My new white paper, "Tobacco Harm Reduction: Policy And Practice" published by the Hispanic Leadership Fund

For those of you who subscribe to follow my work on tobacco harm reduction (THR*), some good news. Ok, who am I kidding -- approximately no one subscribes; I am putting this here as a place to point to for anyone who is interested. Anyway, the good news is that I was not contributing nothing to that field while I was taking a few sick years off from my life. I got this done.

(*For those who read me because of interest in other topics, THR refers to actions or policies that encourage tobacco/nicotine users to make the decision to choose approximately harmless alternatives, like vaping or snus, instead of making the highly harmful choice to smoke. This topic has been a major portion of what I have worked on for the last 24 years.)

It is a policy paper for a Washington DC advocacy organization, so it is not meant to be a scientific report, but it summarizes all the science you really need to know. As you might guess from the identity of the publisher, there is some emphasis on issues specific to the Hispanic community. However, it turned out there was relatively little to say about that community that was not just a general point about the topic (or a point about people who are not highly-networked members of the majority-culture middle/upper class more generally, which I also go into), so anyone interested in THR, vaping, or U.S. policy regarding either of those should find it interesting.

I am obviously a bit biased, but I think if I were asked by an American, or anyone with an interest in American policy, for a single thing to read about THR, I would point them to this. I would probably pick this if they just wanted to learn the basic facts about THR without an interest in policy.

The paper explains what THR is, why it is possible, how huge the potential health advantages are, and why it works. I review the policy history in the U.S. and elsewhere, and make policy recommendations (which mostly come down to “get government out of the way”). I also address why there is (ridiculously) opposition to THR, how FDA policy is just bad governance, how harm reduction is about autonomy and empowerment, and various other nuggets that my readers will probably appreciate. I really think it serves as a pretty complete summary of a quarter century of thinking about every aspect of this issue.

Just for fun — because we are supposed to be learning fealty to our new machine overlords — I asked ChatGPT to summarize it for me. It is not exactly what I would have written, but it is not bad (though you should still read the whole thing!!!):

***

Here’s a concise summary of the Hispanic Leadership Fund’s white paper on Tobacco Harm Reduction (THR) dated July 14, 2025, by Carl V. Phillips:

---

Summary of Key Points:

1. Core Argument:

The paper argues that vaping and other low-risk nicotine alternatives (like snus, nicotine pouches, and heated tobacco products) are highly effective in reducing smoking rates and associated health harms. It advocates for a harm reduction approach over abstinence-only policies.

---

2. Vaping as a Solution:

• Vaping has led to the most substantial drop in smoking rates since the 1960s, especially in countries like the U.S., U.K., and Sweden.

• These products offer a near-zero health risk compared to smoking.

• Vaping is described as “approximately harmless,” akin to drinking coffee, and far less risky than smoking.

---

3. The U.S. Policy Problem:

• U.S. federal policy (especially FDA actions) impedes progress by:

  • Banning or severely restricting most vaping products via a burdensome approval process.

  • Promoting misinformation that vaping is highly dangerous.

  • Taxing low-risk products, reducing accessibility, particularly for marginalized groups.

---

4. Impact on Hispanic and Minority Communities:

• While Hispanic smoking rates are relatively low (~8%), Hispanic and Black Americans are much less likely to switch to vaping due to misinformation and poor access to accurate resources.

• Spanish-language and culturally-targeted harm reduction messaging is virtually nonexistent.

---

5. International Comparison:

• The U.K. is highlighted as a positive example, where the government supports vaping as a cessation tool.

• Countries like Sweden and Japan show that supportive environments lead to major reductions in smoking.

• The World Health Organization (WHO) is criticized for exporting anti-vaping policies to poorer nations, wasting public health resources.

---

6. Policy Recommendations:

• Stop government disinformation campaigns against vaping and low-risk alternatives.

• Remove taxes and regulatory barriers on low-risk nicotine products.

• Implement a “food-style” regulatory model with light-touch safety oversight (as done in Sweden for snus).

• Focus on educating underserved populations, especially in Spanish.

---

7. Conclusion:

The white paper concludes that getting the government "out of the way" — by ceasing misinformation, eliminating overregulation, and supporting harm reduction — could nearly eliminate smoking in the U.S. and dramatically improve public health, especially in underserved communities.

---