Massachusetts Teens Adopting Tobacco Harm Reduction?

Young Americans in the state of Massachusetts may have joined the Swedes in pursuing THR, albeit – like the original Swedish trend – probably without knowing or intending it.

Newspapers in that state recently reported that a the CDC released survey results in which respondents of middle and high school age reported a higher prevalence of use of “other” tobacco products than of cigarettes. It is probably not the case that smokeless use has actually surpassed smoking in this demographic, but it might be close. Apparently much of this public health success story is attributable to the smokeless products being cheaper, an accidental application of the principle that we should use taxes to encourage consumption shifts in a preferred direction. I suppose it is possible that these kids have seen through the anti-harm-reduction propaganda they are immersed in, and have learned that smokeless products are low risk, but I am not too optimistic about this interpretation.

(Unfortunately, due to apparent bad instrument design (what ever would possess someone designing a survey to lump in low-risk smokeless tobacco products with mini-cigars??!) makes it impossible to glean the most useful information available. I looked for a report of the actual methods and results, but could not find one. Perhaps I just missed it, though it would certainly not be unusual for the U.S. government to release claims like this without offering any information about the basis for their claims.)

The newspaper stories (e.g., here and here) show that the reporters and everyone they talked to are completely oblivious to the fact that this is great news for public health. Indeed, most of the focus of the stories is on how a few government officials are trying to figure out how to raise taxes or discourage smokeless use – presumably because they would prefer that teens smoked instead. Fortunately, the reports imply that the opposition to all new taxes that dominates recent American politics will do some good for a change, preventing a new tax that would probably cause thousands of teens to switch to smoking.

Other content in the articles would be hilarious if it were not so sad. Well, it was actually still pretty funny – I laughed.

John Auerbach, commissioner of public health, attacked the tobacco industry for this piece of good public health news as being “sneaky”, though exactly how you can be sneaky while trying to heavily market new products is rather unclear. He said this “at a rally with Massachusetts high school students”, which really makes me wonder what would possess high school students to rally to celebrate someone who is trying to implement laws that are specifically intended to restrict their freedom and manipulate their behavior – I am going to guess they were giving out free beer. The best bit, though, was the school nurse who is portrayed as seeming a bit surprised that she had not seen any cases of oral cancer as a result of this. Even setting aside the fact that these products do not cause any measurable risk of oral cancer, though smoking does, how exactly can she be so utterly clueless as to not know that behaviorally-caused oral cancers (drinking, smoking) occur about half a century after someone leaves high school?

-Carl V. Phillips

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