Monday, April 24, 2023

FDA Commissioner Califf’s Anti-Misinformation Campaign Must Start at Home


In a recent interview with CNBC, FDA Commissioner Dr. Robert Califf said that “misinformation” is driving down U.S. life expectancy, which is now three to five years lower than in other developed countries.  Dr. Califf said that combating misinformation is one of his top priorities, and he called for more regulation by “specific authorities at FDA, FTC and other areas to root out misinformation.”

The Commissioner should put his own agency in order first.  U.S. life expectancy has declined for decades largely because some half-million Americans per year have died from burning tobacco and inhaling smoke.  This tragedy has been going on so long that today few see it as a crisis.  For proof, do a Google News search for “crisis” and here’s what you get: banking crisis, housing crisis, plastics pollution crisis, mental health crisis and opiate overdose crisis.  All of these are serious problems, but their severity pales in comparison with smoking-related deaths.

Today, smokers can avoid premature death by switching to e-cigarettes and vaping products.  The British government has seized on this fact, announcing, “One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new ‘swap to stop’ scheme designed to improve the health of the nation and cut smoking rates.  As part of the world-first national scheme, almost 1 in 5 of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 - reducing smoking rates to 5% or less.”

Yet here in the U.S., rather than encouraging smokers to switch, the FDA has taken millions of vape products off the market; the only products the agency has approved for sale have been tobacco-flavored.  Imagine if the FDA approved a drug to help people suffering from alcoholism, but only if the product is bourbon-flavored!

The chart, showing data from the National Cancer Institute’s Health Information National Trends Survey (HINTS), reveals the extensive damage caused by the federal government’s campaign against e-cigarettes.  In 2020, only 10% of American adult smokers believed correctly that vaping was less harmful than smoking; two-thirds believed vapes were the same or more dangerous, and a quarter didn’t know. 

Who can blame smokers for not switching from cigarettes to products that most believe are as bad or worse for their health?   

A lot has been written about the 2022 Reagan-Udall Foundation report that criticized FDA tobacco regulations, but for me, the most egregious and deadliest regulatory misstep has been the government’s successful misinformation campaign against safer and satisfying smoke-free alternatives, and against nicotine itself.  Dr. Califf is correct in saying that “misinformation is driving life expectancy in the U.S. down,” but it is his own agency that is spewing the misinformation that dissuades smokers from stepping away from the fire.  It is long past time for the FDA and other public health agencies to reverse course and give smokers the tobacco truth.


Tuesday, April 18, 2023

CBS Mornings’ Tony Dokoupil Highlights UK’s Support for Vaping as a Quit-Smoking Tool vs. U.S. Head-in-the-Sand Denial


Broadcast journalist Tony Dokoupil co-anchors “CBS Mornings”.  Last year, Variety magazine reported, “He’s also developing a reputation for explaining abstract concepts to viewers in ways that make the subjects stick.”  Dokoupil says he emphasizes “talking to regular people where the story is happening and happening to them.”

What’s happening is that 480,000 Americans per year die due to their smoking habit.  On “CBS Mornings” April 14, Dokoupil used this number to contrast the stark differences between American and British e-cigarette policies.  He focused on the British government’s new “Swap to Stop”* program that will provide one-million smokers with free vaping products, versus the U.S. government’s refusal to acknowledge the truth about vastly safer smoke-free cigarette substitutes. 

This video should be seen by every American smoker and vaper, and, more importantly, by every U.S. health policymaker and journalist.  The UK has figured out how to save hundreds of thousands of lives yearly.


*Title reminiscent of my 2011 Switch and Quit Owensboro program (here and here). 



Tuesday, April 11, 2023

Campaign For Tobacco-Free Kids Amplifies False Claim from the Council on Foreign Relations


A recent Campaign For Tobacco-Free Kids newsletter touting its crusade to rid the world of tobacco products put the spotlight on menthol cigarettes:

“Due in large part to the tobacco industry’s targeted marketing of menthol cigarettes, Black Americans die at higher rates from cancer and other tobacco-related diseases. A new analysis from the Council on Foreign Relations [CFR] finds a U.S. ban on menthol cigarettes would quickly close disparities in lung cancer death rates among Black Americans.”

As that statement didn’t ring true, I fact-checked the CFR report and confirmed that it stated, “Both incidence and mortality from lung cancer is higher among Black Americans than their white counterparts,” citing CDC data. 

The CDC Wonder Website is the premier authority for U.S. mortality statistics.  Using their numbers, I analyzed deaths from cancers of the larynx, trachea, bronchus and lung (hereafter lung cancer mortality rate, or LCMR) among persons age 35+ years from 2012 to 2016, the latest years in the dataset.  Results are age-adjusted, comparable and expressed as deaths per 100,000 persons per year (or 100,000 person-years, p-y).

It is true that Black men have the highest LCMR, at 126 deaths per 100,000 p-y; white men are next, at 104.  Women have lower LCMRs in general because they smoke at lower rates.  The LCMR among white women is 70, but the rate among Black women is even lower, at 64.  

CFR’s causal statement is wrong anyway, as these facts remain: 1) Burning tobacco and inhaling the smoke for decades produces lung cancer and other smoking-related fatal illnesses; 2) the same cannot be said of either nicotine or menthol.