This joke-format falsehood from our planet’s premier health agency is far from comic, when it’s only the most explicit recent example of a noxious campaign against harm reduction products that save lives.

The WHO and its regional offices and partners persist in outrageously misleading governments and consumers. Thanks to this orchestrated moral panic, many of the world’s adults who smoke are denied harm reduction alternatives—either because of resulting laws, or because they’ve been deceived about relative risks.

None of this is surprising anymore. In 2024, the WHO has earned a whole string of community notes for misleading vape-related tweets.

Take a recent e-cigarette “briefer” from the Western Pacific Region (WPR) of the WHO, which combines cherry-picked factoids and misinformation.

Ignoring adults who smoke, despite over 7 million annual smoking-related deaths among them, the document focuses solely on children—who may vape, though less often than claimed, but are not losing their lives.

That’s become par for the course with the WHO, as demonstrated at its Framework Convention on Tobacco Control (FCTC) COP10 meeting in February. FCTC Secretariat head Dr. Adriana Blanco Marquizo dismissed the lives of over 1 billion adults, arguing that their access to tobacco harm reduction “should never serve as justification for legitimizing products that could send even a single child down the path of addiction.”

Recommending bans or restrictions, the WPR document also claims that vaping products “sometimes” contain harmful toxins at levels higher than in tobacco smoke (utterly misleading, when the dose makes the poison and vapor is exponentially safer than smoke); and that there’s insufficient evidence to support vapes’ population-level effectiveness for smoking cessation (plain false).

The WPR was recently hit with a community note for a tweet listing debunked “dangers” of vaping. But none of this is surprising anymore. In 2024, the WHO has earned a whole string of community notes for misleading vape-related tweets, as Skip Murray described for Filter.

Until 2023, the WHO’s narrative centered on the so-called “youth vaping epidemic” in the United States. Public health agencies including the US Food and Drug Administration and Centers for Disease Control and Prevention declared this “epidemic” in 2018. At its peak in 2019, 20 percent of US youth reported vaping in the past 30 days (a total of “current” users inclusive of those who vaped just once in that month). By 2023, this figure had dropped (by 61.5 percent) to just 7.7 percent. In the face of this decline, the WHO has turned elsewhere in its bid to exaggerate youth vaping trends.

Even in relatively vape-friendly countries like the United Kingdom, youth vaping levels don’t match the WHO’s hype. But even the UK isn’t immune to the WHO’s pressure.

The WHO sacrifices adult health for the sake of an ill-founded youth-protection case.

While the UK’s figure for youth ever having tried vapes has recently risen, it’s still far lower than the 2019 US peak—and data from Action on Smoking and Health show “no significant change” from 2022-2023 in the proportion of 11-17-year-olds “currently” vaping or smoking.

The UK saw a larger increase in youth vaping from 2014-2015. That time, the British government didn’t react with restrictive measures.

Now, however, the UK is considering the Tobacco and Vapes Bill (currently interrupted by an election), which would restrict sales displays and introduce new powers to ban flavors, in the name of youth prevention. A planned vape tax will meanwhile reduce the financial incentive to switch.

Naturally, the WHO’s Europe regional office has been caught misleading the public. An April 25 tweet saying we “must reverse this trend” of youth preferring vapes to deadly combustible cigarettes was community-noted.

This all reflects the WHO’s broader strategy. Back in 2019, the FCTC Secretariat urged member parties to “remain vigilant” about tobacco harm reduction products, calling vapes a “treacherous and flavored camouflage of a health disaster yet to happen.”

In a January 2024 Q&A webpage, the WHO dodged the critical question of vaping products’ relative risk versus conventional cigarettes, instead generalizing that “both pose risks to health.” It included the now-familiar claim that vapes “have not been proven to be effective for cessation at the population level.”

Try telling that to the 2.7 million Brits (as of 2023) who used to smoke but now exclusively vape. That’s the majority (56 percent) of adults vaping there—and most of the rest (37 percent) both smoke and vape, which often means a reduction in smoking and/or a step along the way to switching entirely.

Saying that vapes are “designed to kill” is another new low in what’s become a procession of them.

The WHO’s sickening “designed to kill” tweet conflated vaping products with the tobacco industry—most vapes are not made by tobacco companies—and the WHO and its allies unsurprisingly ignore industry data that would undermine their position.

Major tobacco companies have seen sharp declines in cigarette sales attributed to adults switching to flavored, disposable and other vapor products. One reported an 11.4 percent decline in US cigarette volumes in 2023; another saw US smokeable products sales fall 10 percent in the first quarter of 2024. A third company, meanwhile, reported that in the first quarter of 2024, smoke-free products accounted for more than one-third (39 percent) of its revenues. In one market, heated tobacco products (another harm reduction option demonized by the WHO) are now outselling a major combustible cigarette brand.

Instead of promoting evidence-based ways to reduce the world’s biggest preventable death toll, the WHO sacrifices adult health for the sake of an ill-founded youth-protection case.

Saying that vapes are “designed to kill” is another new low in what’s become a procession of them. Hon Lik, the Chinese pharmacist who invented the e-cigarette, did so because he wished to quit smoking. Many millions have since followed that path.

The WHO should immediately abandon its vilification of vapes and instead empower adults who smoke to make informed health decisions.

But the harder the agency doubles down on harmful falsehoods, the more resistant it may become to what will, one day, be a humiliating climbdown. 

Top photograph (cropped) by United States Mission Geneva via Wikimedia Commons/Creative Commons 2.0. Inset image of Western Pacific Region briefing via World Health Organization.

The author’s employer previously provided a one-off donation to The Influence Foundation, which operates Filter, to support travel to a harm reduction event. Filter‘s Editorial Independence Policy applies.

The post Vapes “Designed to Kill,” Claims Org Designed to Protect World Health appeared first on Filter.

US public health agencies are resistant to adopting technological advancements which could reduce harms for tens of millions of people who are unable or unwilling to quit nicotine. These agencies are thereby not only betraying their mission statements, but disregarding decades of their own findings, thanks to a chronic case of mission creep.

The US Department of Health and Human Services (HHS) had been concerned about harms related to combustible cigarette use since at least the 1950s. The 1964 publication of the Surgeon General Advisory Committee on Smoking and Health report, which linked smoking with real health harms, led to the 1965 establishment of the unit that later became the Office on Smoking and Health (OSH) at the Centers for Disease Control and Prevention (CDC), under HSS.

