Stories and projects

I put on my artists’ smock today to do the hard work of pulling together the final version of a strategic document for a client. Many team members have been putting in a lot of time to produce something meaningful… something meant to change the way our partners see the world and their work in it. We’re trying to tell a new story about place-based public health.

whats your story

That’s a tall order. We could get rejected. Our strategy might not work. We are working at the edge of the ‘known’ in public health, inventing our way into the future based on the most promising science — and hope. Moving forward with head and heart.

I hope the story we’re telling — of how to go farther despite challenge or tension — will be embraced.

For health!
Allison

PS. I’ve been listening to Leap First, about “making work that matters”. It’s a new audio recording from my friend Seth. He recorded it when we were together last summer in his office just outside New York City, and you can hear us clapping and cheering in Track 28.

A researcher milestone: Tobacco retailer reduction paper is in press.

I’ve been told by a board member at Counter Tools to create a “brag book”, which I admit feels very strange. Still, this is a milestone worth mentioning: My first, first-author scientific publication is “in press”.

Here it is. Special thanks to my co-authors, too!

retailerreductionpaper

Why would anyone care about reducing the number and density (think “concentration”) of tobacco retailers? I can give you a list of reasons. First, we know that retailer density in a neighborhood is related to the tobacco use behaviors of the people in the neighborhood: the residents have greater physical access to tobacco, reduced retrieval costs, and therefore higher consumption. Second, if tobacco retailer density is high, the presence of branded advertisements and price discounts is also high, and we know that these two marketing strategies give smokers or people who are trying to quit a reason to “buy now”. Third, tobacco retailers are clustered in high minority and lower income neighborhoods, and this is the social or neighborhood justice aspect I hope we all can get our heads around. Some people hardly have an opportunity to be or stay tobacco free, simply because of the neighborhood where they live, work or play.

What to do about it? Concerned citizens in a community can likely (unless they’re preempted) change their local policies to regulate the number and locations of tobacco retailers. Three options are (1) to prohibit tobacco sales in pharmacies, (2) to prohibit tobacco sales within 1,000 feet of schools, or (3) to prohibit tobacco retailers from being within 500 feet of one another. Any policy will make an impact. Pick one that stakeholders in your community can accept and implement.

PS. San Francisco is doing just this!

For health,

AEM

On my desk today: Dancing with fear

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I talk pretty openly about fear: what it says in my brain, how I work to ignore it, how I put on my smock and do the professional work of dancing with my fear and moving forward. It’s fear that tries to convince you that you don’t have enough time, or enough training, or enough expertise, or that someone else might be better suited to do that job. The work I do everyday is about trusting myself and taking the leap. By trusting myself, I decide that I have plenty of time, plenty of training, and plenty of expertise. I take on the responsibility of bringing my art, my service, into the world and offering it. What I humbly have to give won’t be for everyone, but it could be for someone, and so I keep going.

On my desk today:

1. The fitness challenge from my gym, because, Christmas cookies and PhD student stress.

2. My dissertation proposal, because today is the day the talk gets put together, whether I’m FEARFUL or not.

3. Seth’s new book, Your Turn, because it’s my turn (and it’s yours too).

Enjoy your day.

GASO; Going there with electronic cigarettes.

Today is the Great American Smoke Out and many e-cigarette and vapor outlets are promoting themselves as a way to quit. E-cigarettes are very interesting. If you want to understand them more thoroughly from a group of dedicated experts, I’ll refer you to this article, so you could skip my rant.

Here’s what I think. If you have tried to quit smoking every which way and have never been successful, please give them a try, because they are “better” than combustible tobacco products, which will definitely make you feel bad and could easily kill you.

But, I wrote the previous sentence very carefully, because before going the e-cig route, you would go here or here or here or here or maybe even here to get help quitting.

Here are the caveats to my statement. I mean “you”, as in one person, not the population of people, as in population or public health. I also mean “tried to quit smoking every which way” literally; until you’ve talked to your doctor and used proven effective methods (e.g. telephone-counseling and NRT or other helpful medications), you have not yet “tried to quit smoking every which way”. Careful, too, with “never been successful” because it often takes 7 or 8 or 9 quit attempts with known effective methods until you are permanently quit. And I should say “better than combustible products” in quotes because, they are “better” than combustibles, but let’s be real, inhaling an unknown mixture of heated chemicals many, many, many times a day can’t possibly be “good”. It might be “better” but, “better” than WHAT? (For the record, this is a horrible oversimplification not really fit for a student researcher.)

The problems with e-cigarettes are many. First, e-cigarettes have an incredible potential to renormalize a hand-to-mouth-breathe-in-breathe-out-get-a-nicotine-fix behavior that is no longer socially acceptable — a shift, which has contributed to great reductions in tobacco use (we call this ‘changing social norms’). Second, we don’t know what’s in them because they aren’t regulated (Even cereal has an ingredients list!). Today, all across America, we have e-cigarette baristas, mixing very toxic nicotine (Kills kids! And dogs!) with flavors and other liquids in their back rooms and giving it to desperate/curious want-to-be-ex-smokers or cool-kids-who-vape (or ?). It’s a bit like an undergraduate chemistry lab. Third, scientists don’t really know how they are used among population subgroups or what role they play in health behaviors/tobacco use/health outcomes over time (e.g. Still smoking combustibles? Ever smoked combustibles?) because, quite frankly, they’re not that ‘old’ as devices and good studies by good researchers who use good methods who pass the test of peer-review take time.

The biggest problem: There are too many unknowns. When things are too unknown, thinking people shy away.

What we do know is that they have TERRIFICALLY divided the public health community and that is super sad. Back the article I recommended at the top of this post: If you’re interested in what a group of smart, open-minded experts have to say about e-cigarettes, this is a really helpful summary article of what we know and what we don’t know and what we should try to do as we move ahead.

My last note: I really want everyone to quit smoking combustible tobacco products, and to never use e-cigarettes either. If you yell at me, remember it’s karmic. Please let’s be nice. I do the work I do, for real, to promote good in the world and improve lives. A whole lot of e-cigarette fans would say they do their work for the same reason. I trust that someday it’ll all work out.

aem