“The problem is that as a society, we tend to say, ‘We need to save the kids’ without having a balance,” said David Méndez, Professor of Health Management and Policy at the University of Michigan. If smokers who have used conventional cigarettes for years switch to a lower-risk product like e-cigarettes, “you’re saving their life now,” he added. “The heart attack they’ll have in five years? That’ll disappear now.”

“There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids.”Authors include Kenneth E. Warner, Founding Director of UMTRN , along with Neal L. Benowitz, Ann McNeill & Nancy A. Rigotti

“They have to go through an incredible bureaucratic review process. And if they do manage to get something to the state where they’re going to announce that they’re planning to adopt a policy or regulation, all of a sudden there’s a flood of lawsuits from the tobacco industry.” — Kenneth E. Warner, PhD (Avedis Donabedian Distinguished University Professor emeritus and dean emeritus at the University of Michigan School of Public Health)

“All with an eye toward enhancing public health and, at a certain level, enhancing the value and reliability of these alternative products to help an increased number of smokers stop smoking, and to not use anything wherever possible, but when they do, to ensure that they know what they’re getting.” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

“It is important for there to be a significant price differential between cigarettes (by far the most harmful form of nicotine delivery) and vaping products because millions of inveterate adult smokers they can serve as lifesaving substitutes. When cigarette prices increase, people who smoke can substitute e-cigarettes and reduce their harm. Differential taxes for differential risks make a less risky choice an easier choice financially and is thus an effective tobacco control policy strategy.” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

New Zealand is “engaged in an extraordinarily important natural experiment to see if these significant policy approaches, which have not been implemented elsewhere, succeed in driving down cigarette smoking, as many experts think they’re likely to do,” said Clifford Douglas, director of the Tobacco Research Network at the University of Michigan School of Public Health.

“We have asked, again, but this time in a major professional journal, that our government health leaders correct the serious misinformation that now plagues public understanding related to the significantly lower risk posed by e-cigarettes and their effect, or lack thereof, on promoting youth cigarette use,” Cliff Douglas, one of the coauthors and the director of the University of Michigan Tobacco Research Network, told Filter.

“We are still seeing a decrease in the number of children using e-cigarettes,” said Rafael Meza, a scientist at the Cancer Research Institute in British Columbia, adding that despite the methodological challenges, “we can come to some conclusions, but it is best to look at a few years, and not getting attached to one year versus another.”

Canada’s new excise tax on nicotine vaping products is days away from implementation, and the ramifications could be disastrous. In this episode of RegWatch eminent tobacco control scholars Dr. Kenneth Warner and Cliff Douglas discuss recent research on e-cigarette taxes and why Canada’s new excise tax on vaping could be a public health blunder.

Hard compromises that no one will like is how eminent tobacco control scholar Dr. Kenneth Warner describes some of the recently released recommendations in a new policy paper addressing the struggle over e-cigarettes. In this episode of RegWatch, we take a deep dive into the issues with Dr. Warner and co-author Cliff Douglas, director of the University of Michigan Tobacco Research Network and former Vice President for Tobacco Control at the American Cancer Society.

“I’ve been in the field of tobacco control and research for 45 years,” says Kenneth Warner, a former president of the Society for Research on Nicotine and Tobacco, a former dean of the University of Michigan School of Public Health, and a founding board member of the youth-focused, anti-tobacco nonprofit known today as the Truth Initiative. “I’ve never seen a division like this. Even using a phrase like ‘tobacco harm reduction’ gets the hackles up of the people focused on kids. They think it’s a distraction. And obviously, they’ve been winning the day.”

“...the increase and decrease in cancer mortality moved pretty much in tandem with the increase and decrease in lung cancer mortality, especially male lung cancer. The drop in smoking -- and hence in lung cancer -- has contributed mightily to the impressive decline in overall cancer mortality. Most strikingly, the decrease in the male lung cancer death rate accounts for almost half (47%) of the decrease in the male all-site cancer death rate.” — Kenneth E. Warner, PhD (Avedis Donabedian Distinguished University Professor emeritus and dean emeritus at the University of Michigan School of Public Health)

“Clearly Juul played a significant role, most visibly in 2018, in fueling an increase in youth experimentation with vaping products. By the same token … in the years since then, partly under duress from the FDA, they significantly changed their conduct. ” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