The mission of OSH is to “develop, conduct, and support strategic efforts to protect the public’s health from the harmful effects of tobacco use.” The office envisions a “world free from tobacco-related death and disease.”

It’s notable that while earlier government reports focused heavily on the harms of combustible cigarette use, this later changed.

Since the 1964 report, over 30 more surgeon general reports related to tobacco or nicotine have been published.

Reviewing many of these reports’ hundreds of pages makes it evident that for a long time, US public health agencies have recognized that nicotine, though its use can lead to dependence, is not among the significantly harmful constituents of cigarette smoke.

More recently, we can find years of recognition that nicotine products exist on a continuum of risk, with combustible cigarettes positioned at the most harmful extreme.

It’s notable, however, that while earlier government reports focused heavily on the harms of combustible cigarette use, this later changed.

The most recent surgeon general’s report in which the principal focus was informing the public of harms caused by smoking was in 2014. More recent reports have instead placed a heightened emphasis on youth use of noncombustible nicotine products.

“Ending cigarette use; ending the use of the most harmful tobacco products; or ending the use of all tobacco products?”

That 2014 report—The Health Consequences of Smoking—50 Years of Progress—indicated a “general acceptance of a continuum of risk across tobacco products,” the term used for nicotine products whether or not they contain tobacco. It noted that the “complex chemical mixture of combustion compounds causes adverse health outcomes.”

The same report deliberated on the steps needed to “end the tobacco epidemic.” It presented three differing approaches, asking whether the priority should be: “ending cigarette use; ending the use of the most harmful tobacco products while reducing the harm of remaining products; or ending the use of all tobacco products.”

These approaches were not new 10 years ago, however. Fourteen years earlier, in the 2000 Reducing Tobacco Use report, the surgeon general examined the potential of litigation against the tobacco industry, suggesting that legal outcomes could “encourage the manufacture of safer (to the extent possible) products, which have lower liabilities.”

These products, it suggested, could include “noncarcinogenic nicotine delivery device[s],” which would retain any risks related to nicotine specifically, while creating “less liability both to individual users and to third party health care payers.”

Yet the most recent Smoking Cessation surgeon general report—published in 2020, after the surgeon general and US public health agencies declared a youth vaping “epidemic” in late 2018—erroneously claimed that there is “inadequate evidence that e-cigarettes, in general, increase smoking cessation.”

“The potential benefit of e-cigarettes for cessation among adult smokers,” the 2020 report emphasized, “cannot come at the expense of escalating rates of use of these products by youth.”

This encapsulates US public health agencies’ recent overemphasis on youth use to the point of exploitation.

By the time the last surgeon general’s report was issued, vaping was already decreasing among US middle and high school students, having peaked in 2019. In 2020 13.1 percent used vapes—a 34.5 percent decline from the previous year. Since then, youth vaping has fallen an additional 41.2 percent, with only 7.7 percent of US middle and high school students using nicotine vapes in 2023.

Amid hundreds of thousands of annual smoking-related deaths, US public health continues to fixate on reducing youth vaping, at all costs.

The 1964 surgeon general’s report on smoking was heavily influenced by Smoking and Health, a report published two years earlier by the United Kingdom’s Royal College of Physicians (RCP). In 2016, RCP published Nicotine Without Smoke, examining vapes.

RCP found vapes to be effective smoking cessation tools, with any harms from their use “unlikely to exceed [5 percent] of the harm from smoking tobacco.” RCP even advocated promoting the use of vapes “in the interest of public health.”

If our true priority is a “world free from tobacco-related death and disease,” the path forward should be clear. Yet amid hundreds of thousands of annual smoking-related deaths, US public health continues to fixate on reducing youth vaping, at all costs.

If US public health agencies are to honor their mission statements, they must stop ignoring tobacco harm reduction. They must recall decades of their own findings in pursuing appropriate, up-to-date ways to reduce harms for people who smoke. This will require acknowledging how and why they disastrously lost sight of their original goals.

Photograph via Rawpixel

The post Charting US Public Health’s Disastrous Mission Creep on Smoking appeared first on Filter.

That’s crucial, when individuals who switch from smoking have a variety of different needs. Some won’t find vaping helpful until they hit upon the right flavor, for example. To some, hand-to-mouth action and inhalation are essential elements for harm reduction products to replace; for others, it’s more about the nicotine, and oral products are more convenient.

But others still may prefer the smell and taste of tobacco, delivered over shorter periods—the harm reduction option that perhaps most closely replicates the cigarettes they’re trying to quit, only without the deadly smoke. And that’s why heated tobacco products have a vital role to play.

Heated tobacco products have a real-world track record of being linked with large-scale reductions in smoking.

Modern heated tobacco products (HTP) are devices that heat (but don’t burn) sticks of tobacco to produce vapor. The fact that they don’t produce smoke makes them much less harmful than cigarettes.

HTP also have a real-world track record of being linked with large-scale reductions in smoking—notably in Japan, where HTP were introduced a decade ago.

So what about the States? Regulatory requirements and court cases concerning copyright have greatly hindered HTP access here. But federal decisions over the next few years will be critical in determining how soon the country can make smoking obsolete. The evidence suggests it is time for the Food and Drug Administration (FDA) to lower barriers and allow more HTP to market.

While modern HTP are relatively new, the science behind heating tobacco is not. Researchers have understood since at least the 1970s that it is smoke (not nicotine) which causes most harms related to tobacco use. And ever since, manufacturers have sought to develop technologies that provide satisfying nicotine delivery for people who smoked, without those smoke-related harms.

HTP, in a very different form from later models, first entered the US market in the 1980s. First came Premier, which utilized a “small piece of charcoal-like carbon” to heat  the tobacco. In 1994 the Eclipse HTP was introduced, later rebranded as “Revo.” Various factors severely limited any impact of these early models, whose harm reduction potential is disputed, on US smoking, although Eclipse is still authorized by the federal government to be offered for retail sale.

In 2009, the FDA was granted regulatory authority over tobacco products, and with that came a slew of strict restrictions and requirements to introduce new products to market. To date, the FDA has still authorized only two HTP for sale: Eclipse and IQOS.

Eclipse resembles traditional cigarettes, with each tobacco stick having a charcoal tip at the end to heat it, to be discarded after each use. But IQOS—which was the first HTP to be introduced in Japan—is an electronic device to which you attach a tobacco stick, with only the stick being discarded after use.

