The EU-wide TPD determines what will or won’t be legally available, and how it can be sold. Tobacco harm reduction advocates fear the upcoming revisions may contain damaging restrictions on safer nicotine products, such as a bloc-wide ban on vape flavors, in the region with the world’s highest smoking rates.

In that context, those advocates describe the questionnaire as a sham, its questions skewed in order to favor an anti-nicotine ideology.

The questionnaire was released on May 22 by the European Commission, the EU’s executive arm, which will be collecting answers until August 14. The stated aim is to give “stakeholders”—including national health authorities, NGOs, businesses, academics and private citizens—“the opportunity to express their views on the current rules and suggest possible changes to them.”

“It looks like it is designed to bolster support for simplistic policies that restrict or ban nicotine products that are far safer than cigarettes.”

But consumer group European Tobacco Harm Reduction Advocates (ETHRA) swiftly issued a scathing response, stating that “the survey is impossible to answer for anyone with an understanding of the differences in risk between different tobacco and nicotine products and a rational public health interest in the role that low-risk alternatives to smoking could play in reducing the burden of … disease.”

Tobacco harm reduction advocate Clive Bates, of Counterfactual Consulting, similarly sees the questionnaire as unfit for purpose. It “looks like it is designed to bolster support for simplistic policies that restrict or ban nicotine products that are far safer than cigarettes,” he told Filter.

ETHRA’s detailed response identifies eight generic failings in the nature of the questions asked. These include inadequate breadth or subtlety of available multiple-choice answers; inappropriate aggregation of very different products; no recognition of likely unintended consequences of policies; ignoring the counterfactual likelihood that many youth who vape would be smoking if vapes weren’t available; no recognition of trade-offs in framing questions; asking for opinions on factual matters; ignoring respondent risk perceptions; and no options to deregulate, for example by ending the EU’s existing ban on snus.

The critique additionally gives individual commentary on all 23 questions in the survey. One question, for instance, asks: “How important is it to you that the EU tobacco control legislation supports the following objectives with regard to tobacco, nicotine and non-nicotine products?”

“The question is heavily loaded. It does not differentiate between different products that have very different levels of risk” and “misses major outcome objectives.”

The eight available answers include “Preventing the initiation of use,” “Supporting the cessation of use,” “Ensuring that these products do not have attractive features” and “Minimizing the administrative burden on Member States”—but nothing about reducing deaths. 

“The question is heavily loaded,” ETHRA comments. “It does not differentiate between different tobacco and nicotine products that have very different levels of risk.” And it “misses major outcome objectives (reducing the burden of smoking-related disease) that can be attained by switching from high-risk to low-risk products.” 

Though around 700,000 EU residents die of smoking-related diseases each year, the survey, ETHRA states, “betrays a lack of seriousness about the size of the population, the toll of disease and death, and the options available to address it.”

The stakes are extremely high, advocates note, when around 100 million EU adults currently use nicotine in different forms. The nature of the revised TPD will heavily influence whether they, and future consumers, use safer products or deadly cigarettes.

“The survey is a window on the Commission’s thinking, and we can already see that they will do more harm than good if they get their way.”

“The survey is a window on the Commission’s thinking, and we can already see that they will do more harm than good if they get their way,” Bates said. As well as negative public health impacts, he predicts a much bigger illicit market if this happens—when the Commission should view safer nicotine options as a public health opportunity. 

ETHRA said the questionnaire illustrates “contemptuous attitudes towards the views of citizens who have an evidence-based, nuanced public-health case for tobacco harm reduction.” The intent, it said, is not a “genuine” consultation, but to “frame questions” to create a mere “illusion” of openness.

Despite this, Bates still intends to participate, believing that having some kind of a say is better than none. He plans to attach ETHRA’s critique as a file upload with his completed form.

“I urge everyone with an interest in sound regulation to do the same,” he said, “unless you have a more personal statement to upload.” He plans to assume that each question relates only to products useful to consumers for harm reduction, and answer accordingly.

“We need to square up for a new fight, but this time the opposition is better organized and financed.”

“Where there is an opportunity to oppose a measure that damages consumer interests, I will take it,” Bates said. “I will not allow any answers to be misconstrued as support for excessive measures against vapes, pouches, snus or heated tobacco.”

Bates also counsels against despondency, noting that previous EU battles have been won despite seemingly dire prospects. 

There was a time in 2012, he recalled, during the formation of the TPD, when the European Commission was planning to regulate vapes as medicine—hugely restricting access for people who smoke—and had the backing of many influential bodies. But consumers pushed back hard, and the outcome was a TPD that was far less damaging than anticipated.

“We need to square up for a new fight,” Bates concluded, “but this time the opposition is better organized and financed. Everyone needs to get ready, join or form consumer groups, and start getting busy.”

Photograph (cropped) via RawPixel/Public Domain

The post EU’s “Loaded” Public Questionnaire Pushes Anti-Nicotine Agenda appeared first on Filter.

A young woman is strapped down in a black reclining chair, her mouth covered by an oxygen mask with a vape attached to it. It forces her to inhale vapor continuously. X-rays of the brain and lungs hang on the wall. Meanwhile rats investigate vapes, and nicotine pouches are strewn all around them. It’s macabre.

“When you use nicotine pouches or vapes, your body is part of Big Nicotine’s experiment …” the text reads. “You’re not just their customer, you’re their lab rat.”

It’s all part of yet another fear-based campaign designed to demonize the use of safer nicotine products:  “UNDO: End Tobacco Damage Now,” is currently being promoted by the California Department of Public Health.

It is hard to imagine any other public health campaign around drug use referring to people as rats.

It brazenly insults people who use safer nicotine products. “Are you one of Big Nicotine’s lab rats?” the campaign asks. It is hard to imagine any other public health campaign around drug use—alcohol, say, or even something as stigmatized as fentanyl—referring to people as rats. The hatred and discrimination that’s long existed against people who use combustible tobacco has been transferred to those who want to quit cigarettes through harm reduction.

Crusades against nicotine are usually framed in terms of villains and victims, and both keep changing. The original villain, “Big Tobacco” became “Big Vape,” and now, “Big Nicotine.” The victims used to be people who smoked cigarettes. Now it is those making the healthy decision to switch to a safer nicotine delivery device.

As is always the case in these zealous anti-tobacco harm reduction campaigns, the lies are staggering. Even the campaign’s name—“End Tobacco Damage”—is a lie, when the focus is on products that contain no tobacco and that reduce damage to public health.

