Tobacco Prohibitionists Kill Safer Cigarette Substitutes… and Smokers

 

Dr. Michael Siegel has published a blog entry criticizing a “new article in American Journal of Medicine claim[ing] that youths who use e-cigarettes are 5 times more likely to become cigarette smokers.”  The commentary was authored by tobacco and nicotine opponents Pamela Ling and Edward Goetzl.

Dr. Siegel correctly notes, “the article in question fails to provide any citation or source for its preposterous claim… Apparently, we are supposed to just take it on faith that this is true.”

Reviewing the Ling-Goetzl screed, I found that the authors specified that the five-fold claim was for “tobacco-naive adolescents.”  While that claim was not attributed, the commentary’s authors did include in their reference list one possible source: another commentary, authored by fellow prohibitionist Jonathan Winickoff and coworkers in September’s JAMA. 

Winikoff did not provide a source for his claim either, but he hinted at it with a reference to a 2019 article by Kaitlyn Berry, et al., in JAMA Network Open.

Further complicating the matter, I, along with David Abrams and Ray Niaura, had published a critical comment in that journal, documenting how Berry, et al., engineered their study to make e-cigarettes seem to increase smoking rates by 4 times (in their abstract), not 5.  I also wrote a blog entry on the subject in February 2019 that contained this highlight:

“While Berry, et al., and [then FDA] Commissioner Gottlieb, emphasized the 4.0% probability of current smoking among e-cigarette first users, we found a reverse result buried in a supplemental table: The probability of current e-cigarette use at follow up among cigarette first users was 8.3%.  This means that twice as many first-smoking teens currently used e-cigarettes at follow-up than first-vaping teens who currently used cigarettes.”

The critical lesson here is not about the transgressions of Ling-Goetzl, or Winikoff, or Berry.  It is how the incessant repetition of exaggerated, distorted and sometimes falsified research dangerously distorts public perceptions about vastly safer cigarette substitutes.  It happened with smokeless tobacco; it is happening today with vapor and nicotine pouches.  Millions of smokers will die, and prohibitionists will never be held accountable.

 

FDA Briefs U.S. Supreme Court on the Nicotine Brain Fallacy

Responding to a petition from the FDA, the Supreme Court agreed to review the Fifth Circuit Court of Appeals decision in the Triton case (formally known as Wages & White Lion Investments, LLC).  The Circuit Court, sitting en banc, had found that the FDA failed to follow proper administrative procedures in considering Triton’s vaping pre-market tobacco application (PMTA), and the agency’s denial order was vacated.

Appealing that decision, the FDA filed a brief to the Supreme Court, available here.  I will not comment on the myriad legal and regulatory implications of the case, but in their “scientific” discussion, lawyers for the FDA made numerous false statements about nicotine and e-cigarettes, such as:

“Nicotine is a highly addictive drug that can harm the developing adolescent brain.  Studies have found that e-cigarette use may be associated with diseases such as asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease.  And e-cigarette users may progress to conventional tobacco products, which can endanger human health even more.” (emphasis added, legal references removed)

I have repeatedly warned the tobacco harm reduction (THR) community that the NIH-funded bad-science tsunami would result in federal and state regulations aimed at stifling safer cigarette substitutes (here, here and here).  Now we have a concrete example.

Over the years, I have exposed distorted and false research findings concerning e-cigarette use and respiratory conditions (here, here and here), so today I will focus on the nicotine brain fallacy, which I first discussed four years ago (here):

“Let me be crystal clear.  The harm in brain development federal officials talk non-stop about only happens in laboratory torture of mice.  Mouse studies are well known to be of questionable value in predicting human effects.  There is absolutely no scientific evidence to support the claim that nicotine causes harm to human brain development, so it is astounding that federal officials traffic in this false narrative.  This nonsense is an affront to 34 million adult current smokers and 55 million former smokers in the U.S., virtually all of whom started when they were teenagers.  There is no evidence that their brain development was harmed.”

The facts remain the same today, and still the unfounded attacks on THR continue. For example, the Journal of the American Medical Association (JAMA) recently published a viewpoint authored by tobacco prohibitionists Robert Jackler and Pamela Ling (here).  Criticizing Medscape for creating continuing medical education courses on THR, they also attacked my design of the course content, complaining that my “expert opinion” conflicts with the CDC’s claim that “nicotine can harm brain development…until about age 25.”  They cited a review that purportedly contains “a sizable body of human data,” but that treatise actually offers no evidence of harm to brain development in human smokers.  The fact is that no study has ever demonstrated that human brain development is harmed by nicotine. 

It is a travesty that bad science and fraudulent claims against THR have persisted for so long. No court, including the Supreme Court, is likely to end the onslaught of misinformation that remains the hallmark of the powerful, government-funded tobacco prohibition movement.