Say Goodbye to the American Lung Association

 

While the American Lung Association bills itself as “the leading organization working to save lives by improving lung health and preventing lung disease,” the group’s recent formal comment on the FDA Center for Tobacco Products’ Strategic Plan essentially endorses the greatest threat to lung health: cigarette manufacturers. Here is an excerpt from the group’s filing:

“Strategic Goal #4 - Improve Public Health by Enhancing Knowledge and Understanding of CTP Tobacco Product Regulation and the Risks Associated with Tobacco Product Use 

“Remove language from the description for this goal that references informing adults about the relative risk of tobacco products” (emphasis in original)

“As mentioned in our comments above, the description for this goal included language ‘and to inform adults who smoke about the relative risks of tobacco products.’ The Lung Association strongly recommends this language be removed from the description.”

The ALA asks the FDA to remove any reference to the scientific fact that smoke-free tobacco products are vastly safer than cigarettes.  They are effectively urging the agency to withhold lifesaving information about safer products from smokers and their loved ones.

The nonprofit world’s poor record on cigarettes led me eight years ago to advise the public to say goodbye to the American Cancer Society.  Still, the American Lung Association in 2020 reported revenue of $106 million, with some 60% attributable to fundraising events, gifts and other contributions. 

It’s time for tobacco users and their families and friends to defund the cigarette-manufacturer-supporting American Lung Association.  Send your charitable contributions elsewhere. 

 

 

  

 

Nature Nurtures Nicotine Nonsense

 

The prestigious scientific journal Nature draws considerable attention to its articles from scientists and others worldwide.  That makes it imperative that we point out the many serious flaws in a recent article, misleadingly titled, “Is nicotine bad for long-term health? Scientists aren’t sure yet.”

At this writing, MEDLINE, “the world's leading bibliographic source for biomedical scholarly literature and research,” offers citations to 28,241 articles with the keyword “nicotine”.  While it is true that science always demands additional research, one can reasonably assume that there is sufficient data on nicotine effects to draw meaningful conclusions about its safety.

Apparently, the authors of the Nature article went to great lengths to secure comments from what is surely a minuscule community of “unsure” scientists and from entrenched opponents of recreational nicotine consumption and tobacco harm reduction. 

Aruni Bhatnagar, who runs a tobacco regulation and addiction center sponsored by the American Heart Association, is quoted saying, “We believe that much of the cardiovascular effects of smoking are because of nicotine,” and he postulates that the drug can change the timing of electrical signals in the heart.  This sounds ominous, but the article includes a refutation of these comments by Neal Benowitz, a recognized nicotine authority: “Nicotine is a minor player with respect to smoking-induced cardiovascular disease.”  Benowitz points to “studies of snus – a chewable tobacco product that is popular mainly among men in Sweden and is gaining traction elsewhere – which do not generally show a detectable rise in heart problems among people who use it.”

Maciej Goniewicz of the Roswell Park Cancer Center in Buffalo offers insignificant insights, such as, “[Nicotine] changes lots of functions in our bodies, it’s not a harmless compound.”  That can be said of everything humans consume.  Goniewicz also muses, “Someone chronically exposed to nicotine might have chronic inflammation. There is speculation that it might contribute to increased risk of cancer. [Emphasis added] From animal and cell studies, yes, nicotine is doing something. How this translates into a risk for the [human] user, we don’t know.”  Benowitz counters: “the evidence, for me, is not convincing in tying [nicotine] to cancer in humans.”  The evidence for a nicotine-cancer link is next to nil.

Frequent nicotine critic Laura Crotty-Alexander of the University of California San Diego notes, “We’ve underplayed the role that nicotine has in the health effects of tobacco products.”  Basing her opinion on her own research, in which cells and animals are tortured with nicotine (more info here and here), she offers a weak indictment of the drug, saying, “I’ve been more and more surprised at the changes I’m seeing when I expose cells to nicotine.”

One of the most extreme views in the Nature article comes from Kjersti Aagaard, a maternal-fetal doctor at Houston’s Baylor College of Medicine: “No amount of nicotine is known to be safe in pregnancy. None. If you are exposed to nicotine in the womb, there could be lifelong consequences.”  Aargaard implies that failure to meet that standard could have criminal consequences for the pregnant woman, but the journal contrasts those remarks with the position of the UK National Health Service, which “describes e-cigarettes as safer than smoking for pregnant women, but it notes that there is little research to support the safety of e-cigarettes beyond that. It recommends pregnant women use nicotine patches and gums to stop smoking.”  This is but one example of the startling differences between prohibitionist American and science-based British positions on vaping.

Despite the Nature article’s complaint that “the lack of knowledge about whether nicotine contributes to the damaging health effects of smoking is becoming more worrying,” there is a wealth of knowledge supporting the finding that the effects of nicotine on health are minimal to nonexistent. 

 

   

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.