“You are part of “Big Nicotine’s experiment,” UNDO states. “Each use makes you part of an experiment with your health at stake.” Nicotine is an “addictive poison.”

Nicotine is not a poison; it is a mild stimulant drug that billions of people have consumed safely over thousands of years. It is used ceremonially, medicinally and recreationally. Moreover, no one who ingests it is being experimented on, because the effects of nicotine have been exhaustively studied. 

Note that people who use nicotine patches and gums are exempt from the label “lab rats,” are not part of an experiment, and aren’t seeing their products targeted for prohibition. Of course, “Big Pharma” sells these over-the-counter “poisons,” better known as nicotine replacement therapies.

The campaign section titled “What this poison can do to you” is so full of demonstrably false assertions that you might spontaneously combust!

Lighting tobacco on fire to get nicotine is the problem. With the invention of vapes, nicotine pouches, snus and heated tobacco products, there are many ways to use the drug that eliminate combustion and work as alternatives that people who smoke actually want to use. This is something to be celebrated, not vilified.

The campaign section titled “What this poison can do to you” is so full of demonstrably false assertions that you might spontaneously combust! Nicotine blocks the brain’s ability to pay attention, it claims. But it’s the opposite; nicotine increases attention and focus. Up next; “Nicotine can deepen depression and amplify anxiety.” It’s the opposite; nicotine has been shown to decrease symptoms of depression and anxiety.

Then UNDO offers this whopper: Nicotine poisons the body; it makes you “nic-sick.” It does not. If it did, no one would use it!

There is a strong whiff of desperation in these ads and videos attacking the use of safer nicotine products. That’s because over a decade of science irrefutably shows they are safer to use by orders of magnitude compared to cigarettes, and are more effective for quitting smoking than patches or gums. But with smoking on the decline, public health groups seek to justify their existence by presenting harm reduction tools as the enemy. Moral panic and funding are easier to generate for the innocent “victims” of youth vaping than for the people who genuinely face severe health risks: the predominantly marginalized populations that still smoke.

Happily, millions of people around the world have ignored offensive disinformation campaigns like this one and made the switch. That makes the forces opposed to tobacco harm reduction angry. Moreover, they hate that people who vape nicotine actually enjoy it. Over time, their drug-panic propaganda has become less effective, so they’ve doubled down on the shock tactics and deception.

Then there is the Food and Drug Administration (FDA), which has authorized vapes, flavored nicotine pouches and snus as “appropriate for the protection of public health.” This fact is conveniently omitted in attack campaigns like UNDO because it undermines all their bald-faced lies.

With the widespread use of snus, which the Swedish government promotes, Sweden has become the world’s first “smoke-free” country. This remarkable human achievement is also ignored.

Because the goal of “Big Tobacco Control” agencies like the California Department of Public Health is the opposite. They want to deny access to safer nicotine products that can save the lives of people who smoke. Who are the real rats?

Screenshot showing detail of UNDO video via YouTube

The post People Who Vape Are Lab Rats, Says California “Public Health” Campaign appeared first on Filter.

In an April 4 letter to CDC Acting Director Jay Bhattacharya, Dr. Pesko, professor of economics at the University of Missouri, urged the agency to reconsider the term “E-cigarette, or Vaping, Product Use-Associated Lung Injury,” or EVALI. 

The term was adopted during a highly publicized spate of cases in 2019, which the CDC and other health authorities rapidly implied were caused by nicotine vapes. This sparked alarm in the United States and around the world—causing many people to revert from vaping to smoking, and leading to global policy ramifications that reverberate to this day. 

Never mind that evidence soon indicated a different culprit; the damage to tobacco harm reduction was done.

“EVALI” still lumps together fundamentally different products in ways that mislead clinicians, the public and people who smoke.

Pesko wrote that the evidence points overwhelmingly to vitamin E acetate in unregulated, adulterated THC vaping products—not standard nicotine e-liquids—yet “EVALI” still lumps together fundamentally different products in ways that mislead clinicians, the public and people who smoke who might otherwise switch to less harmful alternatives.

It is vital that public health language should not spread confusion. Inaccurate terminology fosters public mistrust of our health organizations. Language shapes clinical assumptions, media framing, regulation and personal decisions. When the name of an outbreak points people toward the wrong product category, the misunderstanding can persist for years after the science has moved on.

The CDC has been asked this question before. 

In August 2021, Pesko and a group of distinguished colleagues led a petition signed by 75 multidisciplinary experts, including seven former presidents of the Society for Research on Nicotine and Tobacco, asking the CDC to retire the term EVALI. The signers argued that the name was “ineffective and misleading” because, in ordinary language, “e-cigarette” refers to nicotine vaping. They warned that the term was driving misperceptions, stigmatizing nicotine vaping and confusing both the public and health professionals.

The CDC refused.

The 2019 outbreak was time-limited and geographically concentrated. That pattern is consistent with a poisoning event—not with an inherent property of nicotine vaping products.

In its September 22, 2021 response, the agency acknowledged that most cases were linked to THC-containing products from informal sources and that vitamin E acetate was strongly linked to the outbreak. But it still declined to rename EVALI, pointing to residual uncertainty and to reports that 14 percent of patients said they had exclusively used nicotine-containing products. But such self-reports warrant caution, especially in places where cannabis use remains banned, giving people a clear incentive not to disclose it. 

The CDC’s decision may have sounded cautious. In practice, it has been costly.

The central facts have been clear for years. The 2019 outbreak was time-limited, geographically concentrated and strongly associated with a contaminated THC supply chain. It peaked in September 2019 and faded rapidly by early 2020. That pattern is consistent with a poisoning event—not with an inherent property of nicotine vaping products that had already been used for years.

Tobacco harm reduction expert Clive Bates put the logic bluntly in 2021: The evidence indicates that nicotine vaping was not the cause of the outbreak. Vitamin E acetate was the identified contaminant. It served an economic purpose in unregulated THC oils. It is not soluble in the propylene glycol and vegetable glycerin base used in nicotine e-liquids. And no parallel change in nicotine products explains why the outbreak rose and fell when it did.

That conclusion also fits what careful reporting uncovered in real time.

Polling showed that after the outbreak and the flood of media coverage, two-thirds of respondents associated the deaths with “e-cigarettes such as JUUL.”

Early in the crisis, investigators and journalists followed a trail through illicit-market THC cartridges, thickening agents, counterfeit packaging and fly-by-night brands like Dank Vapes. Reporting from Leafly, Inverse, Columbia Journalism Review and Filter documented how unregulated THC carts are often filled using tainted additives to mimic purity and stretch profits. New thickening agents had entered this market in late 2018. Vitamin E acetate emerged as a prime suspect because it was widespread, newly popular, cheap and found in the products used by sick patients.

