Pediatrics publishes 2025 NYTS results that highlight problems with FDA’s permissive policy toward e-cigarettes and nicotine pouches

Pediatrics just published the final version of my paper "Tobacco Use Among Middle and High School Students: 2025 National Youth Tobacco Survey." They key observations are: Overall youth tobacco use is continuing to decline The two most commonly used products are e-cigarettes and nicotine pouches The decline in overall tobacco use is manifest across all products, except nicotine pouches, which doubled from 2021 through 2025…

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UCSF Makes Internal Firearm Industry Documents Public

In 1994 when I worked with the UCSF Library to put the original collection of about 10,000 pages of internal documents from the Brown and Williamson Tobacco company on the internet, I had no idea that the project would grow not only to the Truth Tobacco Industry Documents Library that contains 20 million tobacco industry documents, but the much larger…

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Some Thai e-cig use despite ban on imports and sales

Roengrudee Patanavanich, her Thai colleagues, and I just published "Patterns of e-cigarette use by sex and age in Thailand: The National Health Examination Survey 2024–2025" that provides detailed statistics on cigarette and e-cigarette use in Thailand, a country that does not allow import and sale of e-cigarettes. We found current e-cigarette use among 5.3% of youth (age 10-19), 8.3% of young adults (20-29) and 1.0% among adults (30+).

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Big Tobacco promotes e-cigarettes, undermines health protections through U.S. business groups worldwide

Tobacco companies are embedded in influential U.S. business groups worldwide, giving the industry a powerful channel to undermine public health.

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2025 NYTS highlights problems with FDA’s permissive policy toward e-cigarettes and nicotine pouches

In April 2025, as part of its attack on the federal government’s tobacco control efforts, the Trump Administration pulled the plug on data collection for the 2025 National Youth Tobacco Surve…

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2025 NYTS highlights problems with FDA’s permissive policy toward e-cigarettes and nicotine pouches

In April 2025, as part of its attack on the federal government's tobacco control efforts, the Trump Administration pulled the plug on data collection for the 2025 National Youth Tobacco Survey (NYTS), a large national survey of middle and high school tobacco use the CDC -- later joined by the FDA -- had been running since 1999. In past years, the CDC (later with the FDA) published the topline results in the CDC…

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Comprehensive smoke-free laws reduce cardiovascular deaths

In 2004, when Richard Sargent, Robert Shepard and I published "Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study" reporting that hospital admissions for heart attacks dropped when Helena, Montana passed its smoke-free law, it was controversial. Since then, many studies have confirmed and expanded this conclusion (Institute of Medicine…

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Useful guide to searching Juul documents now available

The UCSF Industry Documents Library has released a very useful new Juul Labs Collection Content Guide on the IDL website that provides a wealth of information and links to key documents to help people get started in searching the Juul documents. It is specifically built around the Multistate Juul Labs Collection, which includes materials disclosed through litigation and settlement agreements with the attorneys general of California, Colorado, Illinois, New Mexico, New York, Massachusetts, and the District of Columbia.

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Switching from cigs to ecigs does not significantly reduce lung cancer risk

Yeon Wook Kim and colleagues' new paper "Electronic cigarette use after smokingcessation and lung cancer risk" shows that smokers who switch to e-cigarettes have about a 50% higher risk of developing lung cancer and about a doubling of risk of dying from lung cancer than smokers who just stop smoking. Most important, this paper is direct high-quality evidence against e-cigarette advocate and tobacco company claims that switching from cigarettes to e-cigarettes would reduce lung cancer risk…

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E-cigarettes increase harm and should be discouraged

Nature Human Behaviour - Ever since electronic cigarettes (e-cigarettes) were first marketed in 2004, they have been promoted as ‘tobacco harm reduction’ on the basis of the assumption...

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We support FDA expanding HPHC list and suggest adding more flavoring agents (public comment)

On April; 26, 2026, FDA announced that it added 18 compounds to its "Harmful and Potentially Harmful Constituents" (HPHC) list to assess toxicity of tobacco products. This was the first update of the list since it was first released 14 years ago in 2012. The updated list includes several things, most notably propelyne glycol (PG) and vegetable glycerine (VG, listed as glycerol), which are important components of e-cigarette liquid and heated tobacco products.

