Cliff Douglas

I commend @MarcGunther’s insightful new piece on the problem with Democratic leaders’ misinformed opposition to tobacco harm reduction. My brief comment, from the perspective of someone who has worked with and for some of those leaders over the years, is here: @cliffdoug/note/c-229951451?r=1lelk&utm_medium=ios&utm_source=notes-share-action" target="_blank" rel="nofollow noopener">substack.com/@cliffdoug/not….

This is a very important post, actually multiple posts, from @OurWorldInData to its 300,000 followers. It makes it clear: The need to reduce smoking globally is a genuine emergency. And one of the major remedies that is immediately available is summed up in this quote, which you will find as you read their extraordinary findings: “The key points about vaping (e-cigarettes) can be easily summarised. If you smoke, vaping is much safer; if you don’t smoke, don’t vape.” – Chris Whitty, Chief Medical Officer for England

@Clive_Bates @FDATobacco @DrMakaryFDA How did you come up with that remarkable suggested title? Someone should use it.

Someone should write a book called “Blind Spots”. @FDATobacco and @DrMakaryFDA continue to ignore real-world evidence in regulating tobacco and nicotine: 1. FDA has created a huge illicit vape market bypassing FDA’s near-insurmountable barriers to entry, but regulates as if this does not exist. 2. FDA’s main impact has been to the benefit of cigarette companies, Chinese vape manufacturers and criminal networks. 3. FDA defines youth vaping as the primary problem, yet vaping has almost eliminated youth smoking - a far greater problem. 4. Older adults who smoke are the main public health and healthcare system challenge and FDA has relentlessly let them down. 5. FDA constantly adds doubt, confusion and misinformation about the risks of smokefree products and nicotine, compared to smoking. Fix that, and much good would follow. 6. The demand for nicotine is based on people wanting its psychoactive effects. It cannot be regulated out of existence, but it can be made much safer. Instead, FDA protects the cigarette trade and promotes organised crime. That’s one gigantic blind spot, @MartyMakary

Well, did they? @FDATobacco could do more than it has to clear up this lingering question. Why raise suspicion when a simple, clear statement might allay concern? I can think of multiple ways in which the agency could manage this more successfully while acknowledging the huge importance of the new data. Teen Tobacco Use Down in New Survey. Why Did FDA Hide It? dcjournal.com/teen-tobacco-u…

Meanwhile, back in the @FCTCofficial ecosphere, they are unfortunately celebrating e-cigarette bans while conventional lethal combustible cigarettes continue to devastate the health of people who live in the very places where those bans have been imposed.

Kudos to Lindsay Lewis and @ppi for highlighting the need to accurately educate adults about the fact that alternative nicotine products are safer and that VA clinics can and should play a central role in making this clear to their smoking patients.

Quote from the author of an important new study: "Our findings show the need to strike a balance in public health messaging that discourages youths from using either product [cigarettes and e-cigarettes] while also ensuring that adults who do smoke have access to accurate information about product risks and cessation options." This is yet one more reminder to @FDATobacco to act with greater urgency on communicating the scientific truth to American adults.

I, too, hope Dr. Emanuel will consider that the current science does not in fact support his conclusions. I’m not asking that he do this because I attended Anshe Emet elementary school with his brother Rahm, but rather based on my careful review of the science as the former VP for tobacco control at the American Cancer Society and advisor to the Assistant Secretary for Health and the Surgeon General during the Obama administration. 🙏

I had a short but important note for Dr @ZekeEmanuel after @drlucymcbride interviewed him on Substack. 🙏 Cutting Through Wellness Noise: 6 Rules for a Long & Healthy Life with Dr. Zeke Emanuel open.substack.com/pub/lucymcbrid…

Rethinking Nicotine: @KatMurti moderates a discussion on the failures of prohibition, with discussion by @Tim_Andrews @ReemAmirIbrahim @SofieHamilton comparing Swedens success in reducing smoking (with snus) vs how Australia's overly restrictive approach backfired.