Meanwhile, the very term EVALI nudged the public toward the wrong conclusion.

The 2021 experts’ letter cited polling showing that, after the outbreak and the flood of media coverage, two-thirds of respondents associated the deaths with “e-cigarettes such as JUUL,” while only 28 percent associated them with “marijuana or THC e-cigarettes.” That is not a harmless misunderstanding. It is a failure of risk communication. When the CDC’s label points people toward nicotine vaping, many people will never make it to the fine print.

Worse, as Pesko and the other experts warned, the confusion appears to have had behavioral consequences.

A 2021 article summarizing new evidence reported that the EVALI scare was associated with a sharp drop in nicotine vape sales and an immediate rise in cigarette consumption in both Massachusetts and around the US.

The damage did not stop there.

Once a misleading name takes hold, it spreads through hospital coding, state data systems and clinical practices. The misnamed EVALI outbreak heightened health care provider wariness, and later coding changes made it easier to tag visits as a “vaping-related disorder” without distinguishing the substance involved. Old panic can then live on in new datasets, where nicotine, THC, smoking and unrelated illness blur together.

The CDC cannot undo the frightened headlines from 2019. It cannot persuade every person who went back to cigarettes. But it can stop repeating the mistake.

The 75 experts proposed one replacement, ATHCVALI: Adulterated THC Vaping Associated Lung Injury. Whether or not that is the perfect substitute is almost beside the point. The larger issue is that the current label remains anchored to the confusion of the outbreak’s earliest days, not to the evidence. 

Pesko’s new letter takes a restrained approach. It does not demand a specific acronym. It simply asks the CDC to revisit its terminology in light of the evidence and the real-world consequences of continued conflation.

The CDC should do exactly that. It should clearly state, without hedging, that the 2019–2020 outbreak was driven by adulterated THC vaping products, especially those contaminated with vitamin E acetate.

The CDC cannot undo the frightened headlines from 2019. It cannot reopen the vape shops that went under because of the panic. It cannot persuade every person who went back to cigarettes because they were falsely told, directly or by implication, that nicotine vaping had caused a wave of damaged lungs and death.

But it can stop repeating the mistake.

Photograph (cropped) by Reed Mansour via Flickr/Creative Commons 2.0

The Influence Foundation, which operates Filter, has received unrestricted grants from Juul Labs, Inc. Filter‘s Editorial Independence Policy applies.

The post Will the CDC Finally Abandon the Damaging Term “EVALI”? appeared first on Filter.

The “expert consensus report” was published in the European Heart Journal in December. A bombastic accompanying press release from the European Society of Cardiology declared, “Vapes, pouches, heated tobacco, shisha, cigarettes: nicotine in all forms is toxic to the heart and blood vessels.”

“The narrative of ‘safer nicotine’ must end.”

It quotes one of the report’s authors, Professor Thomas Münzel of University Medical Centre in Mainz, Germany, as stating: “The narrative of ‘safer nicotine’ must end.”

Presumably, it would be replaced by a narrative that all forms of nicotine use—from the cigarettes that cost millions of lives each year to harm reduction alternatives right through to NRT—are equally risky.

“Nicotine is not a harmless stimulant; it is a direct cardiovascular toxin,” Münzel said. “Our findings show that nicotine itself, even without the multitude of toxic combustion products, tar, or free radicals present in cigarette smoke, drives cardiovascular damage.”

Referring to adolescent use, he warned that without tighter controls, “we risk losing an entire generation to nicotine addiction.”

The authors call for a range of measures to be introduced across Europe, including flavor bans for all nicotine products, taxation that is “proportional to nicotine content,” and other restrictions on use, sales and advertising.

But the report has drawn fierce criticism from health professionals and scientists, who have attacked both the validity of its findings and its explicit policy goals.

“This article is not a scientific study,” said Dr. Jasmine Khouja, a psychologist at the University of Bath in England, in one critique;  “the four experts in cardiology who wrote it describe it as an expert review, but no experts in vaping or nicotine research were included.”

She noted the report’s “strong claims that are backed by no/limited evidence or have contradictory evidence that is not discussed,” and “multiple instances where the authors use irrelevant citations to support their claims … or make misleading claims.”

“The authors’ slogan of ‘one message, one risk’ represents a failure in health communication.”

Dr. Konstantinos Farsalinos is himself a cardiologist, and a research associate at the University of Patras and the University of West Attica in Greece.

“The authors’ slogan of ‘one message, one risk’ represents a failure in health communication,” he told Filter. “While nicotine is not risk-free, there is an undeniable continuum of risk, with a massive gap” between combustibles and safer alternatives.

The clear risk of such messaging, he said, is that people who smoke will be misled into believing there is no benefit in switching to safer, potentially life-saving alternatives.

The report, Farsalinos continued, attributes health threats to nicotine based largely on acute physiological markers, while ignoring extensive epidemiological evidence.

Among other examples, he pointed to a study from South Korea that followed 18,000 people who smoked and had undergone percutaneous coronary intervention, and who variously continued smoking, switched to vapes or quit nicotine entirely. Those who switched and those who quit saw similar reduction in their risk of Major Adverse Cardiac Events (MACE) in the following years.

Sweden, a country that has embraced snus and nicotine pouches as safer alternatives to cigarettes, giving it the world’s lowest smoking rate, is another case in point. Its population offers no evidence that nicotine, without the combustion, equates to poor cardiovascular health.

Dr. Polosa was “shocked” that the report failed to address “strong epidemiological evidence” around Swedish snus from large cohort studies.

“The Swedish cohort data do not support the fantasy that nicotine in oral products produces the [same] cardiovascular profile as tobacco smoking,” Dr. Riccardo Polosa, professor of internal medicine at the University of Catania, Italy, told Filter.

He added that he was “shocked” that the recent report failed to address “strong epidemiological evidence” around Swedish snus, derived from large cohort studies.

“After adjustment for confounders, oral nicotine use was not associated with myocardial infarction, heart failure, atrial fibrillation, or cardiovascular mortality,” he said, “highlighting the importance of combustion versus nicotine per se.”

Needless to say, Farsalinos is no fan of the report’s policy recommendations either.

