Tobacco Harm Reduction IS Harm Reduction - Part 2

A look at University of Iowa Health Care

June 13, 2026

A LinkedIn post by Jason Semprini caught my attention yesterday [1]. After reading an internal communication from the University of Iowa Health Care (UIHC), Semprini was concerned he could no longer trust UIHC’s smoking cessation program because of the information they shared about vaping nicotine [2]. His commentary piqued my interest because I am interested in misperceptions about nicotine and non-combustible products, and lately I’ve been noticing a disconnect between harm reduction practices and the use of nicotine.

Some organizations support harm reduction for alcohol, medications, and unregulated substances, but have not yet recognized tobacco harm reduction as a form of harm reduction [3]. After reading Semprini’s commentary, I started to wonder, does the University of Iowa (UI) and its health care system recognize non-combustible nicotine products as a form of harm reduction?

Before we can answer that question, we need to make sure they understand and support harm reduction outside of nicotine. The UI Addiction and Recovery Collaborative (UI ARC) “brings together clinicians, researchers, educators, and recovery advocates to support individuals with substance use disorders (SUD) throughout their recovery journey.” It partners with ”communities across Iowa to raise awareness, reduce stigma, promote harm reduction, and prevent overdose deaths” [4].

UI ARC’s website states that their “philosophy is unwaveringly patient-centered; we meet patients where they are at, we work across departments and specialties to provide the best possible care for patients who have often previously been disregarded or misunderstood, and we do it all without expecting our patients to be infallible” [5]. Among the experts on their team to support people with SUD are peer recovery coaches, which indicates to me that UI ARC values the participation of people with lived experience.

One of UI ARC’s Substance Use Disorder (SUD) Training goals is to “incorporate harm reduction strategies into clinical practice, such as overdose education and prevention with naloxone prescriptions and education around safer sex and drug use practices” [6].

UIHC’s Addiction Medicine page covers risk-reduction and medication for addiction treatment (MAT), demonstrating knowledge of harm reduction and the use of certain substances as a means of treatment for people with an SUD [7].

What surprised me as I looked into the SUD harm reduction practices of UI and its healthcare programs is that while UI ARC does provide services to people who want to quit smoking, those services make no mention of harm reduction, only traditional cessation treatments of medication, nicotine replacement therapy, and counseling [8].

UI ARC’s training program, RISE-IA, gives statistics on substance-related deaths, but not for tobacco-related deaths. One of the things that students in the RISE program learn is to “promote evidence-based overdose prevention and risk reduction strategies, including naloxone distribution, safer use education, and access to medications for addiction treatment (MAT),” but I don’t see anything to indicate that “safer use” includes using non-combustible nicotine by people who smoke [9].

UIHC also provides smoking cessation services to patients, providing the same options as UI ARC. They also show no signs of supporting tobacco harm reduction [10]. Their smoking cessation page groups smoking, vaping, and smokeless tobacco together in a way that may leave readers without any clear understanding that combustible smoking carries different risks than non-combustible nicotine use. (See photo below) I see no indication of including people with lived experience, such as peer support, in UIHC’s smoking cessation services, and I don’t see a statement of values like those expressed by UI ARC. (See photo above)

This brings us back to the LinkedIn post that grabbed my attention, as what I read showed me that UIHC’s public-facing materials do not appear to recognize tobacco harm reduction as a legitimate option for people who smoke. They have a page dedicated to vaping, and after reading it, I can see why Semprini felt he was struggling to trust UIHC’s smoking cessation program [2], [11].

As Semprini pointed out, there is misinformation on UIHC’s vaping page. He covered it in his commentary [2]. A valid point made by Semprini is that the UIHC vaping page quotes only 1 person, a tobacco treatment specialist (TTS), and does not link to any sources, which leaves one wondering, are those facts or opinions?

I am also a TTS, and my knowledge of tobacco harm reduction is much different than the person quoted on UIHC’s vaping page. For example, the page would lead a reader to believe that vaping nicotine causes EVALI, which was caused by vaping unregulated cannabis products that were adulterated with vitamin E acetate in late 2019 to early 2020 [12].

As a TTS, I facilitate peer support groups for people who want to stop smoking. Our program is person-centered. We educate participants on all the options they have to stop smoking and they choose the method that sounds most appealing to them. We support their choice. Some of them choose the more traditional methods of prescription medications or nicotine replacement therapy, while others will try products such as vaping. Our primary goal is to help them stop smoking. If they want to become nicotine-free, we also support that and help them work towards achieving that goal.

