Tourists and foreign students have a reputation for getting intoxicated and climbing into the priceless antique fountains here, something that is illegal and of course frowned upon. I can’t say how often this happens, but the papers cover such incidents with gusto. The Trevi Fountain tends to get hit particularly hard in the hot summer months.

Naturally, we were all warned not to do this under any circumstances. Getting drunk at all, even far from fountains, was sternly advised against.

Most of my classmates—and especially study-abroads—don’t exactly heed this advice. As yet, none of us have gone skinny-dipping in the Fontana di Trevi, but many go to the local student watering hole almost nightly, and show up to class hungover. Some sip mimosas or down shots at lunchtime, at the bars across the street from campus.  

The ease of access to alcohol here—at low cost, outdoors and in family spaces—takes some getting used to.

Here in Italy, un bar is a cafe-like space, open to all ages, where food and coffee are served in addition to alcohol. Many function as cafes in the morning, cheap eateries around noon, and places to sip a glass of wine in the evening. This is helpful for those of us who don’t drink, because it feels natural and easy to order other options in this environment, even while our friends enjoy wine or Peroni. The awkward questions I’ve been asked in American bars—“Are you, like, a recovering alcoholic?”—don’t tend to crop up.   

The ease of access to alcohol here—at low cost, outdoors and in family spaces—takes some getting used to. And it can be perilous for Americans who are not accustomed to self-moderating their drinking—particularly those who are too young to buy liquor in the United States, and therefore lack experience. 

Here, the drinking age is 18—in line with much of the world, when the US age of 21 is something of an outlier. In practice, younger teenagers tasting wine with their parents seems widely tolerated in Italy. 

In the school garden, meanwhile, I often hear tales of horrendous drunken adventures told with glee, pride even. I personally don’t understand the appeal of getting smashed and embarrassing yourself, but to each his own. 

It’s noticeable, though, that the Italian students’ attitude to drinking seems much more restrained than that of their American counterparts. In my limited experience at least, our Italian friends generally appear to drink not to get blackout drunk, but simply to enhance meals and other social interactions. Their approach reminds me of my various Italian-American relatives, who routinely take wine with meals but abhor getting messy-drunk.

Wine is integrated into Italian life, yet the rate of problematic drinking is low.

People have been observing such cultural drinking differences since long before I was born, and far more rigorously. A large body of research has documented how, while alcohol appears fairly ubiquitous in southern European cultures like Italy and Portugal, binge drinking is much rarer than it is in northern European countries. 

Wine is integrated into Italian life, with a strong culture of drinking a glass or two at mealtimes. Yet the rate of problematic drinking is low.  

“People who live in countries where drinking occasions often lead to intoxication—for example, Sweden and the Baltic countries—more often experience alcohol-related problems when they increase their alcohol consumption when compared to people who live in Italy, where the drinking primarily takes place with meals and less often leads to intoxication,” explained Jonas Landberg, a research at Stockholm University’s Centre for Social Research on Alcohol and Drugs. 

According to the World Health Organization, the prevalence of alcohol use disorder in the Italian population is only 1.3 percent; it’s 11 percent in Sweden, and 13.9 percent in the US.  

One theory around this is that it has to do with how people learn to drink—wine sipped at the dinner table with older family members, versus booze sneaked and chugged alongside equally inexperienced teenage peers. Parents who model moderation have been found to be more likely to raise teens who drink without problems, compared with parents who either drink to excess or abstain.

Another, related line is that alcohol restrictions, far stiffer in places like the US and northern Europe, foster riskier behavior—“crescebat ex prohibitione cupiditas [from prohibition grew desire],” as Petrarch expressed the lure of forbidden fruit. 

As a non-drinker, I can’t claim to have deep personal insight. So I asked some of my classmates about their experiences.

“The fact that they didn’t want me drinkin’ probably made me want to do it a good bit more.” 

John* is a friendly resident student from Georgia in the US. He told me that he began drinking occasionally as a “kid,” which he attributed to his coming from the Deep South. That’s when he first tried moonshine and absinthe. 

However, “I really started drinking when I was 19,” he said, “during my first semester.” He then discovered “the joys of drinking with friends.” In this period, he said, he “got blackout at least three times a  month, two sometimes. I was doing quite the blackout nights. Really blackout weekends. I did a good couple of benders.”