“The fact that lethal cigarettes are sold legally across Europe while their far lower-risk alternative, snus, is banned [in the EU, except Sweden] is not a regulatory success—it is a public health scandal,” he said. “Demonizing nicotine is scientifically unjustified and serves only to perpetuate the smoking epidemic.”

On that note, the report even attributes “vascular harm” to passive vaping.

In 2025 Europe became the continent with the highest smoking rate, according to the World Health Organization, at 24.1 percent. But to Münzel and his co-authors, the threat comes from elsewhere.

“The next heart attack, the next stroke, the next cardiovascular death may not come from a cigarette, but from a flavoured pod, a nicotine pouch, or a waterpipe in a café,” he said in the press release. “If Europe fails to act now, we will face the largest nicotine addiction wave since the 1950s.”

European advocate Damian Sweeney sees the report’s policy agenda against safer nicotine products as deliberately timed.

Damian Sweeney, an Irish advocate and partner with the consumer advocacy group European Tobacco Harm Reduction Advocates (ETHRA), sees the report’s policy agenda against safer nicotine products as deliberately timed.

“It’s not a coincidence that this report, which is essentially an opinion piece masquerading as an evidence-based scientific report, was published just a few days after the adoption of the EU Cardiovascular Health Plan,” he told Filter.

ETHRA participated in the call for evidence for that plan, regarding the cardiovascular implications of tobacco and nicotine use and the benefits of switching to smoke-free alternatives, but was disappointed by the outcome.

“Both documents fail to acknowledge the relative risk of nicotine products, and [that] the harms to heart health are due to toxic byproducts of combustion, not merely using a nicotine product,” Sweeney said.

He dismissed the European Heart Journal report as “little more than a lobbying document” seeking to influence the upcoming revision of the Tobacco Products Directive, which places limits on the sale and merchandising of tobacco and related products in the EU. Proposals from the European Commission are expected at the end of 2026.

Other relevant situations that the report could be looking to sway include the European Parliament working on its cardiovascular diseases strategy, with discussion ongoing in the SANT Committee on public heath. A proposal for a revised taxation directive was also published in July, Sweeney noted, and is now being discussed by EU member states.

In stark contrast to the report, Farsalinos said, “harm reduction has been proven as an essential tool if we want to accelerate the decline in population smoking rates.”

Photograph (cropped) by Madison Oren on Unsplash

The Influence Foundation, which operates Filter, formerly received grants from Global Action to End Smoking and Juul. Dr. Polosa founded the Center of Excellence for the Acceleration of Harm Reduction, which has received grants from Global Action to End Smoking, and Dr. Farsalinos received a consulting fee from Juul in 2018. Filter‘s Editorial Independence Policy applies.

The post Nicotine a Heart Threat, Per “Expert Consensus Report.” Experts Disagree. appeared first on Filter.

Research has shown that majorities of doctors around the world, including in the United States, falsely believe that nicotine, in and of itself, causes cancer, chronic obstructive pulmonary disease (COPD) or other smoking-related illnesses.

When medical providers conflate nicotine with combustible tobacco, patients who smoke are discouraged from pursuing tobacco harm reduction (THR). They might be wrongly advised, for instance, that vaping is as bad for you as smoking, and told not to switch. They’re denied the most successful smoking-cessation options we have: safer nicotine alternatives like vapes, heated tobacco products, pouches or snus.

For many, this missed opportunity will be deadly.

Australia is prominent among countries where nicotine vapes have been demonized by politicians and health authorities. Its highly restrictive prescription-only model meant those who wished to switch to vapes could only access them through a doctor, if at all. When most of those doctors don’t know that vapes are exponentially safer than cigarettes, this model effectively amounted to prohibition. Australia’s bid to cut smoking rates duly stalled.

In October 2024, Australia slightly loosened its policy. Adults can now buy a limited selection of vapes from participating pharmacies, after a consultation with a pharmacist. But those who wish or need to vape at a concentration higher than 20 mg/ml still need a prescription. It remains a hostile landscape.

“There are many people in the health industry who do not want to get involved in THR. Some have expressed that the subject is too controversial.”

One Australian medical professional was deeply unhappy with how many of her colleagues remain ignorant about nicotine, including those meant to act as its gatekeepers. She knew—from personal experience—about the benefits of THR. So she took action, by discreetly organizing education sessions inside a hospital.

Due to how Australian health authorities might view this, and the potential consequences for her, she spoke with Filter on condition of anonymity. Our interview has been edited for length and clarity.

Kiran Sidhu: How was this project conceived? 

Australian Medical Professional: The idea was born after hearing a young doctor give incorrect information to a patient about the dangers of nicotine—not tobacco. I then witnessed a senior doctor correct the young doctor that the dangers are the chemicals in cigarettes, not the nicotine. 

I was annoyed and disappointed with the young doctor, but nurses never correct a doctor in front of a patient. I spoke to the senior doctor the following day, and he, too, was frustrated with skilled medical professionals ignoring scientific evidence and instead “repeating unsubstantiated information from the internet.”

I brought up the idea of education sessions to him; we then spoke to one of the oncologists, and with the help of another person, the sessions started to be designed a week later. At that time, we did not know if the hospital would allow the sessions, but we pushed ahead with correlating the most reliable peer-reviewed data whilst waiting for the hospital’s decision.

“The advice was that we should aim to help the attendees feel comfortable, and not feel they were being judged.”

KS: Can you give us a breakdown of what a session looks like? What are the key messages you’re trying to get across? 

AMP: The sessions are being conducted in conference rooms in a hospital. They run for 90 minutes. Attendees are mainly doctors, nurse practitioners and medical students. The average number of attendees per session is 40 to 60. The sessions have been designed to be informal and non-biased. We want to educate, not alienate.

Our aim is to separate the researched and well-known impact of tobacco use on the body, and re-focus the attention on how nicotine affects the body.

I consulted with two friends, one a psychologist and another who does university lectures, on how to go about the sessions. This topic is controversial; the advice we received was that we should aim to help the attendees feel comfortable, and not feel they were being judged. We were also encouraged that a few jokes thrown in would assist in making the sessions enjoyable and the attendees more receptive.

One example was: “It seems no one needs to listen to highly trained doctors like yourselves anymore. They can now rely on the accuracy of Dr. Google and social media influencers.” That works to bolster their self-esteem and to highlight the dangers of where a considerable amount of misinformation is coming from.

Although I am present, I do not host the session—we have an ex-university medical lecturer conduct them. We have a Q&A afterwards. We have had a guest pharmacologist attend two sessions to explain the pharmacokinetics and pharmacodynamics of nicotine. That data has been used in other sessions and is incredibly important, as it supports the peer-reviewed studies we use. To date, we have had five sessions. It is unlikely that we will have another session this year due to time restrictions.

