On Friday, Dr. Brian Goldman found himself making a difficult decision.

In the interest of harm reduction, he wrote on Twitter, “I bought my first pack of cigarettes. Not for me. For my son.”

Goldman’s son is 17, and he has fetal alcohol spectrum disorder (FASD).

The condition can make learning from past experiences tough, and hinders a person’s ability to make good long-term choices, said Goldman, the host of White Coat, Black Art and an emergency room physician in Toronto.

Goldman spoke with Metro Morning host Matt Galloway about what compelled him to buy those cigarettes for his son, and the challenges of raising a child with FASD.

Here is part of their conversation.

Why did you buy cigarettes for your son?

It’s complicated, for many reasons. My son, a couple years ago, was diagnosed with fetal alcohol spectrum disorder (FASD). We adopted both of our children from orphanages in Russia. It was a highly personal thing. There are many different kinds of harm reduction. I could have bought him a Juul. I could have bought him a vape. But I thought that it would be very easy to turn him into the equivalent of a three-pack-a-day smoker with the nicotine levels that you can acquire, and I didn’t want him to get used to that and comfortable with that, so that if he received vape liquid from other people he would graduate onto other things.

The thing about a cigarette is that you smoke them, there’s a finite amount of nicotine in it, and there’s only so much he can afford. There’s only so much that he’s going to be able to acquire on his own. So there is some limit there. I suppose if he became the equivalent of a pack-and-a-half or a pack-a-day smoker, I might consider switching him, you know, buying him a vape. There are other harms. As an average teenager with fetal alcohol spectrum disorder, he’s got the full range of issues that kids face. (Read more…)

Re-post from CBC Radio, by Kirsten Fenn, November 12, 2019