“I suspect Juul will be around for a while. These things tend to take a long time. [The FDA] has a lot of balls in the air around the menthol ban, its proposed reduction of nicotine to non-addictive levels in cigarettes, the continued PMTA [premarket tobacco product application] process, other pending applications, synthetic nicotine—there’s just a lot on its plate. ” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

“Let us not forget that the overriding public health objective should be to protect the public from harm, especially grievous harm. The greatest harm to health is overwhelmingly caused by inhaling combustible tobacco smoke, which is responsible for virtually all ’tobacco-related‚ deaths. Millions of adult smokers face imminent harm and even death from their use of combustible cigarettes. ” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

Still, some public-health experts wondered aloud whether politics also played a role. “Given the political pressure brought to bear by tobacco-control groups, parent groups, and members of Congress to ban Juul, one wonders whether this decision was solely based on safety,” Clifford Douglas, director of the University of Michigan’s Tobacco Research Network, told the Washington Post.

To stay on the market, companies must show that their e-cigarettes benefit public health. Today on AirTalk, Larry talks about the legal implications with Cliff Douglas, director of the University of Michigan Tobacco Research Network and adjunct professor at the School of Public Health.

Even some anti-tobacco advocates wondered whether the FDA move went too far. “Given the political pressure brought to bear by tobacco-control groups, parent groups and members of Congress to ban Juul, one wonders whether this decision was solely based on safety,” said Clifford E. Douglas, director of the University of Michigan’s Tobacco Research Network and former vice president for tobacco control at the American Cancer Society.

Clifford Douglas, director of the University of Michigan Tobacco Research Network, said that many experts had come to see Juul and other e-cigarettes as valuable tools for helping adult smokers quit conventional cigarettes. “They are off ramps that can provide smokers an alternative to combustibles, which are responsible for virtually every death related to tobacco,” he said. “But now that off ramp is being narrowed and sort of paved over, which is putting millions of adult lives at stake. One hopes Juul can respond effectively to the request for more scientific analysis, make any product adjustments that may be called for, and again offer their products to adults in need.”

Clifford Douglas, director of the Tobacco Research Network at the University of Michigan School of Public Health, said the scientific consensus on Juul is that it is an effective and less-harmful alternative to cigarettes. “The sad irony is that this product would be banned from the market while billions of combustible cigarettes, which kill half of all long-term users, enjoy ‘grandfather’ status and continue to be aggressively marketed to and used by tens of millions of Americans,” he said. “Something is truly wrong with this picture.”

The FDA has opened the public comment period for the agency’s proposed ban on menthol cigarettes. Epidemiology and global health professor Rafael Meza studies data modeling in disease prevention and cancer risk. David Mendez, who studies smoking cessation and tobacco control policies, is an associate professor of health management and policy. These University of Michigan researchers found that, in a 38-year period, African Americans suffered most of the harmful effects of menthol cigarettes. Now the researchers have developed a model to simulate the possible benefits of the menthol ban, based on studies of population trends in tobacco use. As experts on the behavioral and public health aspects of smoking, they explain the role of menthol in smoking-related illness and death.

“The premature demand that menthol be banned in all tobacco products, if implemented, risks handing almost the entire tobacco marketplace over to cigarettes, which kill half of long-term users. Science has demonstrated that a variety of noncombustible products offer reduced-risk alternatives for adult smokers who are either unable or unwilling to quit using nicotine completely.” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)

For the first time ever, the US Food and Drug Administration has given its approval to an electronic or e-cigarette. It was three e-cigarettes, actually, made by Vuse, which is part of RJ Reynolds. There's been a fierce public health debate in the United States about whether e-cigarettes are a help to people trying to quit smoking or another way for companies to hook another generation to nicotine. To get a global comparison to how e-cigarettes are regulated, Marco Werman speaks with Clifford Douglas, the director of the University of Michigan Tobacco Research Network and adjunct professor at the University of Michigan School of Public Health.

“It is also important for the public -- including clinicians -- to be aware of the rapidly growing evidence that vaping can be effective in quitting smoking. Indeed, the CDC reports that more adult smokers use, and have success using, e-cigarettes than other products in their attempts to quit smoking. And vaping is likely more effective for smoking cessation than FDA-approved nicotine replacement medicines, such as gum and patches, according to multiple credible sources, including the respected Cochrane Review.” — Clifford E. Douglas, JD (Director, Tobacco Research Network and Faculty, University of Michigan School of Public Health)