KS: Have the people attending the sessions generally been receptive? Have there been any hurdles? 

AMP: Overall, we have received more positive feedback than negative. Several attendees have attended more than one session. Some have thanked us afterwards for the information.

There are many people in the health industry who do not want to get involved in THR or even conversations about NRT or nicotine. I don’t know all their reasons, but some have expressed that the subject is too controversial. Some want people to quit smoking using therapy, Champix, hypnotherapy, etc. 

“Some attendees did state that nicotine causes cancer.” 

KS: What’s to blame for this absolute stance against THR?

AMP: As the sessions were on nicotine itself, rather than THR or vapes, that is impossible to answer based on the sessions themselves.  It could be the “EVALI” outbreak, the “popcorn lung” lie, the government’s hard stance, and the lack of studies on nicotine usage not associated with tobacco smoking. 

We assume that it’s a combination of all the above, and doctors are fearful of suggesting any product that could lead to a malpractice case. 

I can only state from the doctors who spoke to us after the sessions that a few years ago, they had included nicotine vapes as a smoking cessation tool, especially if the patient had already tried other traditional, medically accepted treatments.

KS: What have you found are the most commonly held misconceptions about nicotine among the medical professionals at the sessions? 

AMP: The misconceptions that we have encountered are that there is a link between nicotine and cardiac and lung disease. Some did state that nicotine causes cancer. 

We countered the misconceptions with multiple studies. Highlights from the studies and links were part of the PowerPoint presentation. We had hard copies of the literature and studies for them to take with them.

I can’t answer whether there was surprise about the truth of nicotine. Doctors tend to be quite guarded about what they believe to be true or false.  

KS: What difficulties do health providers encounter when recommending or prescribing vapes? 

AMP: Presently the biggest issue we have heard is that doctors do not recommend them, as they do not have enough information from evidence-based studies.

We would like more universities and researchers to conduct unbiased nicotine studies.  We need more studies comparing the health of smokers who have smoked for a similar length of time who quit using nicotine harm reduction and have the same health tests done at routine intervals. 

Personally, I experience the gamut of emotions over nicotine falsehoods and vaping lies that I’m sure most who are fighting this battle feel. At times, I want to yell at people who are so closed-minded and refuse to look at the facts. It is exhausting, and at times I feel very low and defeated, to the point where it affects my mental health. That is when I take a step back and re-immerse myself back into everyday life. I regain my strength and come back fighting harder each time.  

It is so frustrating that I, and so many others, are living healthier lives that we never thought possible because, when we were smokers, most of us knew the risks associated with the habit. We owe our futures to vaping, THR and NRT.  But it’s impossible to get some people to understand. 

“We are already helping other people around the country who want to do something similar. Doctors are in a unique position, and they need to learn the truth.”

KS: How, if at all, are medical providers changing their practices having learned about nicotine in your sessions? 

AMP: It’s too early to determine what the long-term benefits of the sessions will be. However, due to the sessions, two general practitioners who did not include e-cigarettes as a method for smoking cessation now include them as an option for patients. 

KS: What are your future plans for the project? 

We are hoping to take the sessions out of the hospitals altogether and use private conference rooms. At present we believe the number of people attending is a good number. We are already helping other people around the country who want to do something similar. There are more of us working on this now.

Our goal is the same: We want doctors to unite in a common cause of defeating smoking-related illnesses and deaths, by accepting that not every person can quit smoking using traditional methods.  

Doctors are in a unique position; they know that people think, behave and react differently. What works for one person doesn’t work for another. The onus is on medical professionals to change the dialogue about nicotine and THR, and they need to learn the truth and keep repeating it. Governments should not be controlling and removing a product that can save, and is saving, lives. In short, we want to keep teaching the science of nicotine to as many medical professionals as possible.

Photograph (cropped) by Cory Mogk on Unsplash

The post Inside One Hospital, a Discreet Project Fights Doctors’ Nicotine Bias appeared first on Filter.

The eight month-long investigation was coordinated by the AG’s Organized Crime Task Force and was part of the Suburban and Upstate Response to the Growing Epidemic Initiative (SURGE). Since 2017, SURGE has led to the arrests of 1,008 alleged traffickers. 

When announcing the seized fentanyl in a press release, James relied on tired drug-scare tactics, stating, “23 pounds of fentanyl is enough to kill one New Yorker every six seconds for an entire year.” The statistic was repeated by journalists.

This would mean that 5,256,000 people would fatally overdose after consuming roughly 2 milligrams of fentanyl each—the lethal amount reported by the Drug Enforcement Administration (DEA). On its website, the DEA depicts the drug’s lethality with a photo of a small amount of fentanyl placed on a pencil tip. 

The truth is that many other factors besides dosage—including a person’s tolerance, biology and route of ingestion, their proximity to harm reduction resources and the nature of any adulterants in the substance they use—all play a role in determining whether or not 2 mg of fentanyl proves fatal.

The message is clear: Fentanyl produces “mass destruction,” and large-scale arrests make our communities “safer.”

Certainly, fentanyl overdoses are deadly; in 2024, fentanyl was involved in almost 90 percent of fatal opioid overdoses across New York State. Yet James’ statistic is more rhetoric than reality: It presumes an inherent dangerousness within fentanyl that puts the public, and New Yorkers in particular, at risk. Drug arrests, the logic follows, save lives.

Onondaga County Sheriff Tobias Shelley (D) echoed this sentiment in the press release. Praising the “collaboration between local and state law enforcement,” he claimed: “Taking these dangerous drugs and weapons off the streets will save lives and make our neighborhoods safer. The individuals charged today were trafficking quantities of fentanyl capable of mass destruction, and their arrests send a clear message that we will not tolerate this.” 

Syracuse Police Chief Joseph Cecile added, “I want to thank the Attorney General’s office, and all our law enforcement partners throughout the state for always being willing to collaborate to make our communities safer.”

The message is clear: Fentanyl produces “mass destruction,” and large-scale arrests make our neighborhoods and communities “safer.”

But massive drug sweeps—enabled and incentivized by our drug policies—are frequently deadly.

As drug policy scholars have long known, prohibition incentivizes people in the drug trade to transport compact, potent substances to avoid detection; this has been referred to as the “iron law of prohibition.” “[T]he harder the enforcement, the harder the drugs,” economist Richard Cowan put it when coining the term.