The products are also treated quite differently under federal regulations. The Eclipse was granted a “substantial equivalence” marketing order by the FDA in 2018, largely because the product was on the market prior to February 15, 2007.

But because IQOS was unlike any previously available product, it was subject to the FDA’s onerous premarket tobacco product application (PMTA) pathway to be authorized for sale.

The FDA granting a modified risk order was a significant step in acknowledging potential benefits of HTP—and of tobacco harm reduction more broadly.

In 2019, the FDA authorized the marketing of an earlier version of IQOS, deeming it “appropriate for the protection of public health” for producing “fewer or lower levels of some toxins than combustible cigarettes.” In 2020, the agency also granted a supplemental marketing authorization for the IQOS 3 model.

These PMTA applications, requiring reams of scientific evidence, cost more than any but the biggest manufacturers can afford. Newer products may also be subject to entirely new applications, depending on FDA decisions.

In 2020, IQOS additionally became the only HTP to date authorized under a different FDA pathway, as a modified risk tobacco product (MRTP). MRTP orders are issued to a “single specific product,” rather than the entire class (i.e, all HTP). To be granted an MRTP, a manufacturer must demonstrate to the FDA that “the product will or is expected to benefit the health of the population as a whole.”

That decision was a significant step in the FDA acknowledging the potential benefits of HTP—and of tobacco harm reduction more broadly.

But other parts of the world are moving much faster. In 2014, an estimated 100,000 HTP devices and 15 million heated tobacco sticks were sold worldwide. By 2021, nearly 30 million HTP devices and over 125 billion heated tobacco sticks were sold.

Increased HTP use has correlated with declines in smoking. In Japan, one report estimates that within five years of the introduction of HTP in 2014, cigarette consumption there decreased by an incredible 44 percent—the biggest decline the country had ever seen.

Even researchers at the American Cancer Society—no champion of tobacco harm reduction—have noted that, “The introduction of IQOS likely reduced cigarette sales in Japan.”

We need all the tools we can get, and inaction costs lives.

Now, three major HTP brands are available in the country. A 2023 study found dramatic increases in HTP use from 2015-18 among Japanese people who formerly smoked and those currently smoking (whether or not they intended to quit)—but not among people who had never smoked.

As of 2022, more than 30 million US adults were currently smoking. All of them deserve access to a wide range of harm reduction options, and the chance to find out what helps them to quit cigarettes and live a healthier life. For many, the best answer might be a heated tobacco product, but when only one recent HTP has been authorized, their chances are limited.

It’s down to the FDA to improve their chances. If the agency knows that one HTP can “benefit the health of the population as a whole,” this must surely apply to other, comparable products. We need all the tools we can get, and inaction costs lives.

Photograph of heated tobacco product and vapes by Vaping360 via Flickr/Creative Commons 2.0

The Influence Foundation, which operates Filter, has received unrestricted grants from Reynolds American, Inc. and Philip Morris International, which manufacture products mentioned in this article. The author’s employer, the Taxpayers Protection Alliance, previously made a one-off donation to The Influence Foundation to support travel to a harm reduction event. Filter’s Editorial Independence Policy applies.

The post Heated Tobacco Products Can Help the US Make Smoking Obsolete appeared first on Filter.

Yet by the time COP10 closed, it had demonstrated how the FCTC has traded this focus on reducing harms of combustible tobacco for an obsession with youth who do not even smoke. The needs of the 1.3 billion adults who do smoke, and who die in their millions each year, are the casualty.

Since the 2003 treaty, our nicotine landscape has dramatically transformed.

The notion of a global health treaty to combat the “tobacco epidemic” grew from the early 1990s. The FCTC was first adopted in 2003, and came into force in 2005. Back then, there were far fewer noncombustible alternatives to cigarettes, although traditional nicotine replacement therapies and forms of smokeless tobacco like snus were available in parts of the world.

Reducing the harm caused by smoking is vital, and international action was overdue. But since the 2003 treaty, our nicotine landscape has dramatically transformed.

It was that very year that Hon Lik, a Chineses pharmacist, developed the first nicotine vape, as he sought to quit the heavy smoking that had killed his father. Not only vapes, but heated tobacco devices and nicotine pouches have rapidly proliferated and improved since then—all of which deliver the largely harmless drug nicotine without combustion.

The broad international response to this should have been easy. Nearly three decades prior, esteemed tobacco researcher Michael Russell had famously stated, “People smoke for the nicotine, but die from the tar.” Now, we had a wide range of enjoyable nicotine options that people could use instead of cigarettes, losing the deadly smoke.

The WHO’s target has morphed from the severe global toll of death and disease to the nebulous concept of “nicotine addiction”—above all, among youth who vape.

Yet the WHO has taken an adversarial stance on tobacco harm reduction products and repeatedly doubled down—even though these are no longer novel or emerging products, but have a decades-long history of consumer use.

In an attempt to justify this, the WHO’s target has morphed from the severe global toll of death and disease to the nebulous concept of “nicotine addiction”—above all, among youth who vape. This doesn’t in itself pose serious harms, making the “addiction” designation highly questionable.

What has been the outcome of this shifting target? Worldwide, the total number of people who smoke is essentially unchanged since the FCTC was first implemented in 2005.

Yes, population increases are at play here, and smoking rates have fallen. But if the WHO promoted use of commercially available tobacco harm reduction alternatives—instead of urging prescription-only access or supporting outright bans—we would be doing so much better.

Even with restrictions or bans across much of the world, at least 112 million people already use safer nicotine products. But thanks to messaging from the WHO and its many allies, most people who smoke still don’t know that these alternatives are safer.

The United States is among a minority of countries that aren’t parties to the FCTC. But the 2009 Tobacco Control Act contains many similar provisions, and some similar dynamics play out.

Despite various states’ restrictions, nicotine vapes are commercially available in the US. And since this has been the case, smoking among young adults has plummeted. Between 2012 and 2022, the rate for US adults aged 18-24 fell by a whopping 65.9 percent.

Yet it was in 2018 that the US surgeon general declared a youth vaping “epidemic,” a concept that has dominated media and political discourse ever since. As in much of the world, many Americans vape, but most nicotine users still smoke. And after scaremongering from US health authorities, most Americans believe vapes are as harmful as cigarettes.

The youth narrative that’s inexplicably erased is how youth smoking has all but vanished.

In 2023, 1.5 percent of US high school students reported current combustible cigarette use—a decline of 89.3 percent from 2012.

