American Lung Association Seeks to Suppress Harm Reduction Information

    The American Lung Association, as you would expect, is eager to point out the dangers of cigarettes. It wants to create a “tobacco-free future.” It also constantly reminds regulators, journalists and the public of how Big Tobacco lied about smoking.

    It’s ironic, then, that this public health nonprofit appears to be comfortable with committing the very same sin: lying to people about information that could be critical to their health. 

    Its hypocrisy concerns—as many of us, unfortunately, have also come to expect—tobacco harm reduction. The website of the American Lung Association (ALA) is peppered with false and debunked information designed to exaggerate or invent risks of vaping. While there is no combustion or smoke from vaping, the ALA has the audacity to tell people that “switching to vaping (e-cigarettes) is not quitting smoking.”

    But not satisfied with that, the ALA now wants the United States Food and Drug Administration’s Center for Tobacco Products (CTP) to lie, too.

    “Remove language that references informing adults about the relative risk of tobacco products.”

    Recently, the ALA submitted comments on the CTP’s five-year Strategic Plan. The CTP’s “Strategic Goal #4” is to “ Improve Public Health by Enhancing Knowledge and Understanding of CTP Tobacco Product Regulation and the Risks Associated with Tobacco Product Use.” 

    The ALA “strongly recommends” that the CTP “Remove language from the description for this goal that references informing adults about the relative risk of tobacco products.”

    That’s right: The American Lung Association wants to suppress the information that some “tobacco products”—the term is used here to refer to all consumer nicotine products—are safer than others. 

    We’re not talking about minor differences, either. Vapes and other harm reduction options are vastly safer than cigarettes, to the point where, for someone who smokes, switching is very likely to save their life. 

    But the ALA doesn’t think people deserve to know that. 

    Globally, millions of people have quit smoking thanks to vaping. Yet the ALA’s comments continue: “CTP should have no part in the industry’s efforts to sustain addiction through the failed and flawed notion that adult smokers should switch to e-cigarettes.” 

    What, exactly, is “flawed” about encouraging people who rely on nicotine to make a switch that hugely reduces their health risks?

    The “switch” that the ALA has performed here, by targeting not harms and premature death but “addiction,” is telling. The “tobacco-free future” it envisages sounds like one where you either quit nicotine entirely—which we know not everyone can do—or you die.

    “As damaging a recommendation as I have ever seen from a supposed public health organization.”

    The ALA’s comments have not gone unnoticed.

    The University of Michigan Tobacco Research Network stated, “We disagree with the head-in-the-sand approach advocated by @LungAssociation, which ignores the science & the urgent need to educate adults who smoke, half of whom will die prematurely of lung and other fatal illnesses if not fully informed about issues such as relative risk.”

    Professor Michael Siegel of the Tufts University School of Medicine considers the ALA’s call to hide the truth from the public “as damaging a recommendation as I have ever seen from a supposed public health organization. I must condemn it in the strongest terms.”

    Brad Rodu, professor of medicine at the University of Louisville, is so appalled by the ALA’s recommendations that he encourages potential donors to “Send your charitable contributions elsewhere.”

    The behavior of US public health groups like the ALA is all the more infuriating when you consider how various lung and respiratory-focused health organizations have endorsed vaping to help people stop smoking around the world.

    The United Kingdom’s lung charity, Asthma + Lung UK, says, “E-cigarettes are a relatively new stop smoking tool, but if used correctly represent a big opportunity to reduce the harms caused by smoking.” 

    The British Lung Foundation similarly tells people who smoke, “Swapping cigarettes for an e-cig can improve your symptoms of lung conditions like asthma and COPD.”

    The Canadian Lung Health Foundation shares this advice: “If you do smoke, switching completely to electronic cigarettes may significantly reduce your exposure to toxic chemicals and carcinogens.”

    Nicotine “addiction” is a phantom threat. Decoupled from combustible tobacco, the harms of nicotine are more akin to those of tea or coffee than to those of the world’s deadliest form of drug use.

    And the Asthma & Respiratory Foundation of New Zealand says it “acknowledges that vaping, along with wraparound quit smoking support, may help some people to quit tobacco cigarettes.”

    Overseas healthcare experts also see the merits of providing people who smoke with facts. More than 30 experts from Australia, for example, signed a statement that, in part, said, “In the case of vaping, the harms from withholding vaping (and denying smokers a safer alternative) are far greater than harms of introducing it.”

    Ernest Groman (MD) of the Vienna Nicotine Institute also has a forward-looking perspective on nicotine use: The data show that the abstinence approach is inadequate. The solution for smokers is to switch to less harmful alternatives.”

    Yet the American Lung Association remains stuck to the antiquated, anti-harm reduction goal of a nicotine-free society—at any cost.

    Nicotine “addiction” is a phantom threat. Decoupled from combustible tobacco, the harms of nicotine are more akin to those of tea or coffee than to those of the world’s deadliest form of drug use. By playing the addiction card, the ALA stigmatizes people who want to use nicotine. 

    And by lying about safer alternatives to smoking, it will keep some people smoking who would otherwise have switched, leaving them at high risk of developing the stigmatized disease of lung cancer and other potentially fatal health conditions.

    The American Lung Association’s claimed mission is to “save lives by improving lung health and preventing lung disease.” How can its recent actions possibly be compatible with that goal? 



    Photograph (adapted) by Mike Mackenzie via Flickr/Creative Commons 2.0

    • Skip started smoking when she was 10, and quit through vaping in 2015. She is an enthusiastic tobacco harm reduction advocate. She works as a direct service professional at a group home providing services for people living with disabilities. Skip also lives with a disability and was diagnosed with autism, ADHD and depression in 2020. She is the co-founder and a research volunteer for the Safer Nicotine Wiki. She previously owned a vape shop and served as the research fellow for the Consumer Center of the Taxpayers Protection Alliance. She lives in Minnesota.

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