The level of misunderstanding among American doctors about vastly safer cigarette substitutes is stunning. Last week I critiqued the president of the American Medical Association (here), and this week it’s Dr. Nicole Saphier, a breast cancer imaging specialist at the Memorial Sloan Kettering Cancer Center. In her January 30 New York Post column she called Robert Kennedy a “hypocrite” because he appeared to use a nicotine pouch during his Senate confirmation hearing.
Here are excerpts from Dr. Saphier’s screed, followed by my comments.
“After decades of relentless public health campaigns and advocacy against cigarette smoking, we are witnessing the tangible benefits, with declining smoking rates and the illnesses associated with it.”
She is only half correct, as smoking rates have declined, but mainly among children and young adults (here). Too few older smokers at highest risk have quit, which is why nearly a half-million of them die prematurely every year.
“These small, flavored packets — filled with nicotine and other additives and tucked between the user’s gum and lip — are surging in popularity, mainly under the pretext that they are a safer alternative to traditional cigarettes.”
“The FDA has authorized Zyn and other pouches as a smoking reduction aid, giving them a reputation as a less harmful alternative.”
Nicotine pouches – in fact, any products delivering smoke-free nicotine – are vastly safer than smoking. That is why the FDA authorized Zyn sales. Also, the agency did not designate Zyn as a “smoking reduction aid.”
“Yet this authorization does not equate to a declaration of safety.”
The FDA authorized Zyn as “appropriate for protection of public health.”
“And these pouches come in varying strengths — with some providing far more nicotine than cigarettes or vapes.”
Saphier repeats a common, inaccurate claim comparing cigarettes, that deliver about 1 mg. of nicotine deep into the lungs, with a wide range of smoke-free products that deliver vastly different amounts of nicotine to the mouth and upper airway.
“This is particularly dangerous to adolescents and young adults. Given their still-developing brains, nicotine can impair cognitive function, alter brain development…”
The “brain development” claim has been fully debunked here.
“It’s alarming to see a new generation hooked on nicotine, reversing years of progress made in reducing smoking rates among young people.”
This is 180 degrees wrong, as the decline in smoking among young people has accelerated during the rise in use of alternative nicotine products (here).
“As he championed the Make America Healthy Again movement before the Senate committee, he was positioning himself as a warrior against chronic illness and discussing how he plans to combat diseases including food and drug addiction. Here is a figure publicly advocating for health, yet engaging in the use of a highly addictive product while doing so. In its most charitable interpretation, the incident shows how even those championing health can be ensnared by the allure of nicotine’s addictive nature.”
If Kennedy used a nicotine pouch during the hearing, it was entirely consistent with making America healthy again, and combatting the diseases and the consequences of smoking, America’s most dangerous drug addiction.
