An Interview With Citizen Tobacco Harm Reduction Advocate Skip Murray

At Safer From Harm, we think about how people can access tools to reduce their health risks, even if they don’t (or don’t currently) choose abstinence from a particular behavior. This is as true in nicotine use as it is in drug use, because smoking cigarettes remains a leading cause of death in the United States, and it can be extremely hard for some people to quit.

We don’t often hear the human stories behind smoking. That’s why we were glad to talk with Skip Murray, a longtime friend of Safer From Harm. Murray is a citizen advocate for harm reduction in tobacco and nicotine. She uses data and her own personal story to make the case that adults who smoke cigarettes deserve access to reduced-harm products like e-cigarettes (vapes) and nicotine pouches.

But first, a brief reminder of the facts: Smoking tobacco is deadly because of the chemicals released in that smoke, about 70 of which can cause disease and death. Tobacco also contains nicotine, which has addictive properties but is not the cause of smoking-related disease and death. For adults who already smoke, reduced-risk nicotine products can deliver nicotine—and in the case of vapes, an experience that closely mirrors smoking—without those deadly chemicals. The Food and Drug Administration (FDA) lays out the case for reduced-harm nicotine products here. Other tools, such as FDA-approved medications, are also available to help people quit smoking.

We asked Murray to tell us about her journey from smoking to vaping and how she helps others find a harm reduction route that works for them.

This interview has been edited for length and clarity.

Jessica Shortall: Skip, can you tell us about your first cigarette?

Skip Murray: I had my first cigarette behind my grandpa's barn at the ripe old age of 10 years old. I had a hard childhood, my dad was abusive; my grandfather was the nurturing male father figure in my life, and I wanted to be like him. So I stole one of his cigarettes and went out behind the barn and tried it. By high school, I was smoking two packs a day, and I kept smoking for almost 50 years.

Shortall: Did you try to quit?

Murray: We all know smoking is deadly—it makes you sick. When I had my son, I wanted to be a good mom, and I tried everything to quit. I tried patches, gums, prescription medications, and hypnosis. I have a phobia of needles, and I even tried acupuncture. I tried over and over and over, and I always failed. Sometimes I would succeed for a little bit of time and then fail again. You can only fail so many times before you start to believe that you can’t do it and you get tired of being a failure. So I just quit trying so I wouldn’t have to fail again.

Shortall: And then you ultimately did quit, but in your own way, right?

Murray: I was helping a family member out with their vape shop, and they didn't like me going out back for a cigarette. So I just vaped when I couldn't smoke. About four months later, I realized I didn’t know the last time I had a cigarette. I was just so surprised.

Shortall: Has switching completely to vaping had impacts on your health?

Murray: Sleeping and breathing were the biggies for me. I have sleeping issues, and it really stinks when you actually are able to sleep, but then you wake up and you're coughing up all that crud, or you have to sleep propped up because you can’t breathe. Those problems went away. Cancer and heart disease run in my family, so my doctor was really excited that I quit smoking because it reduces the risk.

Shortall: It sounds like while you were accidentally quitting, as you put it, you were a dual user of both cigarettes and vapes for a couple of months. We know that the medical and scientific advice is to switch completely, not use both cigarettes and vapes. What do you see in terms of how people are successfully making a full switch?

Murray: I’ve had people who, from that very first inhale off a vape, never smoke again. And I’ve seen people take some time to completely make that transition. I knew someone who dual-used for quite a while, and he was frustrated that he never could make the switch, but he is now smoke free, which is pretty exciting.

Shortall: What kind of approach do you take when you’re talking to someone peer-to-peer?

Murray: It’s important to get to know the person and find a way to meet them where they're at. It’s not just the nicotine that keeps people smoking. You have to find out what smoking does for a person and find out how to substitute that so it’s easier for them to switch. Some people don’t want much vapor; other people need that sensory experience of blowing a cloud. Some people like the tobacco flavor, and some people are like, “I don’t want it to remind me of a cigarette, I want a different flavor.” And no matter how you quit smoking, people who have some sort of support have higher success rates. So it’s a lot of individualism, talking, and listening.