Cliff Douglas

Former CEO GlobalActiontoEndSmoking, VP Tobacco Control, American Cancer Society, Advisor to US Asst. Sec. for Health & Surgeon General. Consultant on THR

[Cliff Douglas @cdoug]

Veteran investigative journalist @MarcGunther examines one of public health's most consequential controversies: why some leading tobacco control organizations continue to resist or fail to accurately communicate the evidence on tobacco harm reduction and the FDA's rigorous review of authorized smoke-free products.

Having worked closely with @LungAssociation over many years, I contributed to his investigation not as an adversary, but as someone who deeply respects ALA's mission to prevent lung disease. That's why I'm genuinely puzzled and disappointed by its position. Millions of lives depend on public health policies and communications reflecting the best available science.

[MarcGunther @MarcGunther]

Big Tobacco used to misinform and mislead. Now the tobacco-control groups do so. My new Substack takes on the American Lung Association.

#smoking #vaping

https://t.co/vTNQkmFiDH

[Cliff Douglas @cdoug]

@Bludn_Gore Agreed. Combine that with clear, accurate, digestible information and guidance, and you have a formula for success.

[Cliff Douglas @cdoug]

When I read this, it struck a chord, for reasons that many people here will understand:

“Malynnda Stewart, PhD, BCPA recently wrote in Health Management on the techniques that doctors can use to help their patients change. They don’t just change because someone tells them to, she writes; in fact, that often has the opposite effect.

What Stewart suggests instead is good advice not just for doctors, but for everyone.

‘Change rarely happens because we push harder. More often, it happens because we build a bridge strong enough for someone to cross, and then we get out of the way and let them walk.’”

From: How to deal with the (inevitable) jerks in your life, https://t.co/gs6T94P512

[Cliff Douglas @cdoug]

You're correct: Gross generalizations about targeting youth and the role of the so-called "tobacco industry" -- most of the vaping product market does not come from tobacco companies -- are unhelpful and promote rather than correct misunderstanding. This contributes to poor public health policy decisions, which in turn can result in greater, not less, harm.

[Cliff Douglas @cdoug]

Researchers at the Rutgers Center for Rapid Surveillance of Tobacco (@RutgersINTS) report their surveillance of marketing activities for Geek Bar, the highly popular #ecig that has not been authorized by @FDATobacco, “showed frequent product releases and marketing targeting young people." They also find that “About 25 % of 16–19 year olds who vaped in the past 30 days and reported having a usual brand, reported Geek Bar as their preferred brand, making it the number one brand reported.” https://t.co/FUw71hiqgY
This highlights again the urgent need to legitimize and strengthen the market for reduced-risk nicotine alternatives for adults who need and wish to use them. Effective regulation is essential. This means FDA accelerating its evidence-based review and authorization of products that are “appropriate for the protection of the public health.”
Cigarettes cannot continue to dominate the marketplace for nicotine delivery if we truly want to reduce preventable death and suffering.

[Cliff Douglas @cdoug]

@RepDebDingell Deepest condolences to your entire family. Wishing you peace in such difficult circumstamces.

[Joe Gitchell @jgitchell]

Please, please, #FixIt, @elonmusk @x @Support.

@Algore09algor has had his X account capriciously suspended for weeks. This denies this community the wisdom and heartfelt emotions of his writing.

See attached for a moving paean to his wife, @Bludn_Gore.

🙏 1/2

[Cliff Douglas @cdoug]

Regarding modern (versus your parents’ or grandparents’) marijuana use, this cautionary discussion with the well-informed physician @DrLizaMD is worth a listen.

And, of course, with any substance, it is better to use noncombustible forms if you have a choice.

[@camjenglish @camjenglish]

"We never used to see people in the ER for marijuana use, ever." — @DrLizaMD.

What changed? Today's cannabis is way more potent than the stuff your dad smoked at Woodstock.

The myth of harmless marijuana for @GeneticLiteracy's Facts & Fallacies podcast.

