Thinking 'bout THR News and Views
Feb 14-23, 2025
Sir Isaac Newton’s third law of motion states that “every action has an equal and opposite reaction.”
I joined The Great Nicotine Debate in 2014. For 10+ years, I have watched people park their beliefs and agendas on a bulldozer and give no thought to the potential graves they are digging.
Every potential policy should be thoroughly evaluated for possible helpful and harmful outcomes. However, in this space, some agendas seem to have a louder voice, and what they feel is useful about a policy is all that’s being heard. I worry about the unintended consequences those individuals seem to fail to see.
Here are four obstacles that prevent reduced-risk products from having as significant an effect on public health as possible.
#1 - focus on youth vaping while turning a blind eye to smoking.
Example: Research shows restricting flavored e-cigarettes cuts vaping rates but raises smoking rates for young adults. “We should always be cognizant that any policy will have unintended effects, especially in the public health space. In this case, our study finds flavored e-cigarette restrictions have the unintended effect of sizably increasing cigarette use,” Pesko said. “This is not good from a public health perspective because cigarettes are far more dangerous products. It’s the equivalence of steering a ship away from a storm straight into a whirlpool.”
The Public Health Triumph No One’s Talking About. “In the end, the half million people who are dying each year from cigarettes, inveterate smokers for whom e-cigarettes were first made widely available about ten years ago, are being failed by those who once set out to save them.”
#2 - widespread misinformation and misperceptions are preventing people who smoke from making an informed choice about safer alternatives and are fueling a push for policies that are not improving public health.
Examples of how widespread the misperception problem is can be found in my notes here.
Here are examples of how science contributes to misinformation and scientists' work to correct it. (I have many notes to add to this page, but it will demonstrate how pervasive this problem is.)
Jeffrey Weiss compares misinformation generated by industry years ago to current sources of misinformation here.
#3 - A too-narrow focus on squashing the industry is deterring it from transitioning away from its lethal products and preventing efforts to educate people on reduced-risk products. Lack of empathy for people who smoke limits the perspective of the ones who want to eliminate the industry.
The linked Rodu article is my “must read” suggestion for the week. Too many healthcare providers believe that nicotine causes cancer, heart disease, and COPD. They can’t give patients accurate information if they don’t know the truth. Therefore, there is a need to provide further education to these practitioners. Is that happening? NO! Why? Dr. Brad Rodu talks about the resistance to and censorship of his efforts to educate healthcare providers. It's a chronic case of fearmongering about “industry” and ad hominem attacks for the win, but that win is the farthest possible from real winning. (Side note: Dr. Rodu’s blog included a link to his training course. That course has been added to the Guides for Healthcare and Social Services Professionals page on the Safer Nicotine Wiki.)
An article was published about the efforts of one of academia’s myth-busters, Dr. Michael Siegel, and why he thinks harm reduction isn’t accepted when it comes to using nicotine. He said, “My theory is that the main reason tobacco control advocates do not accept a harm reduction approach in the context of smoking is that they have a vitriolic hatred of smokers and smoking, and they cannot accept the idea that someone could be using nicotine in a way that improves their health. The idea of someone gaining pleasure from the use of nicotine is anathema to them.”
#4 - policies that make it easier to smoke than to use a safer alternative have opened the door to a quickly spreading illicit market and are leading to the destruction of property, funds wasted on the need for extra enforcement, and contributing to the loss of life.
Example: Sinaloa Cartel Turf War Between Chapitos and Mayiza Expands to Mexico's Contested Vape Market. “The Sinaloa Cartel's entrance to the vaping business was evidenced by a viral social media video of two teenagers being tortured in 2023. The victims were forced to walk naked around the streets of Guasave, Sinaloa holding a sign that read: "This is what happened to me for selling vapes without permission."
Example: Fatal house fire at Truganina linked to Melbourne's tobacco wars. “Police believe a fatal house fire in Truganina in January was an arson attack linked to Victoria's tobacco wars. Katie Tangey, 27, died in the fire but police believe the arsonists targeted the wrong address.” (Note: The family dog also died in the fire.)