The pattern is the same in other countries that have both commercially available vapes and panics around youth vaping. In the United Kingdom, the smoking rate among 16- and 17-year-olds decreased by 66.5 percent from 2007-2019. Canada saw a 50 percent reduction in smoking among 7th-12th graders between 2012-2013 and 2021-2022.

Yet the WHO refuses to center the eradication of disease and early death in its messaging on youth. Objections from some national delegations at COP10 saw plans for further crackdowns on tobacco harm reduction pushed back to COP11 in 2025. But organizers’ goals couldn’t be clearer.

It was no surprise, but it still felt like she said the quiet part out loud.

In her closing address to COP10, Dr. Adriana Blanco Marquizo, head of the WHO’s FCTC Secretariat, praised how youth activists—they opposed tobacco harm reduction, of course, when pro-THR advocates were banned from the event—had joined the COP “for the very first time.” She called them “guardians of the future.”

Marquizo went on to endorse the words of these coveted youths in her speech: “The interests … of smokers, should never serve as justification for legitimizing products that could send even a single child down the path of addiction.”

It was no surprise, but it still felt like she said the quiet part out loud. Youth who are not smoking are the priority for the world’s foremost health agency. And accordingly, despite an annual toll of 8 million lives lost, 1.3 billion adults who smoke should be denied harm reduction, and left to quit or die.

Photograph (cropped) by Afshin Taylor Darian via Flickr/Creative Commons 2.0

The Taxpayers Protection Alliance, the author’s employer, provided a one-off donation to The Influence Foundation, which operates Filter, to support travel to a harm reduction event. Filter’s Editorial Independence Policy applies.

The post The WHO Prioritizes Youth Who Don’t Smoke Over Adults Who Do appeared first on Filter.

Originally planned for November, COP10 will now begin on February 5 in Panama City. All the evidence has pointed to the WHO using the event to advance draconian anti-harm reduction proposals, which would have global policy impacts.

In case we were unsure, the agency declares in a December 14 press release that nicotine vapes are “harmful to health,” although “long-term health effects are not fully understood.” It states that some substances found in e-liquids “are known to cause cancer and increase the risk of heart and lung disorders,” without adding that they are present in such low doses as to be inconsequential to human health.

The WHO approvingly notes that 34 countries already ban vaping products, encouraging them to “ensure strong enforcement.”

The release ignores the critical reality that vapes are exponentially less harmful than the cigarettes they replace, a fact established beyond doubt by years of evidence.

Instead, the WHO approvingly notes that 34 countries already ban vaping products, encouraging them to “strengthen implementation” and “ensure strong enforcement.”

“Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a [smoking] cessation objective,” the agency states, completely erasing the experiences of scores of millions of people worldwide who have quit deadly cigarettes through a consumer-driven revolution.

For those recalcitrant governments that do pursue smoking cessation through vapes, the WHO urges them to treat these products as medicinal devices only—a policy that has been tried, with disastrous outcomes, in Australia. And it wants authorities to restrict a myriad of features that help adults quit smoking, such as flavors and varied nicotine levels. It calls for vape taxes that would remove financial incentives for people to choose harm reduction options over cigarettes.

The agency talks about reducing the “appeal” of vapes to “the population”—which presumably means deterring the entire population, including the estimated 1.3 billion adults who smoke.

For governments (and consumers) across the world, the WHO’s advice should come with a flashing health warning. Its stance in this area is chock-full of cherry-picked alarmism and disregard for the lifesaving realities of tobacco harm reduction. Its position—a bitter disappointment when the WHO supports harm reduction for other drugs—comes right from the top.

Slim hopes of averting more crackdowns will rest with delegates from countries that have reaped rewards by rejecting the WHO’s anti-harm reduction message.

“Kids are being recruited and trapped at an early age to use e-cigarettes and may get hooked to nicotine,” said Dr Tedros Adhanom Ghebreyesus, WHO director-general, in the release. “I urge countries to implement strict measures to prevent uptake to protect their citizens, especially their children and young people.”

In inflating risks of youth vaping while ignoring the needs of populations that are actually dying of smoking, his words echo the talking points of Bloomberg-funded anti-vaping organizations, of which the WHO is one.

Groups representing consumers of safer nicotine products are entirely excluded from COP10. So their slim hopes of averting more crackdowns will rest with delegates from countries that have reaped public health rewards by rejecting the WHO’s anti-harm reduction message.

Delegates from the United Kingdom and New Zealand, for example—both of which embrace vapes as a harm reduction tool—will be able to inform signatories of the WHO’s tobacco control treaty of their successes in reducing smoking. Sweden, with snus, and Japan, with heated tobacco products, have also made dramatic progress by supporting safer alternatives.

UK public health groups acknowledge vapes as harm reduction and the government is embracing their use as a tool to help adults transition to safer products. In a recent UK Government consultation, the Royal College of Physicians (RCP) urged policymakers to refrain from “the wholesale limiting of [vape  flavors] accessible to adults.” The RCP in fact, “supports the use of a range of [flavors] including fruit [flavors],” and finds their use “an integral part of the effectiveness of vaping as a quit aid.”

In April 2023 the UK government vowed to give away vape starter kits to 1 million people who smoke, with local authorities now beginning to distribute them.

But even in the United States, where federal health agencies are themselves guilty of misinformation, there’s acknowledgement that vapes are safer alternatives.

The notoriously anti-vaping Centers for Disease Control and Prevention has finally admitted that vapes are “less harmful than regular cigarettes,” with “aerosol generally [containing] fewer toxic chemicals” than combustible cigarette smoke. The Food and Drug Administration has remarked that “transitioning completely from using cigarettes to an e-cigarette would reduce the risk of exposure to harmful chemicals.”

Smoking kills 8 million people per year. The WHO has betrayed its mission by recommending prohibition of products which can reduce that toll.

The FDA has even authorized the sale of a handful of vaping products, finding them to be “appropriate for the protection of public health.” The FDA notes the authorized products offer a “likely benefit” for adults who smoke.

The notion of the US delegation helping to curb the WHO’s excesses may seem outlandish to beleaguered American tobacco harm reduction advocates, but we can hope.

Governments should roundly reject the WHO’s advice. Although sensible regulation to reduce underage vaping is worthwhile, partial or total prohibition can only be detrimental to public health. Moreover, permitting commercial tobacco harm reduction products costs governments nothing—whereas the toll of death and disease from smoking strains health systems and budgets worldwide.

Smoking kills 8 million people per year. The WHO has taken leave of its senses and betrayed its mission by recommending prohibition of products which can reduce that toll. 

