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Letter to the editor: Harm reduction strategies not best public policy

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There has been a good deal of talk about public policy such as "harm reduction" strategies (i.e., promoting alternative tobacco products, such as chewing tobacco or e-cigarettes, as safer alternatives to smoking cigarettes) as a good option to reduce the risk of using tobacco while maintaining the addiction to nicotine.

Reducing-harm strategies can be an option for an individual who wants to try to reduce his/her own risk of harm while maintaining an addiction. However, harm reduction strategies are not the best public policy.

Here is what I know to be true:

1) E-cigarettes are sometimes touted as a good alternative to tobacco use. We are told by some that the vapor is harmless. This is not true. It has not been regulated or studied enough to know how dangerous it is, but it is not harmless. There is another issue to consider. Have you ever noticed how candy cigarettes and now e-cigarettes mimic the activity a smoker would do with a cigarette? It models the smoking behavior and should not be discounted as harmless.

2) I hear a lot about smokeless tobacco being a good alternative for adult smokers who don't want to quit using tobacco. Consider this: it is not just adults who use chew. The sweeteners added and new products that have come on the market make it an easy way to addict our next generation to tobacco. North Dakota's youth consume smokeless tobacco at a rate almost twice the national average (North Dakota, 13.6 percent, US, 7.7 percent). In addition, smokeless tobacco is not without its health hazards.

3) Consider what would happen if public health professionals advocated for food handlers to wash their hands most of the time, after using the bathroom, rather than every time. After all, it would reduce the chances of contracting disease from someone who never washed his/her hands. One could say it is better than never washing one's hands. The public policy must continue to be the best method of preventing disease transmission, that is: wash one's hands every time, not just sometimes.

Public health providers are accountable to the community to provide up-to-date information and advocate for tried and true strategies to improve or maintain a community's health status.

As a public health nurse, I cannot support harm reduction policies that support maintaining one's addiction to tobacco. Harm reduction policy is not sound public healthpolicy.

Harm reduction strategies are not evidence based. The evidence is clear regarding what works and how to gain access to help. The options are available, FDA approved and researched for safety and effectiveness. They are called nicotine replacement therapy and NDQuits at 1-800-QUIT-NOW.

(Knox is a public health nurse at the Grand Forks Public Health Department)

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