Barry Baines

And you expect people to disprove that if they can, so that we can develop something that's more true. So whether it be research on masks that comes out that says, well, we thought would be helpful, maybe it's not as helpful as it was, or certain vaccine effectiveness. Over time, we accumulate new information that helps us to get better with that. And what's happened is there's been this erosion

This is just my opinion, an erosion of trust in society about science and public health, because things change with it, even though, yes, it changes because we have new validated information that has us offer a different recommendation. But the population at large, I think there's the sense that if you're changing your mind, then you really don't know what you're talking about.

And so there's this notion of trust. And that to me is how do we get that back? You know, where I guess I remember I was just born after the polio vaccine came out. But I you know, you see the films that when the polio vaccine came out, I mean, it was sort of like. It was like, quote, a national holiday. They closed everything so that people could go and get the polio hits.

It was like your civic duty, which I think, you know, certainly, you know, Sheridan talked about that. You know, that's my civic responsibility to do that. And the population did that. And things have, you know, sadly changed so much that that's not the case. So I don't know.

You know, I guess in response to your question, I don't know what it is that physicians, you know, there's any more that we can do other than we keep bringing it up. We tell people how important it is. Reminders. And let them know that there's really good access and that it doesn't cost people anything. I mean, that's the other thing.

Barry. I'll keep this on more along the lines of what Clarence said. Even if you don't want to get the vaccine for yourself, get it for the people that you care about. Exactly.

Okay. Yeah. Barry. Yeah. Dr. Patton, can you just help us to differentiate between nicotine, which is the addictive substance that's in tobacco products, but obviously nicotine pouches and e-cigarettes, et cetera. But between that and tobacco, because it's the nicotine addiction that that gets people hooked and, you know, having them continue to use those products.

Uh, but for tobacco, a lot of the, uh, really bad health effects, um, relate not to the necessarily the nicotine, but as you were just pointing out the burn, you know, the burn products and what that does to lung tissue and all those kinds of things. But aren't they, I mean, they're related obviously. Um, but can you differentiate between the two? In other words, are we

dealing with two different issues that we need to attack to sort of improve health overall in our communities between, again, nicotine and tobacco products, of which it's more overlapped.

I think, you know, as a family physician, the way that played out is not so much certainly having the hammer of the information that this is all bad for you. But these are kind of things, just like with youth, that it's years, you know, it's years from now. And people are living in today, you know, mostly not, you know, what's going to happen 20 or 30 years. or 40 years from now.

But for me, I think one of the biggest breakthroughs was actually more on the behavioral aspect of things is this whole idea of, yes, you give the information, but what's almost as important, if not more important, is to get an understanding of people's readiness to change their behavior. And there's a lot of public health work done for readiness to change.

And every resident today, and certainly in primary care for sure, knows how to help assess their patient's readiness to change when they identify health behaviors, not just tobacco products usage, but other things as well. Because the threat of disease, that's a scare tactic, right? You want to scare people out of it.

And when you're dealing with an addictive substance like nicotine, scare tactics don't necessarily work very well. But trying to work on people's motivation and realize that it's not going to be better quit today or, you know, or else. But really that it's a process and having that relationship over time and keep checking in, keep checking in. And over time, people sort of get the message.

So there's that piece from a clinical perspective. What struck me, and again, I'll ask Dr. Patton about this. I remember seeing these graphs that was almost linear, that as taxing tobacco products, the level of taxes on tobacco products go up, usage goes down. I remember seeing these graphs, it was like,

you know, taxes are going up and usage goes down, especially with youth, because they oftentimes don't have the financial resources to afford the escalating price. And that has been, you know, I mean, please correct me if I'm wrong, one of the biggest or most successful deterrents for tobacco product use in certainly in younger folks and probably other populations as well. So I hope

Clarence and Stan, I kind of addressed the piece with how that information about health effects is just one piece of the puzzle. It's so complicated. You really need a combined strategy. And it's persistence. You have to keep coming back to it to get the message across.

Well, you know, Stan, I'll just be really brief here. You hit the big three, okay? Yeah, right. Drugs or medications, all those, tobacco and alcohol. And some of that is inherent in the society that we live in and they become societal norms. And I think that's what makes it a real public health challenge to do that.

And I was, my ears sort of perked up, Dr. Patton, when you talked about, you know, the request for the family-based interventions. I think that's going to be, you know, the key. And just a quick aside, I remember when secondhand smoke became big. And oftentimes that was a much better motivator for parents to either

you know, could go to, you know, ideally to quit smoking, but as a second choice, don't smoke in the house, go outside, you know, if you want to, you know, smoke, okay. But, but don't make your kids sick because you're smoking in the house. And oftentimes that was a motivator, you know, for parents. So again, I guess the, you know, the glass is half full, at least you help the kid out.

You know, and those cues of seeing their parents smoke all the time in the house, if they're not there, it's less reinforcement of the norm of, of, of smoking. So it's, I know that doesn't really clarify, you know, things, but it's sort of like we have all the tools and, you know, we have a big toolbox and how do we deploy what's in the toolbox that works for this particular person or this family.