Arresting people who sell drugs also forces buyers to navigate an unpredictable market as new sellers fill the gap. Research has indicated that local overdose mortality increases in the immediate aftermath of a drug bust.

Simply put, when drug raids happen, communities become less safe. Drug-war policies, to adopt the Sheriff’s terminology, are capable of mass destruction.

I interviewed people who use drugs when researching the opioid-involved overdose crisis and mass policing, surveillance and incarceration in New York’s Southern Tier. Nate (a pseudonym) shared that, after Operation Get Money in Binghamton, which resulted in the arrests of seven people and the seizure of 2,700 bags of heroin in 2016, consumers started “tapping bags” with fentanyl. 

“Everyone was panicking,” he told me. “People were tapping bags, because they didn’t have the real stuff anymore…They had to get something to recoup, and they didn’t know what else, so everybody started going to the black market [the internet], getting fentanyl, and cutting it. Boom, everybody’s dying… ‘cause everything is gone. It was like a frantic running around trying to figure out what to do.”

Prioritizing drug arrests over health care and harm reduction services puts consumers at additional risk of drug-related illness, injury and death. People are forced to inject quickly in public spaces to reduce the risk of being arrested, and many must do so with drugs that have untested potencies and compositions. 

Overdose prevention centers, syringe service programs and accessible drug-checking strips not only humanize people who use drugs but reduce fatal overdoses. Yet such programs’ budgets are dwarfed by police budgets, despite the fact that drug sweeps counteract New York’s stated commitment to harm reduction.  

Simply put, when drug raids happen, communities become less safe. Drug-war policies, to adopt the Onondaga Sheriff’s terminology, are capable of mass destruction: They put consumers at increased risk of overdose; make people who sell drugs out to be monsters in need of swift punishment; and engender a vengeance-seeking public caught in a cycle of retributive violence. 

If New York aims to prioritize accessible health care and harm reduction services, then the state needs to disinvest in drug-war policing. Only then can the staggering overdose rate truly be addressed.  

Drug enforcement is not complimentary to harm reduction; it is contradictory to it.

Photograph via the Drug Enforcement Administration

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The World Health Organization ended 2024 by tweeting, “WHO continues to fight against misinformation and disinformation—a great challenge to global health. Governments, health agencies, and partners need to safeguard public trust by responding to misinformation and disinformation directly and effectively.”

But the WHO constantly deploys misinformation as it continues its anti-vape campaign, refusing to embrace harm reduction for the world’s leading cause of preventable death despite doing so for other forms of drug use.

WHO entities have falsely claimed that vaping causes seizures, isn’t safer than smoking tobacco, is “designed to kill,” and is a “gateway” to smoking.

On May 31, the day after World Vape Day, the WHO will spearhead World No Tobacco Day—an event that now targets all nicotine use, including the safer forms that replace cigarettes.

WHO entities have falsely claimed that vaping causes seizures, isn’t safer than smoking tobacco, is “designed to kill,” and is a “gateway” to smoking.

Earlier in May, a tweet by WHO Europe that sounded like a preference for young people to smoke instead of vape was deleted—a year after receiving a Community Note.

As those of us in the nicotine space turn our attention towards November’s COP11— the WHO’s next meeting on the Framework Convention on Tobacco Control, with global policy implications—I think about the people who use nicotine and are banned from attending and denied a voice. I think about how stigmatized they are by the WHO and others in tobacco control.

The WHO isn’t the only source of the floods of misinformation that harm reduction advocates try to stem. Misinformation is widely disseminated by leading health officials, government agencies, lawmakers, public health organizations, journalists, concerned citizens, and individuals on social media, as well as by some universities and scientists.

Some scientists are prematurely releasing what they think their findings will be, leading to scaremongering headlines that fuel more misperceptions.

Publishing research should be a meticulous process with many checks, culminating in peer review. But some scientists, perhaps hungry for publicity, are prematurely releasing what they think their findings will be, leading to scaremongering headlines that fuel more misperceptions about vaping. In 2024, for instance, one unpublished study led to loud media claims that vaping causes heart failure. Another unpublished study led to widespread news stories saying that vaping causes heart disease, organ failure and dementia.

The myth that vaping causes “popcorn lung” was debunked 10 years ago, yet advocates had another busy year correcting that misperception. This past year also saw false claims that vaping is a leading cause of cancer, with a claim that dual use of cigarettes and vapes can quadruple lung cancer risk.

Since the last World Vape Day, there has also been a proliferation of scary stories about the chemicals found in vapor products, equating them to bug spray, weed killer or antifreeze.

While the evidence is clear that vaping helps many people stop smoking, the public is repeatedly told it doesn’t. Some organizations, such as the American Lung Association, have gone as far as claiming that switching to vaping isn’t quitting smoking.

In the past year, some countries, like Vietnam and Kazakhstan, banned vapes, while Mexico wrote its vape ban into its constitution.

Even though you can’t smoke a vape because there’s no combustion, some groups call vaping smoking. The Health Center at Hudson Yards, which calls vaping the “latest smoking trend,” is one of many examples. They, like many others, falsely claim that youth vaping is going up in the United States; in fact, youth vaping is at its lowest levels in a decade. 

None of them are celebrating the public health win of record-low rates of youth smoking.

Being misled about the relative risks of vaping and smoking is not the only barrier consumers face. Onerous policies can prevent people from quitting smoking or push them to a riskier, unregulated vape market. Comparing New Zealand with Australia, for instance, shows the stark difference in outcomes arising from pro- and anti-vape policy landscapes.

In the past year, some countries, like Vietnam and Kazakhstan, banned vapes, while Mexico wrote its vape ban into its constitution. Other countries, like Ireland, are raising taxes on vapes, while France and Belgium have banned disposable vapes and the United Kingdom will do so from June 1.

European countries are exploring banning vaping in outdoor public spaces. Slovenia and Latvia banned flavored vapes, while US advocates suffered disappointment at the Supreme Court in their bid to guarantee availability of flavors on which many adults rely to quit smoking. In Singapore, where vaping is illegal, a person caught vaping can be fined up to $2,000.

What’s extraordinary in this light is that the tobacco harm reduction movement is still gaining momentum.

What’s extraordinary in this light is that the tobacco harm reduction movement is still gaining momentum. One simple reason is that consumers are leading the way. People are seeing through misinformation or circumventing bad regulations in order to switch away from smoking in the tens of millions.

And despite the obstacles, advocates for vaping and other safer nicotine products are not backing down. They are a testament to the power of determination—born of a fundamental belief in the human right to access tools that help people quit smoking.

