Cliff Douglas
@cdoug-bsky.bsky.social
Former CEO GlobalActiontoEndSmoking, VP Tobacco Control, American Cancer Society, Advisor to US Asst. Sec. for Health & Surgeon General. Adjunct Prof @umichsph
Behold! The US teen nicotine vaping "epidemic" SPOILER: You need a magnifying glass to see it NOTE: This is "at least one time in the past 30 days" To see daily use, you would need a microscope... fda.gov/media/191376... tobaccocrst.org/data-briefs academic.oup.com/ntr/advance-...
Tobacco harm reduction is harm reduction. The principle is the same: reduce risk, respect autonomy and meet people where they are, rather than demanding abstinence as the only acceptable outcome. open.substack.com/pub/skipscor...
Tobacco Harm Reduction IS Harm Reduction-Part 4
A Look at NHS England
open.substack.com
“They have not considered the unintended consequences," says one expert, including "increased smoking rates across the age spectrum." Ireland's government appears more determined than ever to make tobacco harm reduction harder, reports @kiransidhu41.bsky.social:
Disposables Banned, Flavors Next: Irish Vape Crackdown Gathers Pace
With one ban just confirmed and more restrictions imminent, the government continues to make tobacco harm reduction harder.
filtermag.org
The recent surge is expected to continue. It's unsurprising that more people—especially women—are using pouches to quit smoking, reports @kiransidhu41.bsky.social. But some are switching to pouches from vapes, and the reasons for this are more complex:
What’s Behind the UK’s Migration to Nicotine Pouches?
It's unsurprising that many people are using them to quit smoking. But some are switching from vapes, and the reasons for this are complex.
filtermag.org
I was pleased to contribute to @marcgunther.bsky.social's thoughtful look into one of public health's most consequential controversies. My hope is not to win an argument, but to advance a conversation grounded in the best available science. marcgunther.substack.com/p/the-new-me... @lung.org @fda.gov
The new merchants of doubt
The American Lung Association and its tobacco-control allies confuse and mislead
marcgunther.substack.com
New study: Illicit Geek Bar marketing targets youth. “About 25% of 16–19-year-olds who vaped in the past 30 days and had a usual brand reported Geek Bar as their preferred brand.” FDA should expand legal, regulated nicotine options for adults—or lethal cigarettes will continue to dominate.
Monitoring of tobacco product marketing for rapid public health surveillance in the United States
The US tobacco landscape is constantly changing, with the commercial tobacco industry regularly flooding the market with new brands, flavors, and styl…
sciencedirect.com
Dr. Timothy Vermillion—social worker and Iraq War veteran—offers a thoughtful perspective on nicotine policy, military readiness, and supporting service members who smoke with accurate information. "The Pentagon Can't Have It Both Ways on Nicotine" stripes.com/opinion/2026... #MilitaryHealth
The Pentagon can’t have it both ways on nicotine
If the guidance on this issue is visibly disconnected from reality, why would a service member trust guidance on other critical issues?
stripes.com
Dr. Timothy Vermillion—social worker and Iraq War veteran—offers a thoughtful perspective on nicotine policy, military readiness, and supporting service members who smoke with accurate information. "The Pentagon Can't Have It Both Ways on Nicotine" stripes.com/opinion/2026... #MilitaryHealth
The Pentagon can’t have it both ways on nicotine
If the guidance on this issue is visibly disconnected from reality, why would a service member trust guidance on other critical issues?
stripes.com
Pumped to see The Wallflowers perform here tonight. Great songs never get old. Looking forward to hearing Jakob Dylan live.
Why did it take political pressure for the FDA to move on life-saving alternatives to cigarettes? See my new Substack: "The FDA Finally Moves on Flavored Vapes" open.substack.com/pub/cliffdou...
