Physicians are speaking out to correct widespread misunderstanding in the public and among doctors themselves regarding the now well-proven fact that alternative, non-combustible nicotine products are far safer than cigarettes and can save people’s lives.

Enough nicotine to satisfy cravings can help a product replace lethal cigarettes and save lives. More nicotine does not automatically mean more harm. My new article examines why confusing nicotine delivery with smoking-related harm matters so much. cliffdoug.substack.com/p/nic…

New report: "Use of e-cigarettes for smoking cessation remained common from 2018 to 2023. Perceived lower harm and social exposure were consistently associated with this behavior, highlighting the influence of cognitive and social factors on cessation-related decisions among adults who smoke cigarettes." Link: pubmed.ncbi.nlm.nih.gov/4284… In other words: Tell the truth. If you give people who smoke accurate information about the fact that nicotine vaping (and use of other noncombustible nicotine products) is safer than smoking cigarettes, they will be more likely to stop smoking through the use of these products.

Today at the 14th Annual Conference of the Vermont Center on Behavior & Health (theme: "Cigarette Smoking in Combination with Other Tobacco Products & Other Addictive Substances"), Dr. Richard Miech shared the latest data from the Monitoring the Future (MTF) survey on U.S. trends in adolescent nicotine vaping, alcohol use, and cannabis use since the COVID-19 pandemic. Great news: All three categories have simultaneously fallen by at least 40%. MTF is the gold standard of epidemiological research on youth behavior and public health.

Re-upping this post: Importantly, @FDATobacco’s leadership is now owning and promoting the fact that the agency has the responsibility and the capacity to communicate much more effectively and directly to the public about the continuum of risk and the value of switching from combustible cigarettes to the far safer products authorized by the agency. Dr. Bret Koplow just said so. (Note: They didn’t use to say that.)

Could FDA’s proposed PMTA overhaul mark a turning point? I joined @RegWatchCanada to discuss the prospects for reform—and why success requires both access to a robust marketplace of authorized lower-risk alternatives and accurate information for adults who smoke. Recent moves by newly appointed permanent director of @FDATobacco, Dr. Bret Koplow, suggest essential action in that direction.

“There is a gap between the science and the belief.” Very important observation — and lament — from @FDATobacco director Dr. Bret Koplow, who emphasized today in his keynote at FDLI’s annual tobacco and nicotine conference that adults who smoke can significantly benefit their health by switching to reduced-risk products like FDA-authorized vapes. But a majority of Americans, including PHYSICIANS, don’t understand this. He said that FDA will partner with academic researchers, scientific organizations, and other stakeholders in turning this around.

I’m speaking at #FDLI's Tobacco and Nicotine Products conference, Oct. 6–7, in Washington, DC and virtually. Our panel, “Litigation Update: PMTAs, Preemption, and Regulatory Pressure,” will examine litigation reshaping nicotine regulation and its public health implications.

Appreciate this thoughtful coverage by @2FirstsNews of my talk at #NewApproaches2026. My central proposition: “The continuum of risk should not simply describe the marketplace. It should play a central role in organizing it.” The overriding public health goal: reduce exposure to combustion as rapidly as we can. And “authorization alone is not a public health strategy.” We need a broader ecosystem of science, regulation, enforcement, accurate risk communication, youth protection, and responsible innovation—capable of accelerating the displacement of combustible cigarettes. Thank you to New Approaches and 2Firsts for capturing the argument so thoroughly. 2firsts.com/news/nas-2026--c… #TobaccoHarmReduction #TobaccoControl #PublicHealth #NicotinePolicy

Very encouraging talk today by @FDATobacco’s Center for Tobacco Products Director Dr. Bret Koplow at #NewApproaches2026. Former Iowa Attorney General Tom Miller told him (and the entire audience) that “It’s a breath of fresh air.” I agree. Director Koplow emphasized that tobacco harm reduction should not be controversial. It is an essential approach to helping more adults stop smoking. It is, in fact, what the PMTA process is all about. In essence, he confirmed that this is exactly what Congress had in mind when it passed the Tobacco Control Act in 2009. He also noted his and FDA’s understanding that adults prefer non-tobacco and non-menthol flavors. This is and will be taken into account in reviewing product applications. Critically, he confirmed that public misunderstanding is widespread, and to stay tuned for FDA *action* focused on better educating adults who smoke, medical associations, and others who need to be accurately informed about the continuum of risk and nicotine. Again, a breath of fresh air.