John’s parents, he said, gave him permission to start drinking when he left home to study, but they personally “don’t believe in drinking,” and don’t drink themselves “except maybe a glass of wine twice a year.”

To this day, they still don’t know John drank as a child. He now thinks their attitude made it more appealing. “The fact that they didn’t want me drinkin’ probably made me want to do it a good bit more.” 

John holding his favorite drink

He’s calmed down this semester, he told me, and is currently more of a social drinker. He does think there’s a major drinking culture at our school: “Especially with the study-abroads, they’re getting wasted every  weekend and doing massive, massive rallies every single day.” 

John claimed that the Florida students are the worst. Having roomed with two heavy-drinking Miami students in my first semester, and spent time clearing up their half-eaten plates of chicken nuggets, I was probably not a neutral audience.  

Katie* is a resident student from Florida who doesn’t fit that stereotype. Her relatives make fun of her “all the time” for not drinking as much as they do. But, “I would say the large majority of my family were alcoholics,” she told me. 

She first tried a beer, with her sister and without her parents’ permission, when she was 9, she said, but didn’t start drinking casually until she was 18. “We would go to, like, family-owned restaurants, and I would have a glass of wine and it would be fine.” She never got “super-wasted or drunk” on these occasions. 

These days, Katie really isn’t into drinking. “I just don’t like the idea of it, I don’t like how it makes me feel, and I just don’t like the idea of not being in control of your actions and your emotions.” She feels that “getting wasted or blacking out” places an unfair burden on the friends you’re with. At the same time, “a lot of people [here] drink very socially and if you don’t drink, you’re seen as more of an outcast.” 

Her college-aged friends back in the States drink all the time, she added. “It’s just seen as completely  normal.” Katie’s manner suddenly became more intense, as she told me: “I don’t like the drinking culture the US has, and the idea behind it [of] getting wasted every day.” In Italy, she thinks, “people know how to control their alcohol [intake] a lot more.”  

“It’s seen as normal to give tiny amounts of prosecco, wine or beer during family gatherings, even to the smaller kids.” 

Andrea*, who comes from Rome, more or less concurred with this assessment. They recalled first trying alcohol independently at 14, when they took some drinks from a cabinet while sleeping over at a friend’s place. “Although technically I had already tasted alcohol,” Andrea said, “seeing as it’s seen as normal to give tiny amounts of prosecco, wine or beer during family gatherings, even to the smaller kids.” 

Teen drinking is normalized in Italy, said Andrea, who began drinking regularly at 15. Still, “even as a teenager or college student, I have never seen alcohol as simply something you have to drink to feel inebriated … but rather as something you share with friends.”

When Andrea turned 18, their parents told them to “drink with moderation and stay safe.” However, Andrea said that US drinking culture has been increasingly glorified by Italian youth due to media, including shows like Euphoria. “The impression is that of American students throwing immense parties, with giant crates of beer, and overall doing insane stunts while under the effect of alcohol, although not many Italian teenagers and college students can afford to do such.” 

Andrea knows of a couple Italians who drink heavily, but said this is still outside of the norm. At 19, Andrea feels, “I have achieved a good balance and know my limits.” 

I was able to continue the conversation with Andrea’s father. Lorenzo*, a police officer, is emphatically not in favor of introducing more alcohol restrictions in Italy. He recognizes that there are serious drinking-related harms, and even regrets that alcohol will always be “well liked” because of its “immediate benefits.” But he said that age restrictions, for example, are easy to circumvent when adults will often buy alcohol for minors. 

“The case of the US demonstrates how prohibitionism, or generally speaking secrecy … is not an efficient reduction method,” Lorenzo said. “An eventual approach similar to the American one will not affect the statistics positively. There needs to be a cultural and educational approach.”

Whatever the reasons behind it, the Italian tendency toward moderate drinking appears to me, at least, to be healthier and safer, as well as less likely to get you fined for ending up in the Trevi Fountain.  

*Names changed to protect sources’ privacy.

Top photograph by Lefteris kallergis on Unsplash. Inset photograph by M.L. Lanzillotta.

The post A Clash of Drinking Cultures for US Students in Italy appeared first on Filter.