The FDA Finally Moves on Flavored Vapes
New authorizations could mark a turning point—if the agency follows through on the science of harm reduction and acts with urgency after years of delay.
open.substack.com
And ... boom ... FDA has just announced authorization of "four Glas electronic nicotine delivery systems (ENDS) ... includ[ing] Classic Menthol, Fresh Menthol, Gold, and Sapphire. This action marks the FDA’s first authorization of non-tobacco and non-menthol ENDS products." fda.gov/news-events/...
fda.gov
Cliff Douglas@cdoug-bsky.bsky.social · 3mo agoBreaking news: "A frustrated President Trump" criticized FDA Commissioner Marty Makary for blocking flavored vapes. Makary is "weighing becoming more open to vape flavor approvals." Is needed change coming? wsj.com/politics/pol... My interview on this issue at t.co/SM77ObSZLe @regwatch.bsky.social
Breaking news: "A frustrated President Trump" criticized FDA Commissioner Marty Makary for blocking flavored vapes. Makary is "weighing becoming more open to vape flavor approvals." Is needed change coming? wsj.com/politics/pol... My interview on this issue at t.co/SM77ObSZLe @regwatch.bsky.social
Trump Pressures FDA Commissioner to Approve Flavored Vapes
President Trump upbraided Food and Drug Administration Commissioner Marty Makary for not moving quickly enough to approve flavored vapes and nicotine products.
wsj.com
Oh dear! “High excise is not the cause nor lowering it the solution to illicit tobacco” Emeritus Professor Simon Chapman AO Simon doesn’t suggest what caused dramatic boom illicit cigs. His solution: keep doing what’s already failed but harder! @algore09algor.bsky.social @igas2.bsky.social
Renaming EVALI to reflect that nicotine e-cigs were not the cause remains critically important. I am hopeful that with Jay Bhattacharya at the helm at CDC, our 2021 petition signed by 75 experts will be given a second look and this scientific misclassification corrected.
Cliff Douglas@cdoug-bsky.bsky.social · 4mo agoMore: This gives the Trump CDC an opportunity to right a serious public health wrong that has also impeded a transformation of the marketplace to far safer, alternative nicotine products.
"EVALI" is possibly the most horrific health misinformation tactic I have ever seen. It stands for "E-cigarette or Vaping-Associated Lung injuries. PROBLEMS: "E-cigarette or vaping": logically equivalent to "mice or mammals" The lung injuries were caused by illicit THC vapes, not nicotine vapes
Cliff Douglas@cdoug-bsky.bsky.social · 4mo agoDr. @mikepesko.bsky.social asked acting CDC Director @drjbhattacharya.bsky.social to rename "EVALI" (E-cigarette, or Vaping, Product Use-Associated Lung Injury), which wrongly links deaths from 2019-20 to nicotine vapes: docs.google.com/document/d/1... See onlinelibrary.wiley.com/doi/10.1111/....
Dr. @mikepesko.bsky.social asked acting CDC Director @drjbhattacharya.bsky.social to rename "EVALI" (E-cigarette, or Vaping, Product Use-Associated Lung Injury), which wrongly links deaths from 2019-20 to nicotine vapes: docs.google.com/document/d/1... See onlinelibrary.wiley.com/doi/10.1111/....
Letter
Michael F. Pesko, PhD J. Rhoads Foster Professor of Economics Director, Social Impact Lab University of Missouri April 4, 2026 Jay Bhattacharya Acting Director Centers for Disease Control and Preventi...
docs.google.com
New paper! @mikepesko.bsky.social & @rachelylfung.bsky.social find no meaningful evidence that e-cigs crowd out NRT sales, cessation prescriptions, quitline calls,or smoking quit attempts, suggesting e-cigs reach smokers not interested in quitting otherwise. www.journals.uchicago.edu/doi/10.1086/...
This is unacceptable: “The price of regular gasoline in the United States jumped 25 percent from February to March, the highest monthly percentage increase on record.” A Record Jump in U.S. Gasoline Prices Is Squeezing Consumers www.nytimes.com/2026/04/10/b...
nytimes.com
A report on the personnel process, such as it was, at @FDATobacco prompts me to think about the human beings involved & the impact the tumultuous past year has had on those dedicated & hard-working people and the productivity of the Center for Tobacco Products. tobaccoreporter.com/2026/04/02/f...
Filing Shows FDA Rescinded 229 CTP RIF Notices - Tobacco Reporter
The declaration states that on February 3, 2026, all remaining RIF notices were rescinded except for eight employees who had already moved to other CTP divisions.
tobaccoreporter.com
A new study reports youth using e-cigarettes “to get high from nicotine.” That caught my attention. “Getting high” doesn’t reflect how nicotine is actually experienced. And when such language is wrong or misleading, there are consequences. See my new Substack: substack.com/home/post/p-...
