HIDING IN PLAIN SIGHT

How identity and visibility relate to curbing commercial tobacco use. 

BY MARIELLE REATAZA, MD, MS

Like many, I’ve spent the majority of my time in my apartment for the better part of a year. This past March marked the anniversary of California’s Stay at Home order, one of the most restrictive in the nation. This whole year has led us to question our beliefs around agency and control—and along with it, our sense of belonging and visibility on both deeply personal and collective scales. More than ever, we are questioning what it means to be a contributing part of society and developing scaffolding for what accountability can look like.

Conversations around community and accountability often involve those of identity. I identify as Southeast Asian American. Specifically, I am Filipino/Chinese and a 1.5 generation immigrant from the Philippines. I also identify as bisexual and queer. Having been raised in a strict Catholic home and coming from a country where descriptions of queerness have traditionally been limited, it is so clear to me now how impactful it is to be able to call something by its name and then give it meaning, context, action. 

The ability for folks to define themselves better as an individual among community can be empowering. On a personal level, doing so has helped me understand where I’m starting off and then where I need to go. On a population level, it helps define nuances about pockets of communities that could have otherwise been silenced by “the majority.” It’s often these neglected nooks within Big Data that continue to be overlooked time and time again, leading to some communities rarely being reflected accurately in well-known data. This emphasis on breaking down the nuances of Big Data is the basis for advocacy towards disaggregated data and having better baseline numbers for marginalized communities. When it comes to addressing difficult, decades’ old public health concerns such as commercial tobacco use, the clearer understanding that disaggregated data can bring can help to curb use and support cessation altogether.

When it comes to understanding what a smoker looks like, falling through the data cracks has impacted my own experiences. As someone who simply didn’t have the understanding to see myself in the environment reflected back to me, it was hard to give my own experiences relevance. In my mid-thirties now and having worked previously as a physician and a high school teacher before then, it’s probably a shock to many when I tell them that I picked up my first cigarette when I was thirteen years old and then smoked, quit, relapsed, quit, relapsed, then quit again. This cycle went on for several years. When I really think about it, the most surprising part about my story is probably the fact that I’ve gone years working in healthcare, public health, and tobacco control without ever mentioning my own previous struggles around smoking! 

I am proud to say that I am no longer a smoker. While I take responsibility for my own choices and previous struggles with tobacco use, I can’t help but wonder if I would have thought differently about that first cigarette had I not had regular exposure or access to tobacco in my environment—either at home, with extended family, or with friends at school or around the block. There’s not one reason that applies to everyone who has ever smoked, at least as far as what compelled them to pick up that first cigarette. We’ve all had our reasons, and that goes for anyone in recovery or still struggling with any kind of substance use. In looking back, I now wonder what kind of resources I would have needed that could have led me to drop that first cigarette before I ever put it to my lips. Could anyone have looked at me then, a nerdy and in-the-closet Southeast Asian teenage girl and ping me as a smoker? … 


To read the rest of Marielle’s story go to: https://californialgbtqhealth.org/how-identity-and-visibility-relate-to-curbing-commercial-tobacco-use/