Cliff Douglas

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

[Regulator Watch @RegWatchCanada]

Eradicate nicotine? "Hell no" says tobacco control veteran Cliff Douglas, "why would one want to do that?" Nicotine should be front and center in the strategy to end smoking. @cdoug @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine @GrimmGreen @LegionVaping

https://t.co/E3c9XhVsPR

[Arielle Selya @ArielleSelya]

Another retraction❌of a paper analyzing NHANES and claiming a link between e-cig/dual use and COPD:

https://t.co/NzQvsxXHkx

[Cliff Douglas @cdoug]

@ArielleSelya The methodology used is analogous to giving a biased faith-based analysis to explain dark matter in the universe. Or something like that. Good riddance of another example of ideological, pseudoscientific “research.”

[Cliff Douglas @cdoug]

@X @Support I agree. Freedom of (courteous, honest, and informative) speech is being infringed. Please correct this error promptly.

[Skip Murray, DSP, TTS 🌻 @imaracingmom]

Dear @X @Support
A terrible mistake has happened, and the account of @Algore09algor has been suspended. He is a real person who follows the rules and enhances our experience here on this site. Please restore his account.
Thank-you!

Friends: Sharing is Caring!

[Cliff Douglas @cdoug]

Thanks, Jim, and that's a great look back from you as well -- 16-years-old and running the elevator for members of Congress! Mike Synar was a giant -- principled, honest, public spirited, and as you said, just a real good guy. He sadly left us far too soon. I'm confident he would have had the wisdom and insight to come out on the right side of this debate, and I would have loved to stand shoulder to shoulder with him now.

[Cliff Douglas @cdoug]

I appreciated the opportunity to sit for this @RegWatchCanada interview reflecting on the evolution of tobacco and nicotine policy from the beginning of my career — around the time I helped end smoking on airplanes — to today.

One thing that has changed significantly over the years is my own understanding of nicotine and risk. Like many in public health, I once viewed nicotine itself more simplistically than I do now.

A central lesson: it is the smoke produced by burning cigarettes that makes them uniquely lethal — not nicotine.

That distinction has major implications for public health and tobacco harm reduction.

I hope this conversation is useful for anyone interested in the science, history, and policy debates surrounding tobacco and nicotine.

https://t.co/PIKtpPSzb7

[Regulator Watch @RegWatchCanada]

Eradicate nicotine? "Hell no" says tobacco control veteran Cliff Douglas, "why would one want to do that?" Nicotine should be front and center in the strategy to end smoking. @cdoug @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine @GrimmGreen @LegionVaping

[Cliff Douglas @cdoug]

@ChaunceyGardner Sincere condolences to you and your family, Charles.

[Health Affairs @Health_Affairs]

By adopting a more pragmatic understanding of youth tobacco use and adult consumer demand, the FDA can better support public health and more effectively address the illicit market. | Forefront

@JeffreyGWillett, et al. | @ppi

https://t.co/9DZ7vLs6mb

[Cliff Douglas @cdoug]

I have added a clarification to my new Substack article regarding the action taken by @FDATobacco today.

The agency announced that it sent warning letters to eight retailers selling illicit nicotine pouches and dissolvable tobacco products designed to resemble everyday items such as candy, breath strips, and cough drops.

While the targeted products in this instance are oral products, the action is the kind taken previously against some illicit vaping products for similar reasons.

In any case, the debate is the same, and is one that too often is framed as a false choice: either protect youth or support tobacco harm reduction for adults who smoke.

[Cliff Douglas @cdoug]

The FDA today announced enforcement actions against retailers selling illegal nicotine vaping products designed to resemble everyday items such as phones, gaming devices, smartwatches, highlighters, and even children’s toys.

The debate over nicotine and vaping policy is often framed as a false choice: either protect youth or support tobacco harm reduction for adults who smoke.

That is the wrong framework.

In this short new piece, I argue that we should support strong enforcement against illicit, irresponsibly marketed products that appear designed to appeal to kids — while also supporting development of a truly robust, science-based, well-regulated marketplace for substantially lower-risk alternatives to cigarettes for adults who smoke.

Public health policy should be capable of doing both.

My Substack here: https://t.co/9IcC6bwmBG

FDA announcement here: https://t.co/gWhg0zbePn

[Cliff Douglas @cdoug]

The FDA today announced enforcement actions against retailers selling illegal nicotine vaping products designed to resemble everyday items such as phones, gaming devices, smartwatches, highlighters, and even children’s toys.

The debate over nicotine and vaping policy is often framed as a false choice: either protect youth or support tobacco harm reduction for adults who smoke.

That is the wrong framework.

In this short new piece, I argue that we should support strong enforcement against illicit, irresponsibly marketed products that appear designed to appeal to kids — while also supporting development of a truly robust, science-based, well-regulated marketplace for substantially lower-risk alternatives to cigarettes for adults who smoke.

Public health policy should be capable of doing both.

My Substack here: https://t.co/9IcC6bwmBG

FDA announcement here: https://t.co/gWhg0zbePn

[Cliff Douglas @cdoug]

Preach.