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We support California’s updated”Unflavored Tobacco List” and suggest some improvements

The California Attorney Genera maintains an official "unflavored tobacco product list" to facilitate implementation and enforcement of the state's flavored tobacco product ban. The AG proposed "readopting" an undated list. We support that proposal and made a few suggestions for improving it. A PDF is available here. This is an excellent model for other states, particularly since President Trump has finished off the job of…

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E-cigarettes increase harm and should be discouraged (new paper)

Pam Ling and I recently published "E-cigarettes increase harm and should be discouraged" in Nature Human Behavior that summarizes the current evidence on e-cigarettes. The Introduction sums up the paper: Ever since they were introduced, arguments that e-cigarettes reduce tobacco harm have hinged on three assumptions: (1) nicotine aerosol from heating a liquid rather than burning tobacco substantially reduces disease risk; (2) smokers would quit or switch completely from cigarettes to e-cigarettes; and (3) e-cigarettes would not appeal to youth.

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FDA should drop its draft guidance to allow some sales of flavored e-cigs because it fails to demonstrate that harm to youth outweighs theoretical benefits to adults

My colleagues and I just submitted this public comment to FDA opposing its proposal to allow sales of flavored e-cigarettes and other electronic nicotine delivery systems (ENDS) on the grounds that benefits to adults would outweigh harms to kids. It also presents evidence that two-way communication between ENDS and external agencies (that could include ENDS manufactures or their agents) is exceptionally dangerous because it could allow control of the device to increase addiction and should be prohibited not encouraged.

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I surprised Michael Smerconsih when he interviewed me about UK generational smoking ban

On April 23, 2026, Michael Smerconsih interviewed me about the UK Generational Smoking ban. I surprised him by arguing that generational smoking bans are bad public policy because they divert resources from more effective tobacco control policies that had faster public health benefits. I am also skeptical that they will be maintained in the long term as people age into them.

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Local flavor bans followed by big drops in youth e-cig use

The evidence that comprehensive flavor bans are followed by drops in tobacco consumption keeps piling up. A new study by Giovanni Appolon, and colleagues, Local Flavored Tobacco Bans and Youth Electronic Nicotine Delivery Systems Use, of 2.8 million California middle and high school students across 483 local jurisdictions found that local flavored tobacco bans that took effect before California's state ban were followed by reduced youth e-cigarette use over time.

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MAHA claims that nicotine is good for you echo decades of tobacco industry propaganda

The New York Times recently highlighted how many "Make America Healthy Again" influencers are promoting the benefits of nicotine, including reversing Alzheimer's Disease and improving cognition. While we don't know what role the tobacco companies are playing in this latest resurgence of claims that nicotine is a beneficial substance that poses little or no risk, we do know that…

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FDA adds 18 chemicals to list of harmful constituents in tobacco products, including propelyene glycol and vegetable glycerine

The FDA is required to maintain a list of "Harmful and Potentially Harmful Constituents" (HPHC) in tobacco products. The original list was released in 2012 and was mostly toxicants in cigarette and other tobacco smoke and smokeless tobacco. In particular, this list did not include important compounds in e-cigarettes and other "new" tobacco products. In 2019, FDA proposed adding 19 compounds to the list that were in these products.

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Evidence that ecigs are a gateway to smoking and promote relapse in former smokers keeps piling up

Jagdish Kaur from WHO and several colleagues from India's new paper "E-cigarette use and subsequent tobacco smoking initiation: an umbrella review with Bayesian model meta-analysis" provides the most comprehensive summary of evidence that e-cigarettes promote cigarette smoking in nonsmokers available to date. They also show that e-cigarette use in former smokers promotes relapse to smoking. Kaur and colleagues searched the literature for earlier reviews and meta-analyses of the association between e-cigarette use and subsequent smoking.

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Nicotine pouches maintain the nicotine market for tobacco companies

Nicotine pouches (like ZYN and on!) are being touted by some advocates as a "harm reduction" alternative to smoking cigarettes. Kelvin Choi and colleagues examined whether this happens in real life in their new paper "Patterns of tobacco product use among US adults who use nicotine pouches and the association between nicotine pouch use and tobacco product use cessation…

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