobacco and Nicotine Science and its Potential Impact on Trainees - 2021 Dana Mowls Carroll, PhD, MPH, Rachel L Denlinger-Apte, PhD, MPH, Sarah S Dermody, PhD, Jessica L King, PhD, Melissa Mercincavage, PhD, Lauren R Pacek, PhD, Tracy T Smith, PhD, Hollie L Tripp, PhD, MPA, Cassidy M White, BA - Nicotine & Tobacco Research, Volume 23, Issue 1

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…we are calling for reflection among everyone in the field and particularly among those with influence and power.”

Michael Bloomberg loves data. Except when he doesn’t. - 2022 Marc Gunther

The billionaire philanthropist who finances campaigns against vaping won’t listen to 

dissenting views”

Letter to Bloomberg: Tobacco control: the danger of doing more harm than good 2021 signed by 23 public health experts

Response Letter - 2021 signed by Kelly Henning, MD, Public Health Program Lead, 

Bloomberg Philanthropies 

Response from the experts - 2021 

(Note: as of Jan 2022) no Bloomberg/Bloomberg Philanthropies as not agreed to meet.

Jonathan Haidt - Social psychologist at NYU-Stern. I study moral and political psychology and business ethics

How to Think—Not Feel—about Tobacco Harm Reduction - 2019 Warner K - Nicotine & Tobacco Research, Volume 21, Issue 10

“The debate over tobacco harm reduction (THR) has divided the tobacco control 

community into two camps, one expressing serious reservations about THR whereas the other believes that reduced-risk products like e-cigarettes will disrupt the cigarette market. The often emotional debate would benefit from dispassionate data-based evaluation of evidence.”