Progressives’ Deadly Hypocrisy on ‘Harm Reduction’

California’s progressive Democrats like to present themselves as boundary-breaking advocates of, well, progress as they advocate policies that reject the desiccated notions of the past. This rarely turns out well, as they generally push for more government regulations, spending, and control over the economy. Sometimes, however, they’re on to something — as they work to overturn prohibitionist policies toward cannabis use and drug treatment.

It’s an often-told story, but America’s experiment with alcohol Prohibition was a disaster. Yes, alcohol use fell for a while, but it climbed back to existing levels by the end of the national nightmare. In the process, it destroyed businesses, harassed law-abiding citizens, led to a more toxic supply, and energized organized crime. As an aside, Prohibition was a do-gooding progressive policy at the time, although it had the support from religious conservatives (and from the bootleggers, too).

Although the use of hard drugs is a troubling social ill, the overall War on Drugs didn’t exactly wipe out the market for heroin, methamphetamine, and cocaine. As the great conservative writer William F. Buckley (and his colleagues) pointed out in a 1996 National Review editorial, “It is our judgment that the war on drugs has failed, that it is diverting intelligent energy away from how to deal with the problem of addiction, that it is wasting our resources, and that it is encouraging civil, judicial and penal procedures associated with police states.”

That same year, California did in fact lead the way for ending the war on one of the least-harmful drugs, marijuana, via a citizen-approved medical-marijuana initiative (Proposition 215). It created de facto decriminalization, in that one only needed an easily obtained medical card for ailments including stress. In 2016, votes finished the job and legalized recreational cannabis via Proposition 64, although the initiative’s excess regulations and taxes have kept the black market thriving.

In the meantime, the state and various left-leaning jurisdictions have approved a variety of “harm-reduction” policies (needle-exchange programs, greater availability of the overdose-overturning drug, Naloxone, etc.) designed to treat drug addiction more as a public-health problem than a law enforcement/incarceration issue — a sensible approach, at least when dealing with addicted people rather than dealers. Two cheers on that front.

“Harm reduction,” the California Department of Public Health explains with regard to our official state policy, “is an approach to working with people who use drugs that aims to reduce harm rather than eliminate risk. Harm reduction means acting in alliance with people who use drugs to offer resources for safer and managed drug use to prevent death, injury, disease, and overdose.” It recognizes what Buckley noted — the futility of trying to arrest drug users and the ill effect of heavy-handed enforcement policies on public budgets and civil liberties.

Yet while Gov. Gavin Newsom embraces that approach (along with some justifiable enforcement policies toward those who sell fentanyl) in his new “Master Plan for Tackling the Fentanyl and Opioid Crisis,” his administration has rejected harm reduction in an area where it could potentially save tens of thousands of lives, tobacco use. His approach is not that different than the one taken by other blue states, such as Massachusetts and New York.

The same harm-reduction principle applies to tobacco use. Many Americans are addicted to nicotine. Nicotine is not the problem per se. The health danger comes from combustion, which is why smoking cigarettes will knock 10 years off a smoker’s life. The prohibitionist approach is to ban tobacco products, but that only creates black markets and the problems found during alcohol Prohibition. The Tax Foundation reports that in New York, which has the nation’s highest cigarette taxes, 55 percent of consumed cigarettes come from smuggled sources.

Public Health England, the United Kingdom’s main health agency, has found that vaping is 95 percent safer than smoking combustible cigarettes. Popular nicotine pouches, made from pharmaceutical-grade nicotine (such as Zyn) and snus (its popularity in Sweden is credited for that country’s low tobacco-related cancer rates), are probably even safer. It’s generally best if people avoid such products altogether. But a proper harm-reduction policy would encourage smokers to shift from the most-dangerous products to the least-dangerous ones.

Instead, California and other liberal states are doing the opposite. They aren’t banning deadly cigarettes (except for menthol-flavored ones). They are leaving those on the shelves as they impose bans on flavored nicotine products. Because most vapes and pouches use flavors, which are preferred by adults breaking their smoking habit, these bans are dramatically reducing the availability of the safest products. Recent studies from Massachusetts and San Francisco have shown that such bans have led to a rise in combustible cigarette use.

My R Street Institute colleague Stacey McKenna has just published a new report that focuses on the counterproductive hypocrisy of blue states (and red states are often hypocritical in reverse) that champion harm reduction with regard to drugs but not tobacco. The five most restrictive states when it comes to tobacco (California, New York, Massachusetts, Rhode Island, and New Jersey) are among the most permissive states when it comes to drugs.

“These states’ policies on opioid harm reduction and regulated cannabis markets suggest that their lawmakers understand that even if substances are not 100 percent safe, harm reduction can save lives, and prohibition can create harms,” McKenna wrote. “However, their tight restrictions on ENDS (Electronic Nicotine Delivery Systems) products directly contradict this recognition by creating a conflicting prohibitionist environment around tobacco harm reduction that may contribute to a rise in illicit markets and a return to combustible cigarette use.”

It’s nonsensical but no doubt stems from the Left’s desire to fight Big Tobacco rather than from any principled or consistent stance in advocating better public health. As a result, these progressives are promoting the most regressive and harmful policies possible — which, when you think about it, shouldn’t surprise anyone who has watched California’s leaders.

Steven Greenhut is Western region director for the R Street Institute. Write to him at sgreenhut@rstreet.org.

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