Are Nicotine Users “Getting High”? When Language Distorts Public Health
A new study on youth vaping includes a striking turn of phrase: that adolescents report using e-cigarettes “to get high from nicotine.”
substack.com
This is the right trend - one that will, over time and with concerted effort in multiple sectors, both reflect and contribute to tremendous public health gains.
Dr Alex Wodak AM@alexwodak.bsky.social · 5mo agoDid you know in 2016 Philip Morris International earned 0% of its revenue from smoke-free products but by Q4 2025 they accounted for 42% of its revenue? @chancethegardener.bsky.social @jgitchell.bsky.social @algore09algor.bsky.social @ianamossyd.bsky.social @jmenezes.bsky.social @igas2.bsky.social
I'm looking forward to this event next week. Lots of impressive panelists. It will be an honor to participate with them. You can attend this event online or in person.
Students for Sensible Drug Policy@ssdpofficial.bsky.social · 5mo agoIf you believe nicotine policy deserves evidence instead of moral panic, autonomy instead of stigma, and public health instead of prohibition — Rethinking Nicotine is for you. Register To Attend In Person or Virtually – Students Get In For Free!
FDA just released 2025 teen nicotine vaping, smoking and nicotine pouch use numbers (top left). So I decided to put FDA's graph in a slide with the Y axis set honestly at 100%, rather than 8% (top right). Most kids, BY FAR, do not use nicotine. And that use is dropping (bottom left and right)
Youth cigarette smoking in the U.S. is now just 1.4%. Youth vaping has fallen 74% since 2019. The new National Youth Tobacco Survey tells a story we should be celebrating. I wrote about what the new data really show—and what it means for moving forward more effectively: substack.com/home/post/p-....
From Crisis to Progress: What the 2025 Youth Tobacco Survey Really Shows
New federal data reveal something that should be front-page news: youth cigarette smoking has nearly disappeared—and youth vaping is falling rapidly as well.
substack.com
The @nytimes spotlights the disastrous and widespread illicit trade for cigarettes in Australia: www.nytimes.com/2026/02/15/w.... Australia is harming health by reducing access to safer alternatives, keeping more people smoking, and by misusing taxation to drive many of its citizens to more smoking.
How $40-a-Pack Cigarettes Pushed Australians to the Black Market
nytimes.com
The thoughtful commentator Claudio Teixeira has shared his latest observations in "England, After the Smoke," an analysis of falling smoking rates in that country, where #vaping has helped reduce lethal combustible tobacco use. I was honored to contribute. www.disobedientmargins.com/p/england-af...
England, After the Smoke
Cigarettes are receding, but the air remains heavy with deeper dilemmas: pleasure, risk, and control.
disobedientmargins.com
This forecast of plummeting smoking rates has huge meaning for the health & well-being of millions in our society. Government must help - while the people choose. clivebates.substack.com/p/the-future...
I have 2 goals: Reduce preventable DEATHS and reduce teen nicotine USE. I know these goals carry different moral weight (death is final; use changes). But these are my goals. I share CDC, NIH and peer-reviewed evidence to achieve that. e.g., Here is what's ACTUALLY happening in the USA:
A new study from an expert team of researchers has found that "people who used ENDS products [i.e., nicotine vapes/e-cigarettes] specifically to quit smoking were more likely to achieve smoking abstinence." www.tobaccoinduceddiseases.org/Cigarette-sm...
Cigarette smoking abstinence at follow-up at 12 months among US adults who regularly used Electronic Nicotine Delivery Systems and smoked in the past year: A prospective cohort study
Introduction: Regular use of electronic nicotine delivery systems (ENDS) by people who smoke cigarettes may impact smoking trajectories. ENDS brands are used by different populations in different ways, but their associations with smoking cessation are not well understood. This study evaluated...
tobaccoinduceddiseases.org
The return of vapes (e-cigarettes) to 6,000 @Walgreens stores for the first time since 2019 is a welcome move, especially with growing evidence that nicotine vaping is more effective than nicotine medications in helping adults quit smoking. Progress! cspdailynews.com/tobacco/walg...
Walgreens resumes e-cigarette sales nationwide
Move marks policy reversal as retailer adds FDA-authorized vaping products to shelves, Bloomberg reports
cspdailynews.com