Born in 43 BCE, his blush-making poems ultimately aroused the ire of the first Roman emperor, Augustus Caesar—a traditionalist who sought to instill values like monogamy and chastity in his subjects. In 8 CE, Augustus personally banished Ovid, who lived out the end of his days in rural exile near the Black Sea. All because of, in the words of the poet himself, “carmen et error”: a poem and a mistake.

Ovid frequently referenced poppies and opium in his work, and his personal relationship with the drug has drawn speculation in recent years.

The nature of the mistake has been a matter of debate for centuries, while the poem is generally agreed to be his somewhat skeevy Ars Amatoria, a kind of bisexual guide to courting.

Ovid frequently referenced poppies and opium in his work, and his personal relationship with the drug has similarly drawn speculation in recent years. As a classics student who previously used opioids, I am not wholly immune to this game.

Famously, his depiction, in Book XI of his Metamorphoses, of the cave of Somnus—a deity who personified sleep—relies heavily on heady imagery, which to a modern reader almost suggests a fantastical opium den: 

Near the Cimmerians, in a deep recess there is a cave, home and innermost chambers of idle Sleep, which neither rising, nor midday, nor falling Phoebus [i.e., the sun] could reach by his rays.

[…]

Beyond the entrances of the grotto fertile poppies and innumerable herbs flourish, through which the night gathers the sleep-draught from the poppy-milk and scatters it through the shaded lands. And no door produces shrill squeaks by oft-turned hinges, no guard stands at the threshold nor through the whole house.

But in the middle of the cave is a single-colored, ebony, elevated, downy bed covered by a dusky veil, in which sleeps the god himself, with languor of loose limbs. Here, in every direction lie empty dreams imitating varied shapes, as many as there are ears of harvested corn or leaves carried by a forest, or scattered sands upon a beach. 

[Lines 593-595 & 605-615, my translation] 

Yet there is no evidence that dimly-lit dens devoted to the pleasures of opium were a feature of Ovid’s Rome. In his day, the papaver somniferum, or opium poppy, more swiftly brought to mind religious and mythological associations.

Members of the Cult of Ceres, the Roman goddess of agriculture and fertility, may have used opium in their initiation rituals. To the ancient reader, these verses likely evoked the brief ritual sleep of devotees or the temporary “death” of winter more than hedonistic pleasures. To Romans, opium represented death, rebirth and fertility.

But what, if anything, does this tell us about his life? Some have argued that Ovid used opium for pleasure, and perhaps even experienced addiction.

Poppies were associated not only with Ceres, but also with the fictitious, infernal river Lethe, whose waters bring amnesia to those who drink them. As Ovid writes in the same section of Metamorphoses, “silent repose dwells here. The waters of the river Lethe flow forth from the depths of the stones, their gliding waves inviting sleep with a murmur through rustling pebbles” (Lines 602-604, my translation).

Given Lethe is located in the underworld, Hades, rather than above amongst the Cimmerians, this may suggest that Ovid wished to portray the cave—and sleep itself—as straddling the border between life and death.

But what, if anything, does this tell us about his life? Some have argued that Ovid used opium for pleasure, and perhaps even experienced addiction.

Researcher Paolo Necini notes the regularity with which opium appears in Ovid’s work, as well as referencing the poet’s “suspected opium addiction.”  He stops short of explicitly opining on this question, instead suggesting that Ovid likely “had a personal interest in poppy derivatives,” rather like his famous contemporary Virgil. As Necini notes, Virgil’s interest seems related to the religious symbolism of the plant.

D.C.A. Hillman, meanwhile, writes, “Ovid’s description of the precise effects of opium is proof that he was no stranger to the power of the drug.” Perhaps he wasn’t. But to suggest, as Hillman goes on to do, that this, together with references to other substances, forms compelling evidence that Ovid himself used opium seems a stretch.

Ovid’s other references to the psychoactive properties of papaver occur, for example, in works like his more autobiographical Tristia, which depicts in moving verse his despair in exile. Yet even these examples are too vague to prove his own use.

Nencini argues that despite widespread use of opium in antiquity, addiction to it was likely uncommon because of the context in which it was consumed.

