Tobacco Harm Reduction Is for the Birds, According to the CDC

January 14, 2022

I didn’t know much about birdwatching until a very recent trip to Costa Rica when I signed on for a guided tour.

The birding began on a gringo-packed trail that snaked its way into the dense forest of the Monteverde region known for its cloud-forest tree canopies. Our guide, a veteran birder, knew all the “hot spots” where local avian celebrities hung out.

The three-hour trek (sloth-paced, barely walking on mostly flat land) was a poor match for my amped self. I was irritable and anxious and secretly looking for pumas and monkeys rather than birds. I tried my best to feign interest and dutifully scanned the treetops with my binoculars, awaiting the fateful bird moment.

But it never happened. The best we got was a half-profile view of a quetzal partially obscured by a branch (quick tip: you can also see a quetzal by googling “magical Costa Rican bird”). I celebrated the end of the bird-watching drudgery with a cold cervesa and vowed never to subject myself to the tediousness of that experience again.

After some thought over the last week, I realized I had missed the whole damn point.

No, I don’t think I like birdwatching. But come on. I didn’t even take the time to understand which birds we were looking for or how to look for them. I had done no research, and I was more interested in checking the event off my travel list than actually trying to appreciate it. My approach—a frenetic, self-centered, get-the-job-done energy—was counterproductive to the Pura Vida vibe of the birds and the culture of Costa Rica. The result was a huge missed opportunity.

Would the CDC ever tweet that birdwatching can help you get your mind off heroin craving?

My thoughts on the birds came full circle a few days after my return to the US when I read a January 5 tweet from the US Centers for Disease Control and Prevention (CDC): 


The obnoxiousness of the tweet caught me first. How can the CDC report that smoking kills 480,000 people every year (20 million people since 1964) and seriously recommend a regimen of birdwatching as its antidote?

But it was also the contrast of how tobacco use—which the tweet misleadingly conflates with nicotine dependence—was treated (as a hobby to replace) compared to other health crises, like the overdose and COVID epidemics, which the CDC covers with seriousness and reverence.

Would the CDC ever tweet that birdwatching can help you get your mind off heroin craving? Or that people with alcohol use disorder should take more birdwatching trips?

Like a city girl wandering aimlessly on a Costa Rican mountain searching for birds using all the wrong strategies, the CDC continues to miss the damn point. And the lost opportunity for our national public health agency to share messaging that would actually reduce the harms of smoking is tragic.

Even when it’s not recommending new hobbies for smokers, the CDC is emphasizing the message that vaping is harmful not only for kids but for young adults, and blatantly misrepresenting evidence to suggest that nicotine can harm brain development despite research suggesting otherwise—rather than seizing on the unprecedented opportunity for harm reduction to save smokers’ lives.

It’s not the birdwatching in the tweet that is the problem. It’s the general lack of insight or ability to understand the experience of being a smoker that screams Out of touch


Tobacco smokers deserve serious support from leading health authorities on ways they can successfully reduce or stop their use of one of the most deadly consumer products in the world.

I don’t know if I will ever willingly go birdwatching again. But I know my approach to the whole experience was counterproductive. And so is the CDC’s on tobacco. It’s time we both did better.



Photograph of a quetzal by Francesco Veronesi via Flickr/Creative Commons 2.0

Annie Kleykamp

Dr. Annie Kleykamp is trained as an experimental psychologist and studied the effects of various drugs (nicotine, opioids, alcohol) on human cognition and behavior. Her views do not represent those of current or previous employers. In the past three years, Annie has been been a full-time employee of the American Society of Addiction Medicine (2021-present) and the University of Rochester School of Medicine (2018-2021). She has also received compensation for freelance science writing and adjunct teaching from the University of Maryland College Park, the real-world evidence company STATinMED, the government contractor Palladian Associates, Filter and the health care consulting company, Pinney Associates. Her work for Pinney Associates focused on regulatory submissions related to psychedelic drugs. None of her work in the past three years was supported by funding from the tobacco or e-cigarette industries. Annie was a full-time employee of Pinney Associates between 2014-2018, during which time they provided consulting services to the e-cigarette company NJOY and the tobacco company RJ Reynolds on non-combustible harm reduction products including e-cigarettes and snus.

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