Example: Tobacco & Vapes Wars *Update*. “Yesterday we saw the 220th firebombing occur in Hectorville in the eastern part of Adelaide at a business called "Puff Station". Three people emerged from the vehicle, with one assailant wielding a hammer and repeatedly hitting the store's front window. The other two people hurled what appeared to be Molotov cocktails, causing the shop to erupt into flames.”
Failing to get it right the first time around leads to too many unintended consequences, requiring policymakers to retrace their steps and try to undo the damage being done to society.
Example: The E-Cigarette Committee urges the government to amend the E-Cigarette Act after finding that it is causing problems in Thai society. (Google Translate) - “Spokesperson of the Special Committee to Study the Law and Measures to Control E-Cigarettes in Thailand called on the government to urgently amend the law after the situation of e-cigarettes has escalated beyond the issue of easy access for youth to the issue, expanding to the problem of illegal activities in many dimensions, including illegal production, importation, and distribution without standards, illegal mixing of ketamine, and spreading to other social problems…Mr. Tossaporn revealed that the committee has conducted a comprehensive study and proposed 3 approaches to deal with the e-cigarette problem. 2 out of 3 approaches are to legalize e-cigarettes and heated tobacco products, which will allow the government to systematically supervise, from production standards, distribution channels, to measures to prevent access by youth. Similarly, having a legal measure to control cigarettes as a controlled product can reduce the smoking rate and protect children and youth better than a ban.”
The debate over nicotine has become an emotional one. From pleas to “save the children” to the tears of people who’ve lost loved ones from smoking to an almost fanatical hatred of industry, society has stepped away from evaluating the science to the detriment of public health.
Everyone has opinions, which often influence the policies we support or oppose. Are we letting our emotions determine our truth, or are we evaluating the science?
What does the “other side” say about a policy? Why do they say what they do? Are there any unintended consequences? Will this save lives or contribute to more death, disease, or destruction?
If the questions and their answers make you uncomfortable, maybe it’s time to rethink your position. Making a list of pros and cons for every policy we want to enact or defeat might help us make better choices. For example, we'd save more lives faster with policies that help us transition people away from smoking while assisting others to never to start.
Either way, when debating a policy, choose your words wisely and kindly. More people will listen to you that way.
Until next time…
PS: While many of you have said that the voices of those who use (or have used) nicotine need to be heard, I’m not finding many conferences that include a consumer category with an affordable registration fee for a layperson or an invitation for individuals to contact conference organizers to discuss that option. While I doubt many consumers can afford to take time off work and travel to attend these conferences, why would they even make an effort when the welcome mat is still locked away and remains unseen? #WalkTheWalk!
The kindness and compassion shown to the thousands of people recently fired without cause are inspiring. One example is Dr. Carrie Kuehn, RAC-US, one of many who are keeping their eyes open for employment opportunities to help those needlessly fired get back on their feet as soon as possible. Megan Ranney has been placed on my list of Communication Heroes as she shares not only every story of laid-off federal employees she finds but also job opportunities that might benefit those employees. Go, Megan!
A New Cancel Culture Censoring Science and Research. “Have we reached a point where concern about people dying is an expression of “wokeness” and thus politically incorrect under the new regime?”
Quick Tips to Fact-Check Like a Pro. Master Lateral Reading and Value Checking to Separate Truth from Fiction.
Ten Simple Rules of Live Tweeting at Scientific Conferences. “From our own experiences of attending and live tweeting at several conferences over the past three years, the success of live tweeting appears dependent on the engagement of conference organizers with Twitter and its active encouragement before, during, and after the meeting. Surprisingly few conferences are actively encouraging scientists to tweet. This reticence is probably more likely due to ignorance of the potential rather than the possibility of loss of attendee revenue. We suggest that conference live tweeting is an opportunity to reach beyond those in the room while enabling feedback from those outside.”