We’re never entitled to assume that an author who displays understanding of a practice or state of being in their fiction experienced it personally. Poetry, in particular, is not necessarily factual, even when autobiographical. While Ovid’s apparent fascination with opium could be a sign that he partook regularly, it could just as easily be seen as a tool to illuminate the psychology of his characters. We have no clear evidence that Ovid ever consumed opium, let alone often.

Even if he did, the possibility that he might have experienced addiction seems remote, considering the lack of demonstrated impacts on his life and the culture in which he lived. Nencini, for example, argues that despite widespread use of opium in antiquity, addiction to it was likely uncommon because of the context in which it was consumed. Addiction, after all, is not determined by drug use per se but by the relationship a person has with their use.

“It was Zinberg who helped us realize the impact of any drug not only depends upon the substance, but crucially the ‘set and setting,” Professor Julian Buchanan, a drug policy researcher in New Zealand, told Filter. “So the person, their disposition, mood and expectation, play an important role, as does the culture and the environment where the drug is taken.”

These “contextual factors,” Buchanan added, also affect the level of risk.

I would argue that his artistic output matters far more than the question of whether the “poppy-milk” flowed through his veins.

In antiquity, opium use occurred largely in a ritual or medicinal context—the latter described, for example, by Pliny the Elder, who lived shortly after Ovid—and not so much a recreational one. Today, we know that only a tiny proportion of people—less than 1 percent of those with no history of addiction—experience substance use disorder related to opioids prescribed to them by a doctor. Drug prohibition, which makes use significantly riskier, also didn’t exist in ancient Rome. Buchanan emphasized that some societies can be structured in ways that decrease the risk of problematic drug use.

We cannot deny the prominence of opium in Ovid’s poetry. But despite the temptation to speculate about the lives of long-deceased luminaries, any personal relationship he may have had with the drug remains unknown and unknowable. And I would argue that his artistic output matters far more than the question of whether the “poppy-milk” flowed through his veins.

Ovid’s flair for psychological realism and gripping interpersonal drama have ensured his lasting influence. Opium user or not, he remains a fascinating and significant poet whose elegantly composed verses are still widely read. I prefer immersing myself in these enthralling poems to engaging in unwinnable debates.

Image of the John William Waterhouse painting Sleep and his Half-brother Death via Wikimedia Commons/Public Domain

The post “Sleep’s Cave”—The Speculation Around Ovid’s Opium References appeared first on Filter.

Due to its nature as a “respository of knowledge […] culled from a variety of sources,” Historia Naturalis can be used to infer larger trends in Roman attitudes toward various subjects, including substance use. We also know that Pliny drew on both Greek literary sources and Roman folk beliefs when writing his Historia. In those days medicine and the sciences overlapped with magic, religion and philosophy. Perhaps unsurprisingly, the work is full of what we would today consider pseudoscience, making it a better source for understanding contemporary culture than for scientific information.

I should probably admit that I’ve read only a tiny portion of this immense opus. My focus so far has been the volumes which discuss plants used for medicinal purposes—including some which today would be considered illegal drugs, such as opium. References to opium poppies and their wild relatives appear primarily in Book XX.

Pliny sees no need to preface these passages, as a modern writer might, with a note about not wanting to condone or promote drug use. That’s a significant clue, when we consider his status, to prevailing attitudes in Roman society. It was a society, of course, with many horrifying aspects, like slavery and imperialism. Yet historical perspectives on drugs can serve a useful function in refuting any modern notion that their demonization and prohibition is somehow natural or inescapable.

The Romans lacked the idea that there was something inherently immoral, illicit or shameful about substance use per se.

A Roman reading Pliny’s Historia would not perceive the author as some sort of radical pro-drug advocate, but rather as a perfectly ordinary communicator of practical household knowledge, as authors like D.C.A. Hillman have attested. Certainly, restraint and moderation—sexual, financial and otherwise—were valued by the Romans, particularly those of a more philosophical persuasion. But they lacked the idea that there was something inherently immoral, illicit or shameful about substance use per se.

“Opium was used in antiquity and virtually throughout history,” John M. Riddle, professor emeritus of history at North Carolina State University, told Filter. He has published widely on the history of pharmacy, with particular focus on the works of the Greek physician Dioscorides. He noted that curiously, people in antiquity, the Middle Ages and even the early modern period did not have a concept equivalent to our opioid use disorder. “Physicians and laity alike knew its properties very well yet they did not report addiction as a related problem.

