Tag Archives: real harm reduction

What is Tobacco Harm Reduction?

by Carl V Phillips

In response to a couple of recent requests and my schooling of FDA in a recent Twitter thread, it seems time for me to again write a primer on the meaning of tobacco harm reduction (THR). Rather than return to a previous version I have written, I am doing this from scratch. This seems best given the evolution of my thinking and changing circumstances.

The key phrase, of course, is “harm reduction”, with “tobacco” denoting the particular area it is applied to. This is important: THR is not a concept that stands apart from HR. It means “the principles of harm reduction, applied to the use of tobacco and nicotine products, and other products that tend to get lumped in with them” (see my previous post for an explanation of that last bit and some other useful background about the current politics). Indeed, when my university research and education group was trying to decide on a name and URL in 2005, it was far from obvious that this was the right term, and we considered others (e.g., “nicotine harm reduction”). While the first prominent use of “THR” appeared in 2001, it was far from established as a common term. (There is probably some endogeneity here, of course — if we had chosen a different term, that might have ascended instead.) In any case, the key to answering “what is THR” is asking “what is HR” rather than thinking it is something different. Continue reading


Smoking is normal, and acknowledging that is part of proper tobacco harm reduction

by Carl V Phillips

Audrey Silk, via her CLASH organization in New York, recently launched a “Smoking is Normal” campaign (CLASH Facebook page, campaign Facebook page, press release). All the talk we hear about e-cigarettes “renormalizing” smoking is premised on a claim that something that about a fifth of the U.S. population does (and a larger portion in most rich countries) is not normal. In terms of prevalence, it is much more normal than being gay or being an American muslim. But think of the outcry — from very people who tend to be anti-smoker — that results when someone so much as points out those statistics, let alone suggests anything is abnormal about being in one of these minorities. Smoking is more normal than marrying outside one’s race or even marrying someone whose height percentile differs markedly from one’s own.

Of course, “denormalization” rhetoric is not an empirical claim about prevalence. It is a political tactic, an attempt to denigrate some people as being abnormal, in a sense that means abhorrent or deviant. In that sense, it is every bit as anti-THR as the most visited topic of this blog, attempts to convince people that a low-risk alternative to smoking is more harmful than it really is. No one who supports “denormalization” of smokers can be said to genuinely support tobacco harm reduction. Continue reading