Photograph by Zach Peterson via Flickr/Creative Commons 2.0

The post WHO Renews Tobacco Harm Reduction Attacks in Runup to COP10 appeared first on Filter.

New data suggest it’s pretty clear which way they went. And it should make sobering reading for the Food and Drug Administration, which presses on with its plan for a national menthol cigarettes ban while refusing to authorize any menthol (or flavored) vaping products.

A recent study analyzed discarded cigarette packs and vape packaging collected from streets and public trash cans in 10 Californian cities. The research was conducted by the WSPM Group, an independent firm that was commissioned by tobacco giant Altria.

These thousands of products cannot legally be bought from retailers in the state, yet their presence demonstrates that the ban has done little to reduce demand.

Between May 1 and June 28 of this year, the researchers collected 15,000 cigarette packs and more than 4,500 vaping product packages. They found that 21.1 percent of the cigarette packs were for either menthol or menthol work-around products (marketed to menthol users, with similar packaging but non-menthol descriptors). Meanwhile nearly all (97.9 percent) of the vaping products were flavored.

These thousands of products cannot legally be bought from retailers in the state, yet their presence demonstrates that the ban has done little to reduce demand. Prior to the ban, menthol cigarettes made up 24.5 percent of the state’s total cigarette sales. The discarded packs study showed a reduction in menthol prevalence of just 13.9 percent.

One key objection to the FDA’s proposed national ban is the inevitability of the criminalization of local suppliers, likely to be concentrated in communities of color that disproportionately smoke menthols. California’s experience confirms that menthols won’t go away, and that the threat is real.

There are implications for public finances, too. When people can’t legally buy flavored nicotine products in California but are obtaining them anyway, that hits tax revenues and public services in a state facing soaring budget deficits. Annual revenues will fall by over $300 million, according to one estimate.

In the study, of more than 11,000 packs for which tax origin could be determined, less than half (45 percent) were from California. And in a clear indication of the outcome of a national menthols ban, more than one-quarter (27.6 percent) were of non-domestic cigarettes, intended for sale in markets outside the United States.

What’s more, cigarette packs without the cellophane covers were not included among the tax-determinable packs. Researchers noted that smugglers often remove the cellophane “to hide the origin of the pack and avoid paying taxes.”

Of course, some people will dismiss this study on the basis that it was commissioned by Altria. But its findings match everything we know about drug prohibition, and the existence of huge illicit markets for cigarettes and vapes in the US is not in doubt.

Estimates of the proportion of national cigarette sales represented by the illicit market range as high as 21 percent—billions of packs annually. But it’s a great deal higher in California. For 2021, the Mackinac Center for Public Policy estimates that 44 percent of cigarette packs in California were not legally purchased in the state—second only to New York. How much higher might it be now, in the wake of the ban?

Back in 2017, the US Government Accountability Office reported numerous schemes in which cigarettes are purchased at duty-free stores along the southwest border and brought into the US, either directly or via Mexico, without being declared to Customs and Border Protection. And in 2022, before California’s ban, organized groups in Mexico normally concerned with trafficking other drugs were reportedly muscling into the illicit cigarette trade, and committing human rights abuses to control the market.

What is all this for? Californians are still smoking menthols in large numbers, and the state’s overall situation has worsened.

Enforcement follows, as we have seen over and over and over again with unregulated cigarettes in California, long before Prop. 31 made many more of them illegal.

States far away have meanwhile reported record-breaking seizures of illicit cigarettes this year. In early October, Arkansas state police seized over 3,200 cartons of untaxed cigarettes; the majority were mentholated.

And what is all this for? Californians are still smoking menthols in large numbers, and the state’s overall situation has worsened.

As many past lessons have taught us, banning substances doesn’t end demand. It simply shifts them from a regulated marketplace with oversight to one that doesn’t pay taxes, doesn’t impose product standards and doesn’t check ID.

This is all the more exasperating when in the nicotine field, we have an obvious, positive alternative to prohibition, using the carrot and not the stick.

Instead of banning anything, we could support the availability of a wide range of non-combustible harm reduction options: vapes, snus and heated tobacco products. We could allow the full range of flavors that are important to adults switching from cigarettes. We could use taxation to incentivize harm reduction purchases over the cigarettes that kill. And health authorities could promote these options as the lifesaving alternatives that they are, as happens in other countries.

But this is the United States, and banning things seems to be what we do.

Photograph by Helen Redmond

The Influence Foundation, which operates Filter, has received grants from Altria. Filter’s Editorial Independence Policy applies.

The post Trashed Cigarette Packs Highlight Failure of California’s Flavor Ban appeared first on Filter.

In the United States, about 20 percent of all cancer cases, and around 30 percent of cancer deaths, are attributed to smoking. Nothing in the Moonshot plan meaningfully addresses this. At its core, it’s hampered by a willful refusal to embrace lifesaving technological advances in nicotine delivery.

The latest “Fact Sheet” from the administration includes $15 million in grants from the Centers for Disease Control and Prevention (CDC) to “help increase adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products.” 

The Biden administration is ostensibly seeking to reduce tobacco-related harms while refusing to acknowledge the role of tobacco harm reduction. 

The updated commitments also include a “new plan to decrease the impact of smoking on Americans’ health by expanding efforts to prevent smoking.” These smoking cessation efforts will have “a specific focus on communities disproportionately impacted by tobacco use,” including Indigenous and Black communities, and veterans.

The Biden administration is ostensibly seeking to reduce tobacco-related harms while refusing to acknowledge the role of tobacco harm reduction. 

Negative headlines continue to obscure the reality that a range of novel products—including vapes, “heat-not-burn” technologies and forms of smokeless tobacco, such as snus—are far less harmful substitutes for cigarettes. They provide the nicotine that people who smoke want or need, without the high risk of disease and death. 

In the case of vapes, years of research have produced no good evidence that they cause cancer in humans at all. On the other hand, there is compelling evidence that they increase people’s chances of quitting deadly cigarettes, compared with cold turkey or NRT. 

How can a credible plan to help communities with high smoking rates ignore such a remarkable tool?

Other countries actively encourage adults who smoke to switch to vapes.

Many Americans know better than their government. Though youth vaping continues to dominate headlines, millions of adults use harm reduction products to quit smoking. In 2021, according to the CDC, 4.5 percent of US adults were “current e-cigarette users.” 