In XX.77, Pliny discusses two domestic (“sativus”) species of poppy, which he refers to as black and white poppies on account of the color of their seeds. He notes that “the corolla of the white type is ground and drunk in wine for the purpose of sleep.”

Pliny even goes on to tell us how to harvest opium from the black poppies. He writes, “the stalk having been sliced, opium is brought forth from the black poppy,” before citing two different views on when precisely in the life cycle of the plant to do this. In any case he suggests it is best done “in the third hour of a serene day,” or mid-morning by modern reckoning, because “this is when the dew upon it dries up.”

Pliny goes on to describe other positive uses of opium.

He continues that “they suggest that the plant be cut below the head and corolla” (incidi iubent sub capite et calice). This phrasing, without any explanation of who “they” are, implies that this is common knowledge—similar to the common Latin phrase, “as they say” (ut aiunt or ut dicunt). The juices are then “drawn out with wool or, if meager, by one’s thumbnail.”  This can then be “pressed into lozenges and dried in shadow.”

Yet in the very same sentence (painfully long to a Latin student), he warns that the resulting pastilles have the strength not only to serve as “soporifera,” substances which cause deep sleep, but to be “mortifera,” or deadly substances, if consumed in excess. He goes on to say that “we know that in this manner the father of P. Licinus Caecina, a man of the praetorian rank, ended his life in Spain, because intolerable illness had created a hatred of life.”

Pliny then approaches more modern territory when he notes that because of this, there existed great controversy regarding the use of opium, which was totally condemned by some as a deadly substance (mortiferum). He warns that it can also harm the vision—a claim that should be taken with a grain of salt, although there are modern equivalents. Still, despite these potential risks, he points out that “its use was not rejected in a celebrated medicine, called διὰ κωδυῶν [diacodion].”

Pliny goes on to describe other positive uses of opium, explaining that “the seeds, pressed into pastilles with milk, are used for the purpose of sleep, just as they are used for headaches with rose oil; this combination is also administered for ear pains.” He discusses various similar concoctions, including a slightly alarming mixture of the seeds (or sometimes the leaves) and human breast milk, applied topically for gout. Nevertheless, he rejects the use of opium in eye salves (collyria), as well as certain other medications.

After this, Pliny returns to discussing various potential uses and manners of preparation, along with other practical information, such as methods of testing quality and descriptions of the ideal climate for cultivation.

“The idea of drugs shifts quite a bit, it’s not necessarily a static concept. Our current notion of drugs is also very tied to prohibition.”

Roman medicine was often prepared and administered by laypeople. People commonly relied on remedies made at home or purchased from apothecaries, many of which were either placebos or potentially quite dangerous. Still, some of these drugs were powerfully effective.

Despite these knowledge gaps, and like almost every human society across time and geography, the Romans used psychoactive substances. Frankly, I don’t blame them. As Hillman writes in The Chemical Muse (2014), “the ancient world was very much a place of overwhelming anguish,” due to the myriad horrific ways in which someone might fall ill or die.

The drive to ingest drugs—whether to alleviate pain, for ritual purposes, for pleasure or for some other reason entirely—is no modern vice but very ancient and logical. The Ancient Greeks likely used opium as early as the 8th Century BCE. Archaeological evidence of psychoactive plant cultivation dates back to prehistoric times in Eurasia and over 1,000 years in South America, for example; actual use around the world surely predates the evidence.

Alex Betsos, a drug anthropologist and co-host of podcast Drug Futurisms, told Filter that the very concept of “drugs” has changed over time. Only a few centuries ago, they explained, herbs and spices such as chamomile and cinnamon were considered drugs—something few would define them as today. “The idea of drugs shifts quite a bit, it’s not necessarily a static concept. Our current notion of drugs is also very tied to prohibition.”

Even now, they noted, concepts of “drugs” are “contested by Indigenous peoples when it comes to plants such as coca, khat, and a plethora of psychedelic substances,” who instead refer to these as plants or medicines.

Why shouldn’t we calmly acknowledge the potential risks and benefits of substances without assigning moral values?

