A matter of equity

The tobacco industry’s attempt to co-opt proven harm-reduction strategies or to supposedly support those in recovery is faulty on many levels

Robin Rieske, a certified prevention specialist and community substance-prevention consultant, has worked in the field of substance use for over 35 years.

I recently turned down a deal with the devil.

Two lobbyists with Altria, a big tobacco company, reached out to me because of my work with Vermont's recovery and harm-reduction community.

They tried to convince me that flavored tobacco products serve as a "coping mechanism" for people in recovery and compared these products with proven harm-reduction approaches like "needle exchange."

However, their products are the leading cause of death for nearly a half million people in our country each year.

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As a huge proponent of harm-reduction strategies that are proven to save lives (syringe support, naloxone, wound care, Suboxone, etc.), I find it hard to see how flavored tobacco products reduce harm. In fact, according to the Centers for Disease Control (CDC), flavored tobacco products are more addictive than regular tobacco products, and those using menthol products also have a much more difficult time quitting tobacco.

This approach is so typical of an industry that asserts the rights of adult users, while spending billions yearly targeting our youth, Black, and LGBTQ communities with candy-flavored products.

This attempt to co-opt proven harm-reduction strategies or to supposedly support those in recovery is faulty on many levels.

There is no evidence that mango-flavored e-cigarettes, for example, provide any added value for those adults wanting to quit or use less. And it is absolutely true these products have driven the increase in youth vaping use that will likely contribute to decades of increased tobacco use.

This is not about prohibition. Tobacco-flavored products would still be available. This is about recognizing the role the industry has played in creating a culture of use and addiction among targeted populations for decades.

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I believe that ending the sale of flavored tobacco, including menthol (which is the flavor of choice of nearly 80% of Black smokers) will increase health equity for all. The tobacco industry has historically targeted the Black and LGBTQ communities with flavored tobacco products.

And this marketing works. Our Vermont Department of Health Youth Risk Behavior Survey indicates that, more than their heterosexual, white, non-Hispanic peers, BIPOC and LGBTQ youth in our state are more likely to use these flavored tobacco products. They are also more likely to suffer the lifelong consequences of tobacco addiction.

The Vermont Legislature is considering S.18, "An act relating to banning flavored tobacco products and e-liquids." Passing laws to promote health is not uncommon. When smoke-free indoor laws were passed, we saw a significant reduction in tobacco use for the first time.

Policy change often goes hand in hand with education, providing support and addressing social determinants of health.

I hope that the Vermont Legislature will see this bill as an opportunity to prevent youth addiction and reduce health inequity in our state.

As one colleague in the field said, "even in countries that have decriminalized heroin, you won't find candy-flavored heroin on the market."

This Voices Viewpoint was submitted to The Commons.

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