Of these, 40.3 percent formerly smoked but had been able to quit. An additional 29.4 percent were currently smoking—likely to indicate that they were either smoking less thanks to vapes, and/or that they were taking a typical path toward quitting cigarettes entirely. 

The Consumer Advocates for Smoke-Free Alternatives Association (CASAA) has compiled tens of thousands of testimonials from adults who have quit smoking with the aid of tobacco harm reduction products. Many of these individuals had previously tried quitting with nicotine gums or patches, but found vaping was the only thing that worked for them.

Other countries actively encourage adults who smoke to switch to vapes.

In the United Kingdom, the National Health Service supplies guidance for people looking to switch, noting that “thousands of people in the UK have already stopped smoking with the help of an e-cigarette. There’s evidence they can be effective.” The government plans to hand out free vape kits to 1 million people who smoke. 

Meanwhile, the Canadian government clearly informs people that “switching completely to vaping nicotine is less harmful than continuing to smoke.” And the New Zealand Ministry of Health declares that vaping “is not harmless but … is much less harmful than smoking” and “can help some people quit smoking.”

Yet the millions who smoke in the US still routinely hear tobacco harm reduction products being demonized. And their access is consistently threatened as the US Food and Drug Administration (FDA) attempts to regulate an industry it has essentially pushed underground.

To date the FDA has only authorized 23 vaping products, all of which are only available in tobacco flavor. The FDA continues to use youth vaping as a reason to deny hundreds of millions of product applications, yet youth vaping has decreased, and the same survey data indicate flavors are not a top cited reason why youth use and continue to use vapes.

Biden’s Cancer Moonshot plan seeks to ban what’s shown to reduce use of menthol and other cigarettes. 

Flavors are, however, of key importance to many adults who switch from cigarettes. Even adults who had smoked for years rely on flavors to remain smoke-free, as evidenced in videos of older folks who have quit long-term smoking with the help of flavored vapes.

Biden’s Cancer Moonshot plan aims to prohibit sales of menthol cigarettes—itself a deeply controversial move given enforcement fears for communities that disproportionately smoke menthols. 

But it also—when “flavored tobacco products,” in federal nomenclature, includes vapes—seeks to ban what’s shown to reduce use of menthol and other cigarettes. 

Rather than imposing even more draconian prohibitions, the Biden administration should implore the FDA to authorize sales of a wide range of vaping and other harm reduction products, including many flavored ones.

Without such steps, the Cancer Moonshot will be at best futile, at worst counterproductive, in addressing hundreds of thousands of annual smoking-related cancer deaths.

The late, esteemed tobacco researcher Michael Russell famously said, “People smoke for the nicotine but they die from the tar.” He said that in 1976.  It is past time for the Biden administration to reconcile this truth with its policies.  

Photograph via the White House

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A series of videos published on Labor Day once again sound the alarm on youth vaping, urging educators—from coaches to principals to teachers—to talk to their students about it. The videos serve up a few morsels of truth with large helpings of fear-mongering and misinformation.

We should no longer be surprised by such fare from the nation’s leading health authorities. The United States Food and Drug Administration (FDA) recently admitted its failure—if not its culpability—in communicating relative risks of nicotine and tobacco products, with growing ignorance among health professionals and the public.

“Tell your students about how nicotine exposure can cause addiction and can harm learning, memory, and attention.”

In “Get the Facts on Youth Vaping,” the CDC’s video description urges educators, “Tell your students about how nicotine exposure can cause addiction and can harm learning, memory, and attention.” The video relays that nicotine can harm “the developing brain.” 

There is no valid evidence to support these claims. 

The video also states that nicotine vapes “can contain harmful and potentially harmful substances, such as heavy metals and cancer-causing chemicals.” 

While that’s technically true, the lack of context is dishonest. There is no mention of the low exposure involved in vaping, when numerous household items also expose people to traces of such chemicals. Nor of the absence of solid evidence to link vaping with cancer in humans. Nor, naturally, of the relative risks of vapes and cigarettes. 

In “What Are the Health Risks of Vaping for Youth?” the CDC states that youth are more susceptible than adults to nicotine addiction, which “may put youth at a risk for addiction to other substances in the future”—a version of the “gateway theory” that simply isn’t supported by meaningful evidence.  

The CDC darkly warns of students “not acting like themselves” as a sign of nicotine addiction.

The video also doubles down on the developing brain schtick—as does “Talk to Your Students About Vaping,” which darkly warns of students “not acting like themselves” as a sign of nicotine addiction.

The videos do acknowledge that some students “might vape when stressed, creating a cycle of nicotine addiction,” and urge educators to “empower your students with positive coping skills,” including physical activities and healthy diets.

A few realities are buried in the scientifically dubious drivel.

For example, in “How You Can Support Youth Who Are Quitting Vaping,” the CDC suggests that youth be informed that “vaping is less common than they might think.” 

That is quite the turnaround from the agency that declared a youth vaping “epidemic” in 2018. Just last year, the CDC’s chief epidemiologist told media that the “e-cigarette epidemic in our country is far from over.”

It is over, if it even existed in the first place. 

In 2018 when the CDC first announced the epidemic, 20.8 percent of high school students reported “current” use—meaning they’d vaped even once in the past 30 days. This grew to 27.5 percent in 2019. Some concern over the sharp increases was understandable, even if youth use of deadly cigarettes continued to decline as vaping rose.  

The FDA is no longer using the term “epidemic” to describe youth vaping. This hasn’t stopped certain public health groups continuing their well-worn battle cry.

By 2022, only 14.1 percent of US high schoolers reported currently vaping. While media hyped a 27.8 percent increase from 2021’s levels, the 2022 figure was still a 32.2 percent decrease since the epidemic declaration—and a whopping 48.7 percent decline from 2019’s peak.

Earlier this year, the head of the Center for Tobacco Products at the FDA declared that the agency in charge of regulating vapes is no longer using the term “epidemic” to describe youth vaping.

This hasn’t stopped certain eager public health groups continuing their well-worn battle cry. The American Cancer Society Cancer Action Network applauded the CDC’s new video series, remarking that there is a need for “continued awareness and action to address the epidemic of e-cigarette use by youth.”

And, just like many public health nonprofits that oppose access to vapes and tobacco harm reduction, the CDC Foundation also receives funding from billionaire Michael Bloomberg.

The Foundation is currently tracking vape unit sales on its webpage titled “Monitoring E-Cigarette Use Among Youth,” a project funded by $10.5 million from Bloomberg Philanthropies. According to the Foundation page “the availability of flavored e-cigarettes is one of the most commonly cited reasons for e-cigarette use among youth.”