[Lisa Ciarlone @LisaCiarlone]

@SenBlumenthal @SenJeffMerkley
Why are you fighting harder against smoke-free nicotine products than against combustible cigarettes, the product that actually kills more than 8 million people globally every single year and over 480,000 Americans annually? 🚬💀🪦

Cigarettes are the deadliest legal consumer product ever sold. Smoking has caused more preventable death than wars, plane crashes, natural disasters, HIV/AIDS, alcohol, illegal drugs, car accidents, and many infectious diseases combined over the past century.

Combustible cigarettes cause cancer, heart disease, COPD, stroke, vascular disease, and countless other smoking-related illnesses that destroy families and cut lives short every single day.

Yet instead of focusing their energy on eliminating combustible smoking, some lawmakers are demanding the FDA remove smoke-free alternatives that millions of adults use to move away from cigarettes.

I guess 480,000 American deaths every year means nothing to them.

The product that burns tobacco and creates toxic smoke remains fully available everywhere, while alternatives that do not involve combustion are treated like the greater threat.

No responsible person wants youth using nicotine products. But adults who smoke matter too. Their lives matter. Their health matters. Their families matter.

When you remove alternatives from the market, many people go back to smoking. That is the reality.

Public health policy should focus on reducing death and disease caused by combustible cigarettes, not eliminating lower-risk alternatives that many adults rely on to stay away from smoking.

[Cliff Douglas @cdoug]

Thank you, Dr. Moghanaki. I have very positive memories of our meetings during your service at the VA while I was serving as tobacco policy advisor to Assistant Secretary for Health Howard Koh. Your voice as a medical expert and leader in the field of oncology means a great deal in this dialogue regarding how we can tackle this persistent epidemic in the most evidence-based ways.

[Cliff Douglas @cdoug]

And now, confirmation from inside the @WhiteHouse:

https://t.co/NS0lhIG0EF

[Cliff Douglas @cdoug]

The @FDA's Commissioner, Marty Makary, reportedly may soon lose his job, according to @l_e_whyte at @WSJ. It is profoundly important that a highly qualified, evidence-driven -- and less politicized -- leader be appointed to succeed him.

The FDA Commissioner holds one of the most influential public health positions in the world. FDA regulates products that affect nearly every American, every day — food, tobacco, medicines, medical devices, and many consumer products. The commissioner’s decisions shape not only the speed and rigor of scientific review and public health protections, but also broader national policy, industry behavior, innovation, and public trust in science and medicine.
https://t.co/3mL8yuT26x

[Cliff Douglas @cdoug]

@Clive_Bates @plopnl @FDA @l_e_whyte @WSJ 😉

[Cliff Douglas @cdoug]

The @FDA's Commissioner, Marty Makary, reportedly may soon lose his job, according to @l_e_whyte at @WSJ. It is profoundly important that a highly qualified, evidence-driven -- and less politicized -- leader be appointed to succeed him.

The FDA Commissioner holds one of the most influential public health positions in the world. FDA regulates products that affect nearly every American, every day — food, tobacco, medicines, medical devices, and many consumer products. The commissioner’s decisions shape not only the speed and rigor of scientific review and public health protections, but also broader national policy, industry behavior, innovation, and public trust in science and medicine.
https://t.co/3mL8yuT26x

[Cliff Douglas @cdoug]

At the #NicotineSummit 2026, Dr. Jacqueline Avila, a gerontology expert at the University of Massachusetts-Boston, highlighted THE NEED TO SUPPORT OLDER ADULTS WHO SMOKE. Smoking rates are not falling among older people, while every other age group's prevalence continues to drop. Key takeaways:

- Older adults aren't quitting smoking and they aren't switching to less harmful nicotine products.
- Older smokers have been largely ignored by targeted cessation campaigns.
- Most attention is on protecting youth initiation, but we should not overlook the potential benefits of alternative, reduced-risk nicotine products as a harm reduction tool for older adults who have not successfully quit smoking through traditional methods.

[Cliff Douglas @cdoug]

@WHAorg @SenBlumenthal @FDA That is excellent, thoughtful guidance, thank you. It really speaks to the importance of meeting people where they are, literally and figuratively. And it gives respect to the real-life challenges and needs of people with SUDs/mental health conditions.

[Cliff Douglas @cdoug]

Agreed, the system, as devised, has built-in weaknesses - including, many believe, the extraordinarily laborious and time-consuming case-by-case approach. As FDA CTP's director of the Office on Science, Matthew Farrelly, said in recent days, the agency is stuck with the statute that guides them. That said, some important proposals have been made for streamlining the process and building into it a more holistic approach that takes into account the larger context. Fingers crossed.

[Cliff Douglas @cdoug]

The Director of @FDATobacco, Bret Koplow, spoke again today at the annual #NicotineSummit 2026. Kudos to him and his team for really getting out there to engage with the field. Let me say this: Dr. Koplow's views, thoughtful, and approach to moving things forward is a refreshing change from the past few years of leadership at the tobacco center. A few key thoughts: