Center for Critical Public Health, the Institute for Scientific Analysis, Alameda, CA 94501, USA.
Int J Environ Res Public Health. 2021 May 22;18(11):5560. doi: 10.3390/ijerph18115560.
The controversy of tobacco harm reduction in the United States persists despite evidence that an important audience of tobacco prevention and control, i.e., the people who use or are likely to use nicotine and tobacco products, are engaging in practices that may be considered harm reduction. Despite this, a significant proportion of the US tobacco control and prevention field continues to be guided by a precept that there is "no safe tobacco," therefore failing to acknowledge practices that may be used to reduce the harms associated with consuming combustible forms of nicotine and tobacco. In this commentary, we argue that ignoring the potential benefits of harm reduction strategies may unintentionally lead to an erosion of trust in tobacco control among some members of the public. Trust in tobacco control as an institution is crucial for the success of tobacco control efforts. To ensure trust, we must return to our basic principles of doing no harm, developing programs that are responsive to people's experiences, and providing resources in assisting people to reduce the harms that may be associated with practices, such as smoking, which adversely affect health. Only by respecting an individual's priorities can we cultivate trust and develop tobacco prevention efforts that are grounded in the realities of people's lives and responsive to their needs.
尽管有证据表明，烟草预防和控制的一个重要受众，即使用或可能使用尼古丁和烟草制品的人，正在采取被认为是减少伤害的做法，但美国在减少烟草危害方面仍存在争议。尽管如此，美国烟草控制和预防领域的很大一部分仍然遵循这样一个前提，即“没有安全的烟草”，因此没有认识到可能用于减少与消费可燃形式的尼古丁和烟草相关的危害的做法。在这篇评论中，我们认为，忽视减少伤害策略的潜在好处可能会无意中导致公众对烟草控制的信任受到侵蚀。公众对烟草控制机构的信任对于烟草控制工作的成功至关重要。为了确保信任，我们必须回归到不造成伤害的基本原则，制定响应人们体验的计划，并提供资源，帮助人们减少可能与吸烟等做法相关的危害，这些危害会对健康造成不利影响。只有尊重个人的优先事项，我们才能培养信任，并制定基于人们生活现实和响应他们需求的烟草预防措施。