UIHC is one of Iowa’s major health care providers and the state’s comprehensive academic health system. It is not the largest Iowa system by number of hospitals, but it is one of the largest and most influential providers in the state, especially for specialty care, teaching, research, and referral care [13], [14]. As a teaching and research facility, UIHC could be a leader among Iowa’s healthcare systems by incorporating tobacco harm reduction into its student training and patient services.

You cannot improve the health of or save the life of someone who has died due to an addiction. That is why including harm reduction is so important; it keeps people alive. Imagine how many more Iowans could experience improved health, a better quality of life, and a longer life with loved ones if UIHC included tobacco harm reduction as a tool to help people who smoke. They wouldn’t have to start from scratch; there is plenty of guidance already available to start on a path of offering tobacco harm reduction information for their patients who smoke [15].

References

[1] Semprini, J. LinkedIn post about UIHC internal communication on “The Dangers of Vaping.” LinkedIn. Accessed June 13, 2026. https://www.linkedin.com/posts/jason-semprini-00a9a534_this-week-my-local-hospital-sent-an-internal-ugcPost-7471341792722853888-KQxk/

[2] Semprini, J. Do I trust University of Iowa Health Care? When it comes to smoking cessation, I’m no longer sure. LinkedIn. Published June 12, 2026. Accessed June 13, 2026. https://www.linkedin.com/pulse/do-i-trust-university-iowa-health-care-when-comes-smoking-semprini-xojmc/

[3] Murray, S. Tobacco Harm Reduction IS Harm Reduction Part One: Why do public health principles so often stop when the substance is nicotine? Skip’s Corner. Published June 3, 2026. Accessed June 13, 2026. https://skipscorner.substack.com/p/tobacco-harm-reduction-is-harm-reduction

[4] University of Iowa Addiction and Recovery Collaborative. UI Addiction and Recovery Collaborative. University of Iowa. Accessed June 13, 2026. https://uiarc.uiowa.edu/

[5] University of Iowa Addiction and Recovery Collaborative. Our Team. University of Iowa. Accessed June 13, 2026. https://uiarc.uiowa.edu/our-team#accordion-item-2241-2

[6] University of Iowa Addiction and Recovery Collaborative. Integrated Substance Use Disorder Training Program. University of Iowa. Accessed June 13, 2026. https://uiarc.uiowa.edu/ISTP

[7] University of Iowa Health Care. Addiction Medicine. Accessed June 13, 2026. https://uihc.org/services/addiction-medicine

[8] University of Iowa Addiction and Recovery Collaborative. Patient Care Services. University of Iowa. Accessed June 13, 2026. https://uiarc.uiowa.edu/patient-care-services

[9] University of Iowa Addiction and Recovery Collaborative. RISE with UI ARC. University of Iowa. Accessed June 13, 2026. https://uiarc.uiowa.edu/education-training/rise-ia

[10] University of Iowa Health Care. Smoking Cessation. Accessed June 13, 2026. https://uihc.org/services/smoking-cessation

[11] University of Iowa Health Care. Is vaping safer than smoking? What you need to know. Last reviewed August 2025. Accessed June 13, 2026. https://uihc.org/health-topics/vaping-safer-smoking-what-you-need-know

[12] Safer Nicotine Wiki. ENDS EVALI VALI THCVALI. Accessed June 13, 2026. https://safernicotine.wiki/mediawiki/index.php/ENDS_EVALI_VALI_THCVALI

[13] University of Iowa Health Care. About Us. Accessed June 13, 2026. https://uihc.org/about-us

[14] Definitive Healthcare. Largest IDNs in Iowa. Published September 3, 2024. Accessed June 13, 2026. https://www.definitivehc.com/resources/healthcare-insights/largest-idns-iowa

[15] Safer Nicotine Wiki. Nicotine / THR - Guides for Healthcare and Social Services Professionals. Accessed June 13, 2026. https://safernicotine.wiki/mediawiki/index.php/Nicotine_/_THR_-_Guides_for_Healthcare_and_Social_Services_Professionals

Until next time…

Notes:

• I create these newsletters as a personal project. They are not affiliated with any current or past employers or groups with which I volunteer. I receive no financial compensation for my efforts to create these newsletters. Thank you to those who have offered to fund this project and compensate me for my time and effort. This is my gift to those interested in nicotine. Community service is important to me. Volunteering is something I have done since I was a child.