By spreading misguided fears, the CDC helps ensure that people who smoke face obstacles to accessing far safer alternatives.

As the CDC video series actually notes, the “most common reason students give for continuing to vape is ‘I’m feeling anxious, stressed, or depressed.’” In 2021, nearly half (43.4 percent) of US middle and high school students who vape reported doing so to self-medicate those feelings. Only 13.2 percent cited flavors as a reason for continued use. Similarly, among students who had only tried vapes, 13.4 percent reported flavors as a reason for doing so. 

Vape flavors remain a key factor for adults who use them to quit the cigarettes that kill almost half a million people annually in the US.

Despite mixing some truths in with its alarmism, the CDC’s latest contribution to the discussion is another public health failure. By spreading misguided fears, it helps ensure that people who smoke face obstacles to accessing far safer alternatives.

Screenshot from CDC video “Understanding the Mental Health Effects of Youth Vaping“

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What he conspicuously failed to acknowledge was his own agency’s role in perpetuating misperceptions that cost lives.

Dr. King was commenting on a study published earlier this year by Dr. Olivia Wackowski et al., which found that just 18 percent of participating adults who smoked held the correct belief that “e-cigarettes contain fewer harmful chemicals than cigarettes”—a belief associated with higher chances of switching to vapes.

The research is valuable. Yet for years, a litany of other surveys and studies have found the US public to be disastrously misinformed on a comparison that is critical to public health. Only now does the head of the CTP pronounce that “opportunities exist to educate adult smokers about the relative risks of tobacco products, including e-cigarettes, using evidence-based approaches.”

Actions speak louder than words. The FDA is responsible for a mess of regulatory inaction and confusion.

Better late than never. But while King’s recommendation is encouraging—even if he immediately follows it with a warning on youth use, referencing the FDA’s notorious “Real Cost” campaign—actions speak louder than words.

So far, the FDA is responsible for a mess of regulatory inaction and confusion. Without drastic policy changes, mere lip service will do little for the millions of US adults who could benefit from safer alternatives to smoking.

The FDA has long acknowledged, if quietly, that “tobacco products” (as it terms all nicotine consumer products) exist on a “continuum of risk”—with combustible cigarettes being the most harmful and other alternatives presenting significantly fewer risks. Smoke, not nicotine, is the primary source of harm. Yet misconceptions about nicotine have become so entrenched that US doctors, never mind the general public, overwhelmingly believe that nicotine directly causes cancer.

In 2017, then-FDA Commissioner Scott Gottlieb unveiled an ambitious plan that aimed to strike “an appropriate balance between regulation and encouraging the development of innovative tobacco products that may be less dangerous than cigarettes.” In the accompanying statement, the FDA noted that a “key piece” of the agency’s “approach is demonstrating a greater awareness that nicotine—while highly addictive—is delivered through products that represent a continuum of risk and is most harmful when delivered through smoke particles in combustible cigarettes.”

In the years since, the agency has spectacularly failed to communicate this message.

It is the FDA’s own inaction that is causing the most damage, through a convoluted application process to bring new products to market.

Perhaps the misperception stems in part from the language in the Tobacco Control Act (TCA). Line 46 of the 2009 act prohibits the FDA from “approving” tobacco products. The TCA states that if a manufacturer is allowed to market their product as “approved or inspected by [the FDA] or complies with [FDA] standards,” then consumers—get this—“are likely to be confused and misled.”

As such, the FDA does not approve tobacco products, regardless of their relative safety, but authorizes them to be sold.

This allows certain public health groups—funded heavily by billionaire Michael Bloomberg—to imply that since the FDA has not approved any vaping products for smoking cessation, they are no safer than combustible cigarettes. These organizations are actively spreading misinformation, hampering the transformation of the US tobacco market into a sector with a wide variety of safer nicotine products.

But it is the FDA’s own inaction that is undoubtedly causing the most damage. This immobility is due to a convoluted application process to bring new products to market, regardless of the harm they may or may not pose.

Currently, there are two pathways to seek FDA authorization for tobacco products introduced after February 15, 2007 (the predicate date established in the TCA): substantial equivalence (SE) and premarket tobacco product applications (PMTAs).

The SE pathway demands that a product either has the same characteristics as a preexisting product, or raises no different public health questions from a preexisting product. In other words, it offers expedited authorization for products that maintain the marketplace status quo.

To date, FDA has issued hundreds of SE orders, including 421 marketing orders between 2019 and 2022. Of these, 127 were for combustible cigarettes; none of them were for safer alternatives to cigarettes.

Absurdly, this double standard makes it easier for new cigarettes to receive authorization than vapes.

The PMTA pathway, in contrast, demands that the FDA must determine a product to be “appropriate for the protection of public health” (APPH)—a far more onerous standard, requiring reams of scientific research that only the biggest companies can realistically generate.

Since 2015, the agency has rejected millions of PMTA applications. It has authorized just 45 different products under the PMTA pathway—of which only 23 were vaping products, made by only three different manufacturers.

Absurdly, this double standard makes it easier for new cigarettes to receive authorization than vapes.

It’s a curious reality for a federal agency with funding tied to combustible cigarette sales. The CTP is “solely funded by tobacco user fees,” which are applied to six different types of tobacco products including combustible cigarettes, cigars, chewing tobacco, pipe tobacco, roll-your-own, and snuff. The fee amount is determined by market share, with combustible cigarettes making up over 83 percent of tobacco user fees collected. Essentially, cigarettes (and the adults who smoke them) are funding CTP’s actions.

It’s fair to point out that the FDA remains mired in ambiguities and near-impossibilities spun by the underlying statute. The TCA states that APPH “shall be determined with respect to the risks and benefits to the population as a whole, including users and nonusers of the tobacco product,” and including the likelihood of either using the products. And while the TCA makes note of tobacco companies marketing to youth, it offers no concrete definition of what constitutes a youth-appealing product.

In this context, the FDA continues to use youth vaping as a pretext to deny marketing orders for all flavored tobacco harm reduction products—flavors with central importance to many adults who switch—using the APPH determination.

In 2021, in the first (of many) marketing denial orders for flavored e-liquid PMTAs, the FDA claimed that the “applicants lacked sufficient evidence that [the products] have a benefit to adult smokers sufficient to overcome the public health threat posed by the well-documented, alarming levels of youth use of such products.”

