Beneficiaries of Harm Reduction Reform
2026 ATNF Keynote
As this entry to Skip’s Corner goes live, I will be speaking these words on the ATNF stage in Leesburg, VA. This keynote will be the lead-in for the panel that follows:
Adults Who Smoke: The Beneficiaries of Harm Reduction Reform
Moderator:
Dr. Jasjit Ahluwalia - Professor of Behavioral and Social Sciences and Professor of Medicine, Brown University School of Public Health and Alpert School of Medicine.
Panelists:
Kim “Skip” Murray - Consumer Advocate, Skip’s Corner
Phillip Kirschberg - Harm Reduction Educator, Consumer Advocate
Elizabeth Hayes - Head of External Affairs, Consumer Choice Center
Hello Everybody!
Thank you for inviting me to return to the ATNF stage and for giving people with lived experience a seat at the table.
I’d like to start with a quick exercise. I’m going to ask two questions, and I’d love for you to just shout out whatever comes to mind first - don’t overthink it!
First: What is the most valuable thing a person can have in their possession?
That question made me think of material things.
My second question: What’s the most valuable thing a person can have that’s completely free, but absolutely priceless?
That question made me think of the things that make life worth living, but can’t be bought.
And I’ll be honest - while I was thinking about those answers, I noticed I was missing the most important one. The thing is, you never know how much of it you have. You can’t save it forever. And once you spend it, you can’t get it back. When it’s gone, there are no refunds and no do-overs.
I realized I could have answered both questions with one word…
time.
And time is precisely what brings us together for this panel. Because when we’re talking about harm reduction, we’re not talking about an abstract product category. We’re talking about whether adults who smoke get access to a broader range of lower-risk alternatives soon enough for those alternatives to matter in their lives.
Lives - measured in minutes, hours, days, weeks, months, and even years.
I used to work in a vape shop, and I’d like to tell you a story that still stays with me because it puts “time” into human terms.
I was standing behind the counter, watching out the window, when an older woman walked by very slowly, leaning a hand on the window as she walked. It took a lot of effort to climb the two steps to the door and pull it open.
As soon as she stepped in, I could hear her gasping for air. She stepped forward and collapsed on the couch that was right inside the door. I greeted her and asked if she was OK. She held up one finger, and I could see her chest heaving up and down.
It was several minutes before she got up and made it across our small shop to the counter, and once again she struggled to catch her breath as she leaned on the counter. I grabbed a bar stool and brought it to her so she could sit down, and I gave her a bottle of water.
She explained the multiple health issues she has and told me she smoked two packs of cigarettes a day. She had been trying all the things her doctor suggested to help her stop smoking, and none of them worked. Finally, her doctor told her he wasn’t sure how safe vaping was, but in his opinion, it was the only thing left for her to try.
I spent the next hour teaching her about vaping, pointers to help her stop smoking, and having her try various devices and liquids until she found a combination that appealed to her. She purchased a considerable amount of liquid and coils because she was from another town that didn’t have a vape shop, and she didn’t come to our town very often.
Months went by, and we never saw her. I thought about her now and then with a twinge of guilt, believing her not returning was a sign we had failed to help her quit smoking.
On May 10, 2016, the FDA Deeming Regulations became official when they were published in the Federal Register. As you know, those regulations gave the FDA’s CTP the authority to regulate vapes. Our hearts were heavy that day, knowing that a small shop like ours, which depended on the sales from the liquids we made, had just received a terminal notice that our days were numbered.
As the weight of that revelation took hold, the door suddenly swung open, and the woman who struggled to breathe took an enthusiastic step inside. She had the biggest smile, threw her arms into the air, and said, “Look at me! I can breathe!”
She walked briskly to the counter as we both got a wicked case of happy tears. She filled me in on how she quit smoking the day she came to our shop and then quickly experienced improvements in her health, the most noticeable being able to breathe better.