Pliny’s pragmatic manner of addressing potential uses and dangers of opium lacks the theatricality and moralizing so common today. He speaks directly, reporting what he believes to be true with a dryness suited to an encyclopedia writer. Despite noting its potential dangers and use as a suicide method, he—and, by extension, many of his sources and contemporaries—viewed opium as too useful a tool to discount. Abhorrent as many of the cultural values of  the Roman world were, this is a reasonable and logical approach to this particular matter.

It’s also proof, as if we needed it, that the breathless, sensationalized way of talking about drugs favored by today’s media and politicians is not the only option.

Why shouldn’t we calmly acknowledge the potential risks and benefits of substances without assigning moral values to them, or to people who use them? Why fear-monger about brains being “hijacked,” exaggerate harms and ignore positive properties, when we could be realistic instead?

Image of Pliny the Elder via US National Library of Medicine/Public Domain

The post Pliny the Elder’s Ancient But Refreshing Take on Opium appeared first on Filter.

In the Washington, DC, metro area, where I spent the first 23 years of my life, vaping is significantly more commonplace. Many of my friends there vape, either nicotine or THC. Vape shops, with their familiar neon signs, are a common sight.

Here, I’ve yet to see a single one, although I’ve been to many a tobacconist for everyday items like stamps or bus tickets, and some of these do carry vaping products. (IQOS, a heated tobacco product which I’d only read about before, and which does reduce harm compared with cigarettes, seems more widely used and advertised.)

I’ve noticed that many of my American classmates used to vape but now regularly smoke combustible cigarettes instead.

Statistics support my anecdotal observations. Over 23 percent of the Italian population is estimated to smoke, about double the rate in the United States.

“Chronic exposure to combustion chemicals generated from tobacco cigarettes can kill,” Dr. Riccardo Polosa, an Italian expert in tobacco harm reduction, told Filter. “That’s why we need combustion-free tools that can cause much less harm and that are attractive for cigarette substitution.”

I’ve also noticed that many of my American classmates used to vape but now regularly smoke combustible cigarettes instead. Of course, opponents of vaping would immediately allege a “gateway” effect—but such a notion has been debunked at a population level, even as some US health officials cling to it. Youth smoking has fallen to historic lows in the US as youth vaping has increased, and then declined. Most people who vape do so to stop smoking. And some research has suggested that if vapes weren’t available, more youth would be smoking instead.

In the university’s smoking section—essentially the entirety of the garden, in spite of signs relegating people who smoke to one side only—one rarely sees a vape. The one or two times I have seen students vape there, the cartridge contained not nicotine but weed. Curious about this, I decided to interview my classmates.

Nancy, an 18-year-old freshman, started vaping in her senior year of high school. “[But] I couldn’t bring my vape on the plane, I got scared,” she explained with a laugh. “So, when I came here I bought a Blu—which is a different kind of vape here—and then my friends just started smoking cigarettes.”

This led her to start smoking as well. “For the first three weeks I was here, I was like, this shit is expensive, [and] I was going to quit. Then I went to psych class and she told us that it’s a 10-day physical addiction but the mental addiction can be up to 15 years. So I was kind of like, Fuck it.”

Nancy said that she doesn’t actively seek out information about the risks of smoking or harm reduction, but that she hasn’t knowingly experienced any health effects yet. When she went back to the US for a time she continued to smoke there, partly because both her parents smoke. “[Dad] always talks about my spending but he never mentions cigarettes.”

“I vaped for like a few months, when it was a trend or whatever.”

Two of the students I spoke with were a lot more casual about their tobacco use. Mark, 21, told me: “I vaped [in the US] for like a few months, when it was a trend or whatever.” He’d taken up smoking a few months after arriving in Italy.

“Over break I don’t smoke, but back here I do,” he explained. He didn’t struggle to stop smoking when he returned to the US. “It wasn’t hard at all.” Here, though, he’s often asked for a cigarette by strangers, which he thinks would make quitting a lot more difficult if he were trying. He doesn’t think either vaping or smoking will be difficult to stop again, partly because he hasn’t been smoking for very long. He said vaping also made him feel sick, which encouraged him to quit. Yet he really wasn’t sure which was more dangerous.

