Cliff Douglas

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.

@cdoug @SenBlumenthal @FDA I’m with you and disagree as well. Burnt cigarettes are the real killler. Why are they still legal?

This shortsighted decision by FDA will turbocharge nicotine addiction & rollback progress made in reducing youth tobacco use. We know flavored products draw in young people, there is no excuse for enacting contradictory measures—exacerbating disease & death in a new generation.

And now, confirmation from inside the @WhiteHouse: politico.com/news/2026/05/0…

@Clive_Bates @plopnl @FDA @l_e_whyte @WSJ 😉

@cdoug @plopnl @FDA @l_e_whyte @WSJ Almost sounds like a @cdoug job application! Wouldn’t be a bad pick, IMHO. #CD4FDA

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. wsj.com/health/healthc…

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.

@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.

@cdoug @SenBlumenthal @FDA Harm-reduction policy gets stronger when housing is in the frame. In recovery housing, behavior change tends to stick more when nicotine goals are stepped (combustibles -> lower-risk options -> taper) rather than all-or-nothing on day one. Stability first, then deeper change.

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.

A key problem remains. My hypothesis is that a key factor making nicotine vapes the most popular smoking cessation option in America is their sheer diversity (device types, flavors, and nicotine strengths). FDA’s case-by-case approach means they can’t see that forest for the trees.

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:

@camjenglish @DrLizaMD @plopnl @SenBlumenthal @FDA Well said, and with thanks for your powerful, personal testimonial.

@DrLizaMD @cdoug @plopnl @SenBlumenthal @FDA This "shortsighted decision" is one of the best public health developments in years. Nicotine vaping and pouches got me off cigarettes. Now I'm nicotine free for the first time in two decades. Get out of the way, senator.

With reference to @FDA's/@FDATobacco's authorization of mango and blueberry e-cigarettes, Dr. Koplow made a critical observation: “Products with age-gating will not be for everyone.” His own father continued to use a flip phone in the age of smartphones. His dad wasn't a smoker, but had he been, an age-gated product "wouldn’t have been for him." This strongly suggests a clear awareness on the part of Koplow and his scientific team that other flavored products without age-gated technology ought to be authorized for lawful sale.

Dr. Koplow doubled down on what he has emphasized in recent days: Adults also prefer flavors. “They like fruit," he said. Therefore, it is clear that fruit-flavored alternative nicotine products that are assessed to be "appropriate for the protection of the public health" (which means the benefit to adults who smoke outweighs the risks to youth) should be authorized and made available to adults who smoke.

Yes, exactly. I disagree with the unfortunate perspective reflected in @RepRobinKelly’s post, which mirrors that of some other officials with whom I generally agree, but not on this issue. I hope they begin to see the light on this profound public health and social justice matter.

@cdoug @RepRobinKelly @FDA I take it that you're disagreeing with the OP and not with me as we seem to basically say the same thing. 🙂

The FDA caved to Trump’s pressure to approve flavored e-cigarettes. Kids and teenagers, especially Black youth, will pay the price. Flavored vapes are especially addicting, designed to pad the pockets of billionaire vape companies and to deteriorate our health. robinkelly.house.gov/media-center/p…

@SenBlumenthal Calling on all adult Americans that have quit smoking with the help of vapes to share their experience on thrglobal.org/en/share. Certain members of the US Senate are ignoring the science. Let's see if they are prepared to ignore the experiences of their constituents!

I disagree, and I do so as a former health advisor to President Obama’s Surgeon General. In this case, President Trump called @FDA Commissioner Marty Makary on the carpet for blocking the authorization of a carefully controlled nicotine vaping product that the FDA‘s scientific experts cautiously reviewed and recommended be permitted on the market. What you may be missing here is the irony that the action taken by Trump in this case actually *depoliticized* the science, which recognizes that nicotine neither causes cancer nor the many other illnesses resulting from smoking, which result from the burning of tobacco (which produces thousands of chemicals in cigarette smoke). Millions of addicted adult smokers stand to benefit from this action. This underscores that significant reform must be undertaken at FDA, possibly starting with the dismissal of the commissioner. And then the agency, including the Center for Tobacco Products, must be permitted to carry out its science-based regulatory work unimpeded. I urge you not to interfere with that lifesaving mission.

@RepRobinKelly That's not really what happened. The scientific staff at the FDA first recommended the products for authorization, but FDA Commissioner Makary was blocking it. Trump intervened and stood with the FDA staff. msn.com/en-us/health/g… x.com/gbentley1/stat…

Apart from being basically flat wrong, your post is interesting. The so-called “tobacco industry” you refer to must be to illicit manufacturers, most of whom illegally import vapes from China, and not any of the rule-abiding companies whom you are likely thinking about. In addition, on a list of motivations for young people to vape in the US, flavors rank #5. The top two motivations are curiosity and peer pressure. Please start with accurate facts, and then form and express your opinions. It will be refreshing to reengage with you then.

Flavors are one of the tobacco industry’s most effective tools to hook young people. STOP’s flavor blog series reveals ➡️ How flavors hook young people—making products more appealing, masking harshness, and lowering perceived risk ➡️ Why the industry fights to keep them—because flavors help turn experimentation into long-term use ➡️ What works to stop it—comprehensive flavor bans that reduce uptake and support quitting Learn more: bit.ly/48nJFw3 #UnmaskTheAppeal #TobaccoExposed