She said she was in a hurry because, now that she could breathe, she could keep up with her grandkids, and she was going to pick up her granddaughter and play with her at the park.
She again purchased several months’ worth of supplies and grabbed a flyer off our counter. I remember that flyer. It encouraged people to join CASAA and support H.R. 2058 and the newly introduced Cole-Bishop amendment. Both were our last best hope to change the 2007 predicate date and save shops like ours.
As she prepared to leave, she asked me to come out from behind the counter because she wanted to give me a hug. As she hugged me, she said, “this is from my doctor. He wanted to thank you for helping me stop smoking.”
And then she asked for another hug. This time, she squeezed me tightly as she began to sob. “Thank you,” she said, “I think you saved my life.”
After she left, I sat down on the couch, on the very spot she collapsed on months earlier. I sat there and cried. I was so grateful to have helped her stop smoking.
Suddenly, my tears of joy turned to grief because I knew that that day was the beginning of the end. I knew then that sooner or later, the shop would have to close because there was no way small-town folks like us would ever make it through the PMTA process.
I knew the sense of community these shops had built would fade away someday, and sadly, I knew the people most affected would be the ones with the least power to change it.
We’ve talked a lot this week - everything from illicit trade to the latest evidence, to regulations and policy. I considered talking about other aspects of time.
The time spent by children watching their parents smoke, which increases the child’s risk of initiating smoking. The time spent on preventing youth initiation of vapor products.
The time some of us have spent watching our loved ones slowly die from heart disease or lung cancer. Their last weeks of life were spent suffering as they struggled for every breath.
The time some of you have spent trying to save the lives of people who smoke. The time that has passed since the Deeming Regs were passed, and the limited number of products that have made it to the finish line.
But the aspect of time that pulls most on my heart is the gift of time given to the woman in my story and to people like her. Time with an improved quality of life. Time spent with grandkids, making cherished memories that will stay with those kids for the rest of their lives.
And when we give someone the gift of more time - time with better health - we don’t just help that person. We give time back to everyone around them: their family, their coworkers, their neighbors, and the people who count on them.
We give society more time, too - more time for people to show up, to contribute, to share hard-won knowledge, to mentor and coach, to volunteer and advocate, to serve their community, and to strengthen the lives of others.
Delays in reforming our regulatory process doesn’t just steal time from individuals - they steal it from families and communities.
While I thought about time, I kept going back to the same question: have we designed a system that gives adults who smoke a real chance to gain time back - while they still have time to gain?
The answer is painfully clear…
NO.
Standing here representing people with lived experience, I want to know how we ended up with a system that keeps failing millions of adults who smoke and the families who want more time with them.
Time to hug, work, and play.
And more importantly, time to live, laugh, and love.
Let’s make sure more stories end with ‘I can breathe’ rather than an early ‘goodbye’.
Thank you!
Thank you ATNF for giving so many people with lived experience a voice this year. Thank you for helping us with travel expenses so we could share our stories and our perspectives with the audience. And lastly, thank you for dedicating two panel discussions to our needs and including people with lived experience on both panels. It is an honor to add my voice to theirs.
Until next time…
You have captured something the regulatory debate too often abstracts away: time. Have we designed a system that gives adult smokers a real chance to gain time back, while they still have time to gain? What a powerful question, Skip! A reform that ignores distribution is an incomplete reform.
I feel that a robust, age-verified online and mail-order distribution framework deserves serious policy attention as part of any harm reduction reform. A well-enforced online system with delivery requiring adult signature, strict retailer licensing, and meaningful penalties for verification failures creates more friction for underage access than an uneven patchwork of physical stores with variable compliance. The UK's age verification framework for online tobacco products is a good starting point, needing further strengthening. Regulated online channels with verified sellers are traceable, auditable, and enforceable in ways that informal supply never will be, and it will help us achieve the goal of helping the adults while protecting the children at the same time.
That was a beautiful speech Skip, well done.