Opening session of the Rethinking Nicotine conference. @KatMurti moderates a discussion on how strict nicotine policies harm people, with @cdoug @imaracingmom @cdoug & Julia Hilbert: Misperceptions, driving back to smoking, punitive/abusive law enforcement against consumers.

I’m very pleased to be participating today in this important conference hosted by Students for Sensible Drug Policy. It signals an encouraging paradigm shift toward constructively incorporating tobacco harm reduction into broader, widely accepted harm reduction approaches. I appreciate the passionate interest in letting people know the truth — that nicotine separated from combustion (cigarettes) does not cause the illnesses and death resulting from smoking. And that alternative nicotine-containing products like e-cigarettes and pouches are magnitudes safer and can be helpful to adults who want to stop smoking, especially when other methods don’t work for them. (Photo credit: Robert Rush) @KatMurti @ArielleSelya @FloeFoxon @jacobjamesrich

I've written at @Filtermag_org on the new US National Youth Tobacco Survey data which show smoking amongst youth has all but disappeared. The 'gateway' theory is nothing but fiction. Why does no-one want to talk about such great news? filtermag.org/youth-smoking-…

@FDA_Track Do you mean flouted?

Tobacco regulations flagrantly flaunted in Ukraine / The New Voice of Ukraine english.nv.ua/business/tobac…

This is an eye-opening and worthwhile thread about the state of tobacco harm reduction, rapidly fading youth smoking and vaping, and what @FDATobacco is doing versus what it should be doing. This is the kind of discussion of hard facts that everyone involved — regardless of your ideology, affiliation, or positioning to date — should at least consider, and with an open mind. If nothing else, it offers an opportunity to gain some useful insight in this sadly polarized arena.

@JMacNYC @jgitchell @CochraneLibrary @CochraneTAG @opinion_joe This is a fascinating and important thread and discussion. Kudos. Another relevant factor: Which products proven to help people stop smoking are most appealing, most accessible, and most widely used? The answer to that question matters - a lot.

@jgitchell @CochraneLibrary @CochraneTAG @opinion_joe If only STAT News aspired to your levels of open dialogue and fastidiousness!

No journalist has been more prescient and straight-shooting on vaping-as-tobacco-harm-reduction than @opinion_joe. Compare this logically reasoned piece to the public health orthodoxy on display in mainstream press and you'll see the whole big picture in stark relief. 1/🪡

The study itself, while encouraging — and I take no position here — sounds much more cautious, as follows: “What this study adds: •In two large cohorts and using Mendelian randomisation, cannabis use was associated with slightly higher baseline cognitive scores but showed no link to longitudinal cognitive decline or dementia, and no evidence of a causal effect was observed. “How this study might affect research, practice or policy •These findings suggest that prior cannabis use may not substantially impact cognitive ageing in older adults, though clinicians should continue to assess exposure. Further studies with detailed dosing and long-term follow-up are needed to inform clinical guidance.”

😚💨 Researchers reported that those with a history of cannabis use "demonstrated significantly better cognitive performance" and that  use "was not associated with increased risk of dementia." norml.org/blog/2026/03/0…

@jgitchell @cdoug Many thanks, Cliff. Such a thought-provoking conversation and much appreciated. Will be keen to follow your upcoming talk in Pittsburgh and yes, let's keep hope alive. x.com/ssdpofficial/s…

🚨😶‍🌫️Shaping Vaping Special😶‍🌫️🚨 Thursday, 3/12 - 11:30AM Eastern @JMacNYC and @jgitchell welcome distinguished guest Cliff Douglas @cdoug - #SRNT2026 recap - @FDATobacco draft guidance on flavors - Prospects for THR advocacy in light of NYTS numbers. youtube.com/watch?v=ilYrM1…

Greatly enjoyed, and found deeply valuable, my conversation with @JMacNYC and @jgitchell - two thought leaders nonpariel in this important space. Many thanks!

I'm very pleased to be joining tomorrow's "Shaping Vaping" podcast, where we'll address some of the key opportunities and challenges facing us now. I appreciate Jim and Joe's generous invitation.