Harm reduction can always be practiced, regardless of whether you have government approval and specially designed products. I know this is true because I live in a place without either, yet I do it every day.
I’ve been doing it for years here in prison, around drugs and HIV, though it took me a while to internalize that harm reduction was what it was.
Here, there is nothing legal about sexual contact between prisoners, and condoms are considered contraband. People still have sex.
The same goes for a wide variety of banned drug use. There is no policy that says folks can get clean rigs and Narcan. People still do drugs.
In these areas, I share my knowledge and experience so others who come in here suffer fewer harms. And hopefully, some of that knowledge carries with them as practice to the street.
Lately, I’ve been exploring the inclusion of tobacco harm reduction in all my conversations and efforts. Here, bans have made tobacco completely illegal. That doesn’t make it unavailable, but it does make it expensive. Tobacco right now costs about $10 for a quantity that would fill a regular cigarette outside. At least one person committed a felony in order for you to get it. Possessing it can earn an infraction that will move back your release date. Depending on how often you’ve been caught, they may decide to do even worse.
We have none of the “appropriate, affordable and acceptable” products that advocates demand in the free world. But still, harm reduction can exist.
In these circumstances, people in prison often use other highly risky substances in place of tobacco (namely “spice”).
All safer nicotine products are also illegal, and unlike tobacco they’re pretty much impossible to find. So we have none of the “appropriate, affordable and acceptable” products that tobacco harm reduction advocates demand in the free world.
But still, harm reduction can exist. Some of the ways tobacco is used here are more dangerous than others. And there are many times when the regular harms of smoking are far from the most acute risk.
I’ll give you an example. The guards are banned from smoking too, but they are allowed to chew tobacco on the premises, and many do. When they’re done, they spit it out on the sidewalk or in the garbage cans. Some prisoners collect this used chew, and either chew it or smoke it.
Chewing saliva-soaked chew that may have come from a lip with broken skin poses some risk of disease. I’ll discuss that with those guys, but they are going to use the tobacco, period. What remains is finding the safer way to do it.
One approach is placing it in the microwave for a minute. The theory is that a high temperature will kill viruses and bacteria. Though there is some evidence to support this, the heating may be uneven and it’s hardly foolproof. But it’s something that’s available in prison.
With any kind of harm reduction advice, it’s important for me to remember that I don’t get to make decisions for anyone else. It would be safer not to use the discarded chew at all. But they’ve already made that choice. My suggestion to take a safer step may be looked at with disdain. But my experience is that when folks learn of something like this that can still give them what they want, they tend to respond well.
Those guys who smoke the discarded chew have their own concerns. Chew doesn’t burn well, and it takes a long time to dry out. Having it sit around is also harmful, because of the threat of losing “good time” on your sentence if you’re caught with it.
It’s like a low-tech version of heated tobacco products, though the risk profile may be completely different.
People have devised methods for hiding it and drying it out at the same time, but that still leaves the harm of smoking this really dark and heavy tobacco. Some guys have taken to mixing it with other vegetable matter to stretch it out and make it easier to burn. But others have taken to a new way of “smoking” the chew.
It’s like a low-tech version of heated tobacco products, though the risk profile may be completely different—I have no way of knowing.
Prisoners will use a stolen battery, usually a C-size or an A. Near the positive end at the top, they’ll scrape off a small piece of the coating, exposing the metal casing.
The chew, now slightly dried out, is wrapped with a piece of copper wire, thin, like speaker wire, with the ends hanging off. Attaching one end of the wire to the bare spot in the battery with a piece of tape, you then hold the other end of the wire to the little post on the positive end of the battery.
Current runs through the wire, heating the tobacco but (mostly) not burning it. Vapor comes off the tobacco, and this is inhaled, sometimes with a tube, sometimes without. The vapor doesn’t feel as rough to inhale as the smoke from a rolled cigarette, and only rarely does the tobacco cherry and smolder. This process produces less smoke and less smell, which leaves a smaller footprint for the cops to find, whether or not it’s actually better for your health.
In here, harms related to tobacco use extend far beyond diseases.
If we think of tobacco harm reduction as only addressing the harms of cancer and other smoking-related diseases, then yeah, nothing else works except cutting down or ideally quitting—with or without the help of safer nicotine products.
But in here, harms related to tobacco use extend far beyond diseases. It’s the threat of more time in prison. It’s how the ban has fueled a huge contraband market that produces debt and violence, which I also work to reduce. It’s the risky workarounds people use to get their nicotine, or a replacement substance, under this regime.
Those circumstances speak to a broader point: If our approach to harm reduction includes only our own understanding of the harms, rather than the experiences of the people being harmed, then we’re not really doing harm reduction—we’re just trying to make other people do what we want. Just like the folks making bans.
Harm reduction isn’t just pushing for policy. And for me, tobacco harm reduction looks different to just saying we have to have products available. Sometimes, smoking is not the immediate concern.
Photograph by Lindsay Fox via Flickr/Creative Commons 2.0
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