On a global scale, vaping advocates of all political persuasions are united in their common mission. Their efforts have led to significant victories, defeating measures such as flavor bans, punitive taxes, registry bills, and outright vape bans at all levels of government.

In Thailand, amid a ban on vape sales and law enforcement raids, a government committee that includes consumers was established to provide policy recommendations. Advocates in Panama initiated a lawsuit to have the ban on vapes declared unconstitutional—and won. Recently, advocates in Costa Rica halted a decree that would have banned all tobacco harm reduction products.

Chile enacted balanced regulations that define vapes independently, instead of conflating them with combustible tobacco. Peru went from an unregulated vape market to a regulated one. Brazil clarified the language of its vape ban, making clear that possession for personal use is not a crime.

While many of these victories were only partial, all were steps in the right direction. The lesson is that in the fight for vaping rights, activism matters. When consumers come together to advocate for their rights and health, they can have a powerful influence on policy and effect positive change.

Countless more battles lie ahead. But let’s take these successes as a beacon of hope—and amplify and replicate them for all we’re worth on World Vape Day and beyond.

Photograph (cropped) by Richard R. Schünemann via Unsplash

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Calling Commissioner Varhelyi “out of touch with the basic science on safer nicotine products,” European advocates have requested that he meet with scientific experts and consumers who could correct his misperceptions.

This comes as anti-vape policies unfold around the European Union, which experts fear will prolong smoking-related disease and death.

On May 13, at a meeting of the European Parliament’s environment committee, Varhelyi claimed that vaping “has created completely new health risks that are comparable to, or even greater than smoking itself.”

That comparison with smoking is utterly false. The benefits of switching from combustible cigarettes to vapes are well documented by researchers and prestigious institutions. The most notable attempt to put a figure on it estimated that vapes are 95 percent safer than cigarettes.

The supposed evidence that Varhelyi cited in support of his contention included articles claiming that vaping causes “popcorn lung”—a persistent myth that has long been debunked.

“To hear the commissioner repeat the myth that vaping causes popcorn lung is quite concerning, especially as it was said during a committee meeting with MEPs.”

On May 23, European Tobacco Harm Reduction Advocates (ETHRA), a consumer organization advocating on behalf of the millions of people who use nicotine in the EU, responded by sending a letter to Varhelyi, criticizing his “factually incorrect and baseless assertion that vaping causes popcorn lung.”

“To hear the commissioner repeat the myth that vaping causes popcorn lung is quite concerning, especially as it was said during a committee meeting with MEPs,” ETHRA Partner Damian Sweeney told Filter.

“Popcorn lung” was originally observed in factory workers exposed to a chemical called diacetyl, used to give popcorn a buttery taste. Extreme exposure to diacetyl has been associated with the lung disease bronchitis obliterans. However, only trace amounts of diacetyl have ever been used in some vaping e-liquids; diacetyl is banned as an ingredient in many places—including under the EU’s Tobacco Products Directive, though this is not always consistently enforced.

Even where it is present, the mere presence of a chemical does not equate to a quantity sufficient to cause harm. And there have been zero confirmed cases of vaping causing “popcorn lung.”

ETHRA’s letter notes that “the most likely way for diacetyl to emerge in vapes in the EU is through unregulated illicit trade, and not legally available nicotine vapes.” And illicit trade, as the letter points out, “will be driven by excessive and counterproductive EU regulations, such as flavor bans, that deny adult consumers the products they wish to use.”

“The concern for us as consumers is that false statements could influence MEP decisions and lead to further restrictions or even bans on safer nicotine products.”

It’s anticipated that the EU Commission may publish proposed revisions to the Tobacco Products Directive, the law regulating the manufacturing and sale of tobacco and related products in the bloc, in the next year. If that happens, MEPs will have the opportunity to discuss and amend the proposals in the committee stage before a full vote on the legislation.

“The concern for us as consumers is that false statements such as ‘vaping causes popcorn lung’ could influence MEP decisions and lead to further restrictions or even bans on safer nicotine products,” Sweeney said. “Policy decisions should be based on science and facts—not fiction.”

To point Commissioner Varhelyi toward the former, ETHRA has requested a meeting with him, so he can hear from people who use safer nicotine products and from scientists with extensive tobacco harm reduction research experience.

“If the Commission cares about how policy decisions affect EU citizens, then they absolutely should meet with groups like ETHRA, who represent millions of consumers,” Sweeney said. “However, I would say that a meeting is unlikely but not impossible.”

Ironically, as tobacco harm reduction proponent Peter Beckett has noted, Vahelyi flagged the dangers of misleading health information while seeking election for his current role in 2024.

“Protecting European citizens from harmful effects of disinformation will be top priority for me, including in the area of health,” said the Hungarian nominee in a written statement to MEPs.

He’s far from alone in spreading it. In February, EU Climate Commissioner Wopke Hoekstra told a different parliamentary committee that “vaping kills,” as he advocated for higher nicotine taxes.

As health commissioner, one of Vahelyi’s responsibilities is the European Beating Cancer Plan, which aims to reduce cancer rates by cutting smoking to below 5 percent of the EU population by 2040.

Smoking is the EU’s biggest cause of deaths from cancer. Meanwhile there is no good evidence that vaping causes cancer in humans, and widespread evidence that vapes prompt mass smoking cessation in countries where they are readily available. 

Photograph of Varhelyi in 2019 by European Parliament via Flickr/Creative Commons 2.0

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Individuals and groups who receive no funding from the tobacco or vape industries may nonetheless be characterized as nefarious agents of those interests—a cheap way for opponents of THR to dismiss arguments without troubling to grapple with their merits. For media, such claims are often about eyeballs.

That’s why a recent ruling from New Zealand’s Broadcasting Standards Authority (BSA) carries such significance.

ASH (Action for Smokefree 2025) is an organization campaigning for smoking cessation and THR in New Zealand. It’s funded by its members, and by donations and grants. It does not accept funding from the tobacco, vape, nicotine or pharmaceutical industries.

But ASH NZ found itself under attack in a July 26, 2024 TV broadcast by ThreeNews—a New Zealand news bulletin, produced by the media company Stuff, which airs on a channel owned by Warner Bros. Discovery.

A ThreeNews reporter interviewed ASH Director Ben Youdan without informing him of the true nature of the story—which was ultimately presented as a special investigation into alleged links between ASH and the “pro-vaping lobby” in Australia.