Alex, 20, similarly told me, “I used to vape in the United States very briefly, because it was a trend—especially during COVID. And then I didn’t smoke any tobacco products till I came here [to] Italy. If I were in the United States, I wouldn’t be smoking.” In Italy, she is.

The respective cultural milieus have certainly contributed to her choices. “At least where I’m from in California, you don’t see anybody smoking,” she said. “There is a social stigma that shames you, so you don’t want to be in public smoking a cigarette. Whereas here, it’s very prominent culturally.” Growing up, she was always informed of the risks of smoking. But she never specifically sought out information or researched the matter. She does not plan to smoke long-term.

“I fully understand the risks, but at our age I think it’s just hard to weigh them appropriately.”

In contrast, Logan, 19, didn’t start using nicotine products until after arriving here in Italy. For the first four or so months, he vaped. Even now, he still primarily vapes. “I prefer the taste of cigarettes but hate the loss of energy that comes with them,” he said. “If I smoke, I can’t run for a few days, but if I vape, I feel normal.”

Interestingly, he’s done quite a lot of reading about the risks of smoking as well as ways to combat them. “I fully understand the risks, but at our age I think it’s just hard to weigh them appropriately.” He was also aware of the fact that, whilst neither vaping nor smoking are entirely without risks, the former is much safer. As for quitting? “I actually successfully quit [both] for over a month; I’d like to permanently quit one day.”

One might wonder if the tobacconists—a common sight here, and one Americans tend to comment on—could be part of the issue. Dr. Polosa quickly dispelled this notion. “On the contrary, in many other countries tobacco cigarettes can also be bought in grocery stores, discos, petrol stations, convenience stores, etc,” he said. “Therefore, it is speculative to link the number of tabacchi licenses to high smoking prevalence.”

“Perhaps, by educating tobacconists about the benefits of harm reduction, it will be possible to switch a large number of smokers to tar-free nicotine delivery products.”

He explained that cigarette sales in Italy are only permitted in specific, licensed locations and that the number of licenses is intentionally related to the number of local residents (specifically, there can only be one tabacchi for every 1,500 people in the neighborhood).

Polosa also pointed out the fact that tobacconists can also sell vaping products. “Perhaps,” he said, “by educating tobacconists about the benefits of harm reduction, it will be possible to switch a large number of smokers to tar-free nicotine delivery products.”

Italy is still culturally and politically somewhat resistant to tobacco harm reduction, however. “It is ironic,” Polosa said, “that much of this resistance comes from health care organizations and institutions, which have now decided that ‘zero nicotine addiction’ is the ultimate goal.”

This kind of all-or-nothing thinking is all too familiar to American harm reductionists. Polosa said that fear-mongering about vaping in Italy discourages people who might’ve switched from smoking—just like in the US. “However, on the taxation front, the Italian government seems to recognize the principle of harm reduction, given that the existing taxation scheme takes into consideration the lower risk of combustion-free products relative to conventional tobacco cigarettes.”

The one student who did seek out harm reduction information had a much more solid grasp of the relative risks.

Judging by my interviews, cultural attitudes seem to be the largest factor in the tendency of American students to switch from vaping to smoking upon moving to Italy. It didn’t seem so much to be misinformation, as I’d initially assumed from discussions about “popcorn lung” in the smoking section at my university—although a lack of information was evident. Unfortunately, the average college student who uses nicotine products isn’t that likely to seek out harm reduction information. This is dangerous, when people’s health and lives are at stake.

Ideally, both the Italian and US governments would put more effort into calm, factual harm reduction messaging regarding all drugs, legal or not. But frankly, that doesn’t seem likely to happen soon.

At least the one student who did seek out harm reduction information, Logan, had a much more solid grasp of the relative risks of these two forms of nicotine consumption. I don’t think it’s a coincidence that he primarily vapes rather than smokes—which is obviously good news. 

Photographs by M.L. Lanzillotta

The Influence Foundation, which operates Filter, has received grants from Philip Morris International, which manufactures IQOS. Both The Influence Foundation and the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), founded by Dr. Polosa, have received grants from the Foundation for a Smoke-Free World. Filter‘s Editorial Independence Policy applies.

The post Why Are My Classmates Switching From Vaping to Smoking? appeared first on Filter.