Full episode below.⬇️

[Cliff Douglas @cdoug]

@ChaunceyGardner I would add that, based on my query, this journal is often utilized by medical students, residents, and researchers looking for a legitimate, indexed platform for case reports and studies.

[Cliff Douglas @cdoug]

Pleased to share some important findings from a new analysis on the benefits to cardiovascular health of switching from combustible tobacco use (smoking) to alternative forms of nicotine delivery.

The authors conclude that:“Supporting the complete displacement of cigarettes with the use of NGPs (next‑generation tobacco and nicotine products) has the potential to reduce CVD (cardiovascular disease) risk and improve both individual and population health.”

Specifically, they report:
1) In vivo and in vitro modeling studies demonstrate the potential for NGPs to reduce CVD risk compared with cigarette smoking.
2) Switching to the exclusive use of these products leads to reductions in biomarkers of exposure to cardiovascular toxicants and favorable changes in CVD risk-related biomarkers of potential harm.
3) Population‑level data show that switching to the exclusive use of both electronic vaping products and heated tobacco products is associated with reduced risk of CVD and related comorbidities compared with continued smoking.
4) Regulators are increasingly using science‑based evidence when approving marketing authorizations and the use of consumer‑facing reduced exposure claims.

https://t.co/esEegvdsd0

[Cliff Douglas @cdoug]

@ChaunceyGardner Likely, yes. On the other hand, one *could* take the time to consider the research based on its objective merits, as was presumably done in the independent peer review process.

[Phillip Kirschberg @RushmoreExt23]

This is a well thought out response to the question of what are the main factors driving the public's broadly irrational & intolerant perceptions of nicotine vaping and tobacco harm reduction in general.

H/T @camjenglish

[Cliff Douglas @cdoug]

Cam, I think the double standard boils down to a few things:

* The unscientific demonization of nicotine
* Widespread misunderstanding of relative risk
* The conspiratorial portrayal of tobacco harm reduction as an industry plot
* The exaggerated prioritization of concerns about youth to the exclusion of all else
* Extraordinary global funding in support of the perpetuation of the above by an extremely wealthy, aggressive, and ideologically driven media magnate

[Cliff Douglas @cdoug]

Cam, I think the double standard boils down to a few things:

* The unscientific demonization of nicotine
* Widespread misunderstanding of relative risk
* The conspiratorial portrayal of tobacco harm reduction as an industry plot
* The exaggerated prioritization of concerns about youth to the exclusion of all else
* Extraordinary global funding in support of the perpetuation of the above by an extremely wealthy, aggressive, and ideologically driven media magnate

[Cliff Douglas @cdoug]

I’ve just enjoyed this popular mini-can of beer at a family restaurant by Lake Michigan. It naturally reminded me of the controversies related to the marketing of nicotine vaping products. The “Lil Buddy” can looks like it was decorated with crayons. But there is no controversy involved.

None of this is to suggest that there is not a serious problem involving illicit vaping products, some of which have appeal to young people. Nonetheless, there seems to be a disconnect in how some folks have singled out vaping as a unique risk for our youth, even as youth vaping continues to plummet.

[Cliff Douglas @cdoug]

All of those examples can be seen as versions of harm reduction. None of them eliminates risk or illness. Each of them reduces risk and provides evidence-based protection for consumers.

But acting with hubris and elitism —and without realistic regard for scientific and real-world evidence — too often results in increasing risk.

[Cliff Douglas @cdoug]

@JeromeAdamsMD Love this - and my shirt!

[Regulator Watch @RegWatchCanada]

76% of the global vape market is now illicit, and the U.S. is the largest player. This is not a black-market problem. It's policy failure. @DrMtyndall explains. @cdoug @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine @GrimmGreen @LegionVaping

https://t.co/1hOB9GPN2u

[Phillip Kirschberg @RushmoreExt23]

From @MarcGunther's outstanding new Substack piece:
https://t.co/YsCM5H6Bmn
By email, @cdoug, a lawyer and lifelong anti-smoking activist who now favors tobacco harm reduction, described the misinformation from health authorities as “a problem of epidemic proportions.” He said: