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