In May 2023, the FDA issued additional denial orders citing that the agency determines “whether the products in the applications showed an added benefit to adult smokers … that could outweigh the known and substantial risk of flavored e-liquid and e-cigarette products to youth.”

Youth and adults alike use flavored vaping products. Yet youth users are not widely citing flavors as a reason for vaping. In 2021 (the same year FDA issued massive denials for flavored products because of youth), nearly half (43.4 percent) of US middle and high school students currently vaping said they were self-medicating feelings of anxiety, depression and/or stress. Only 13.2 percent said they had used vapes because of flavors.

There is an obvious starting point for the FDA: acknowledging its own part in misleading the public and keeping people smoking.

If the FDA finally wishes to rectify public misunderstanding around tobacco harm reduction products, it faces an uphill battle.

The agency will need to overcome the challenges of language, definitions and determining exactly why youth use e-cigarettes—without inflating the harms. It will need to clarify and reform processes to relay accurate information to consumers. It will need to streamline its authorization pathway for a far wider range of products that are much safer than cigarettes.

We can hold out hope that the FDA will belatedly follow the science and the imperative to save lives. But if it wants to begin communicating clearly and honestly, there is an obvious starting point: acknowledging its own part in misleading the public and keeping people smoking.

Screenshot from the FDA’s “Real Cost” campaign via YouTube

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The good news—the news that should dominate headlines—is that increases in adult vaping correlate with significant decreases in smoking.

In 2021, according to data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) survey, 16.1 million adults, or 6.7 percent of US adults 18 years or older, were currently using vapor products (defined as having used in the past 30 days). This is a 32.6 percent increase from 2017, when 4.6 percent of US adults were current vapers. In terms of absolute numbers, approximately 4.6 million more adults were using vapes in 2021 than in 2017. 

These figures provide valuable insight into the harm reduction path taken by growing numbers of the forgotten adults who smoke.

Nearly half of the adults (46.4 percent) who were vaping in 2021 were between 25 and 44 years of age, the largest contingent. This proportion has increased by 6.8 percent since 2017, when 42.6 percent of adult vapers were in this age range.

These figures provide valuable insight into the harm reduction path taken by growing numbers of the forgotten adults who smoke. Public health agencies should be educating and encouraging adults to switch. Unfortunately, US public health does a poor job in conveying relative risks.

Although the CDC’s BRFSS does ask respondents whether they previously smoked, or currently do, the agency does not provide that critical information in a concise and accessible manner. But we know from research on other populations that a majority of vapers formerly smoked. In the United Kingdom, for example, an estimated 4.7 million adults vape; of these, 56 percent used to smoke and 37 percent currently smoke, indicating they may be on a journey to switching entirely or smoking less. Under 7 percent never smoked.

Despite the political, media and public health rhetoric, vapes, like other tobacco harm reduction products, are far less harmful than combustible cigarettes. They have also been shown to be effective for both smoking cessation and continued abstinence from cigarettes.

The UK Royal College of Physicians, for example, found that any harms from vapes are “unlikely to exceed 5 percent of the harms from smoking.” This is the same public health body that reported, in 1962, that combustible cigarettes cause cancer—two years before a US surgeon general’s report came to the same conclusions. Earlier this year, the UK government announced a national plan to help one million adults who smoke switch to vapes by giving out free vapor products.

Yet, in the US, access to vapes is increasingly threatened. Five states—California, Massachusetts, New Jersey, New York, and Rhode Island—have banned sales of the flavored vaping products that most adults who switch find helpful. 

These bans correlate with increases in young adult smoking rates. In fact, between 2020 and 2021, three out of the four states that then had active flavor bans saw increases in smoking rates among people aged 18-24. In the same period, smoking rates among young adults nationwide decreased, on average, by 19.7 percent.

Alarmingly, US public health agencies and anti-harm reduction nonprofits continue to spew misinformation and hamper progress.

Nicotine vapes are substitutes for combustible cigarettes. Their wider use could not only benefit the disadvantaged populations that disproportionately smoke, but help governments by reducing health care costs attributable to smoking.

According to the CDC, approximately 23.9 percent of Medicaid enrollees were currently smoking in 2021, compared to only 10.5 percent of insured adults. One study found that in 2012, Medicaid savings could have amounted to $48 billion if every Medicaid recipient who smoked combustible cigarettes had switched to vapes.

By failing to fully embrace vapes, governments are also missing out on substantial tax revenues. Even as things stand, vapes have been an economic boon to the US.

In 2021, retail vapor establishments (i.e., vape shops) contributed more than $8 billion in economic output and generated more than $4.7 billion in taxes. In 2021, according to the CDC’s National Youth Tobacco Survey, only 9 percent of US middle and high school students who were currently vaping reported using a tank/mod open vapor product system. These are the types of devices commonly found in vape shops.

Alarmingly, despite the many benefits of vape uptake, public health agencies and anti-harm reduction nonprofits continue to spew misinformation and hamper progress.

To date, the US Food and Drug Administration has authorized the sale of a mere handful of vaping products as “appropriate for the protection of public health.” All the authorized products are available only in tobacco flavors, in the face of reams of science showing that adults rely on flavors to quit combustible cigarettes and remain smoke-free.

Smoking-related harms to adults should massively outweigh the far more marginal and contested harms of youth vaping among our priorities.

A 2018 survey of nearly 70,000 adult vapers (95 percent of whom reported ever smoking) found that 83.2 percent and 72.3 percent reported vaping fruit and dessert flavors, respectively. A 2020 cohort study of nearly 18,000 adult vapers found a greater likelihood of quitting smoking among vapers who had used non-tobacco flavors compared to those who vaped tobacco flavors.

Unfortunately, the CDC’s BRFSS does not track the types of devices adults are using. Further, the CDC seems to be adding to alarmism on disposable vapes, with recent research claiming that these devices are “youth appealing.” This research only looks at data from retail scanner data. Yet, many (if not most) brick-and-mortar vape shops are not included in that data, and many adults report using disposables as a low-barrier option, particularly in the early stages of switching.

Vapes and other novel tobacco harm reduction products have revolutionized smoking cessation efforts among adults in the US. Smoking-related harms to adults—costing over 480,000 lives each year in the US—should massively outweigh the far more marginal and contested harms of youth vaping among our priorities. It is long overdue for US public health and policymakers to recognize these realities and embrace safer alternatives to cigarettes.

Photograph via Vaping360/Flickr/Creative Commons 2.0

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