A full guide to vapes: Post 1 and A full guide to vapes: Post 2. This is a “series of posts describing how vapes work, the aerosol they generate, their properties, their optimal regime of operation, overheating conditions and dry puffs, as well as comparisons with tobacco smoke and other aerosols.”
BSMS - “New Study Alert! Over half of smokers in England wrongly believe vaping is as bad or worse than smoking. But research shows vaping is far less harmful and this misinformation is stopping people from making healthier choices.”
Jeffrey Willett - “I believe we could dramatically improve public health, particularly among lower-income Americans and other marginalized communities, if more tobacco control organizations and professionals in the U.S. emphasized the following among their key principles: …”
Joe Gitchell (thread in response to a tweet encouraging Brian King to resign) - “I know I'm starting from a different place, but let me offer some counterpoints…”
Chris Allen - Compliance, Pressure, and Opportunity: How the Fraud Triangle Explains Nicotine Product Challenges in the US.
Jeffrey Weiss - “Upon hearing of this nomination, many within the tobacco harm reduction community quickly searched for evidence of prior positions by Dr. Makary on vaping and THR – to see if we might expect a change in direction. As it turns out, he has previously said little if anything on these issues. But I don’t think this should end the inquiry.”
Adam Gambrill - “I recently visited New York and Las Vegas for TPE to explore pouch opportunities in the U.S. … The U.S. pouch market is at an interesting crossroads. Consumer awareness is low, regulations are restricting product development, and price-driven competition is pushing more low-quality (and illegal) products into the space.”
VAADA Conference 2025: Keynote Dr James Martin. “A contemporary case study on the emerging war on nicotine will then draw parallels with traditional drug markets, illustrating how similar enforcement strategies are generating black market opportunities.”
VAADA Conference 2025 Panel Discussion - Vaping in focus: health, policy and regulation. “This panel brings together experts from diverse fields to explore the complexities of this pressing issue.”
ASAM Practice Pearls - Dr. Peter Selby and Dr. Nancy Rigotti explore current and emerging strategies for treating tobacco use disorder (TUD).
Ep 11 - Nothing Is Harmless "The Dosage Makes The Poison" with Dr. Farsalinos.
AVM Shaping Vaping. New episode with Jim McCarthy and Joe Gitchell
Roberto Sussman | Censorship & Misconduct in Tobacco Harm Reduction.
1 HORA COM INGRID DRAGAN TARICANO - #Vaporacast94 - TOXICOLOGIA E REDUÇÃO DE DANOS. (Portuguese)
Entrelineas: La Lucha Por la Reducción de Daños Con Carmen Escrig. (English CC available)
After SCOTUS arguments on sweet vape flavors, some lawyers hope opinion brings more FDA clarity.
Utah’s flavored vape ban — and lawsuit — could be out the door with new bill.
Putting on the brakes:
False and misleading statements about vaping. “In his response Commissioner Hoekstra made the extraoridinary and false statement that “Smoking kills, vaping kills”. Such a statement is extremely dangerours and damaging to the understanding of the relative risks of vaping compared to smoking, particularly when it is delivered in a meeting with policymakers.”
Iowa Health Says There's No Real Difference Between Vaping and Smoking. “This web site is like a dream come true for the cigarette industry. They literally could not have paid a health organization money to produce a fact sheet that minimizes the health effects of smoking as much by equating it merely with vaping.”
Update - Tweet(s) now displaying a community note:
The Mirror. “Vaping bombshell: World's first study reveals truth about habit that will horrify millions of e-cigarette users.”
Coalition to Protect SC Kids - “The rise of flavored, disposable vapes has fueled a 2,600% increase in high school vaping since 2019. Weak regulations allow these products to flood our communities, hooking kids on nicotine. South Carolina must act now to stop this crisis.”
The American Lung Association tweeted the same photo and misinformation three times in one day. The third time was after one of the earlier tweets had a visible community note.
First #GFN25 speaker announced - and it’s our Michael Russell Orator… “Without further ado, we’re delighted to reveal that this year’s Michael Russell Oration will be given by Dr. Arielle Selya!…Titled ‘The State of Academic Research on Nicotine: Flaws, Incentive Structures, and Opportunities’, Arielle’s Oration will also explore why, despite decades of consumer use of safer nicotine products, there remain repeated critical flaws in the literature about them.”
Sell Flavored Tobacco in Massachusetts, Go To Jail. “In 2022, I wrote an article for Reason predicting that it was only a matter of time before selling flavored tobacco products landed an American behind bars. Almost three years later, that day has arrived in Massachusetts.”
A plea to spare vapers from sin tax hikes. “By making vaping more expensive through taxation, smokers may be deterred from making the switch.”
The Vaping Market Is a Case Study in Regulation Gone Bad. “And, therein lies the real issue. Laws aren’t working, and the economic incentives of providing a quality product have been removed from the market.”
How we ended up jailing sellers of flavored e-cigarettes. “To those reasons we can now add another, which is that by banning voluntary transactions between consenting adults, they create crime where none existed before. It’s a familiar consequence of prohibition, and it shouldn’t be surprising to find that it applies to nicotine and tobacco too.”
Lawmakers target increased nicotine taxes, but miss the mark. (Note, this article won’t let me copy/paste a quote.)
Africa: Harm Reduction in Smoking - Prof. David Khayat Advocates for a Pragmatic Approach. “Prof. Khayat calls for a policy shift based on technological innovation and appropriate regulation. He cites Sweden as an example, where the use of snus (a smokeless tobacco product) has helped achieve one of the lowest lung cancer rates in Europe. "We need strict regulations to prevent misuse—especially among young people—but we must also accept that harm reduction is a pragmatic solution," he insists.”
Nicotine not carcinogenic, Israeli expert tells Filipino doctors. “Previously a non-believer in tobacco harm reduction, Zimlichman changed his position after reviewing the emerging scientific evidence supporting the novel public health strategy.”
Consumers be heard on vaping, before it is too late. “I suggest that others write if they feel strongly and explain the situation from a user’s point of view. It seems that the NGOs and trade associations for manufacturers have been asked, but no one represents consumers.”
Stark Contrast In Smoking Reduction Highlights Implications For Asia Pacific. “The organisation points to the recent study published in Addiction, which compared vaping regulations and smoking trends in Australia and New Zealand. The study found that New Zealand's more liberal approach to vaping was associated with a more rapid decline in adult smoking rates compared to Australia's restrictive policies.”
Nicotine less harmful to the brain than previously thought: study. “Nicotine opponents frequently claim that changes in the brain structure of nicotine users are caused by nicotine itself. However, the new research indicates such claims are built on a common misunderstanding of correlation and causation.”
Latvia Strengthens Regulations on Vaping and Nicotine Products. “Latvia has implemented stricter regulations on vaping and nicotine products, becoming the ninth European nation to ban flavoured vapes.”
Voices of Harm Reduction Pt 7: Fiona Patten. “They seem to actively ignore what’s happening in New Zealand. Which is highly unusual for Australians because we’re so competitive with New Zealand. You would think we would be trying to win this one, but we’re letting New Zealand’s smoking rates drop much lower than Australia. They’re going to reach a smoke free classification probably by next year. And Australia is probably never going to reach it the way it’s going right now.”
Bill raising NM's tax rate on vaping products, nicotine pouches advances at Roundhouse. “A proposed tobacco tax increase in New Mexico is advancing at the Roundhouse after being slimmed down to target vape devices and nicotine pouches.”
More news: Vapers Digest Feb 17, Feb 19, Feb 21.
Not researched for this edition
Notes:
I create these newsletters as a personal project. They are not affiliated with any current or past employers or groups I do volunteer work with. I receive no financial compensation for my efforts to create these newsletters.
My blog, Skip's Corner, has an X/Twitter account. My personal accounts are on BlueSky, LinkedIn, and X (Twitter).