This centered, as the BSA ruling expressed it, on “an alleged ‘pro-vape lobbyist’ who was reported as having received funding from vaping companies and having facilitated a trip by [Youdan], to Australia to ‘promote’ New Zealand’s vaping policies.”

For what it’s worth, New Zealand’s pro-vape policies have had far better public health outcomes than Australia’s heavy restrictions on vapes. And Youdan’s trip was not paid for by industry funding.

The broadcast included the ThreeNews allegations and clips of Youdan, interspersed with a clip of a spokesperson from the organization Vape Free Kids, who said, “We’ve learned that the words ‘harm reduction’ are a battle cry for the tobacco industry and their friends.”

ASH NZ complained about this set-up to Warner Bros. Discovery, but the company rejected its complaints. So ASH referred the matter to the Broadcasting Standards Authority.

“These stories appeared intentionally slanted against ASH and the broadcaster persisted with that narrative despite having information to the contrary.”

The BSA found in its March 26 ruling that the broadcast “had the potential to cause harm under each of the three standards nominated—fairness, balance and accuracy—which outweighed the broadcaster’s freedom of expression and is significant enough to warrant our intervention.”

The broadcaster’s failings, which the BSA described as “at the higher end of the spectrum of seriousness,” included misleading ASH about the nature of the story prior to the interview, omitting important facts, and not giving ASH a fair right of reply to the allegations.

A second ThreeNews broadcast, on July 30, 2024, was also subject to the ruling. This was portrayed as a “breaking news” story, focusing on a school’s reluctance to participate in a survey on smoking and vaping due to its concerns over ASH’s stance on vaping.

ASH’s “multiple complaints” about that broadcast, as it explained in a press release, included that ThreeNews “omitted the crucial fact that correspondence from the school was from 2021, and had been responded to despite being labeled breaking news.”

The BSA found that the item demonstrated “shortfalls,” and failed to include central information that would have made a difference to viewers’ opinions.

“These two ThreeNews broadcasts fell short of the standards the public expects of New Zealand broadcasters …” the BSA concluded. “These stories appeared intentionally slanted against ASH and the broadcaster persisted with that narrative despite having information to the contrary, causing serious damage to the reputation of a charitable entity and its director.”

The BSA has now ordered Warner Bros. Discovery to publish a statement conveying the decision, and to pay costs to ASH NZ and the Crown.

The ruling, Youdan said, “rightfully erodes trust in those who are using dirty tactics to undermine the evidence.”

Reflecting on the decision, ASH Director Youdan told Filter that it’s “a very significant ruling for New Zealand, and at a level of seriousness rarely seen.”

Asked if he saw it as a victory for THR, he replied that “it’s not about a victory, but about holding people across the spectrum of harm reduction debate to account.”

“This includes those reporting on vaping and other products,” he continued. “I hope the outcome is to encourage balance, and more responsible reporting rather than sensationalism.” 

The ruling and penalty imposed by the BSA, Youdan said, “rightfully erodes trust in those who are using dirty tactics to undermine the evidence.”

Youdan explained how New Zealand has made substantial progress in reducing its smoking rate over the decades, and how harm reduction—including people switching to vapes and heated tobacco products—has played a big role in continuing that decline in recent years.

However, “it is frustrating when progress is undermined by a debate that has deteriorated to attacking reputation and integrity,” he said. “We hope this decision will help us return to a far more respectful and balanced discussion.”  

That wish is echoed by Colin Mendelsohn, a doctor and longtime THR advocate from Sydney, Australia, who has written for Filter. He has endured a number of similar experiences of being smeared.

“I was portrayed on a national television program as a representative of Big Tobacco. The television network denied any wrongdoing until I hired a lawyer.”

Dr. Mendelsohn explained that he has conducted advocacy at his own expense. He has never received funding from the tobacco or vape industries. But that hasn’t stopped media outlets saying that he has.

“I was portrayed on a national television program as a representative of Big Tobacco,” he told Filter. “The television network denied any wrongdoing until I hired a lawyer and took the matter to the national television regulator. A ruling was made in my favor and an apology issued.”

The Australian Media and Communications Authority issued this ruling against Channel 7 Sydney in June 2024, as Mendelsohn described in his blog. 

In addition, “Anti-vaping advocates have repeatedly tried to block my presentations, teachings and media articles,” Mendelsohn said. 

In 2022, an invitation to present the evidence on vaping at a leading Sydney hospital was withdrawn, Mendelsohn recounted, after a professor falsely and secretly accused him of being funded by a tobacco company. 

One of Mendelsohn’s peer-reviewed publications was almost retracted, he continued, based on a fabricated conflict-of-interest claim. That was only reversed after he spent thousands on legal representation. 

“These personal attacks are unfortunately common and are a sign of desperation,” Mendelsohn said. “When critics can’t win the scientific argument, they attack the messenger. The aim is to undermine our credibility and discourage advocacy—a form of censorship.”

Youdan agreed that instead of valid debates over differences in opinion, the THR field is facing “increased efforts to attack integrity and reputation, however tenuous or untrue.”

“Such smear campaigns are often anonymous, which makes them harder to refute,” Mendelsohn said. “While these attacks once strengthened my resolve, over time they wear you down.”

Smears can divert advocates from important work, costing them considerable time, money and emotional energy.

“Such smear campaigns are often anonymous, which makes them harder to refute,” Mendelsohn said. “While these attacks once strengthened my resolve, over time they wear you down and affect your effectiveness.”

All of this contributes to a wider climate of fear in tobacco harm reduction, with flimsy-to-nonexistent connections to industry funding being used by anti-THR groups to exclude and silence both credentialed experts and people with lived experience. 

Some THR advocates do receive nicotine industry funding, while Pharma companies have funded certain harm reduction organizations that support people who use drugs. Funding for the nonprofit behind Filter includes unconditional donations from tobacco and vape companies. 

Though it’s a contentious area, many harm reduction advocates believe that such funding, particularly if disclosed, does not invalidate evidence-based arguments that have the potential to help people in need.  

When it comes to the kind of mud-slinging he was subjected to, Youdan is clear about who pays the biggest price. 

“Ultimately,” he said, “the people who lose are those who still smoke, and are being denied access to good information and support.”

Photograph (cropped) by Pixabay via Picryl/Public Domain

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By portraying reduced-risk nicotine options like vapes, pouches and heated tobacco products as far more dangerous than they actually are, these falsehoods and distortions have been shown to dissuade people from quitting combustible tobacco—which causes 8 million annual global deaths.

Evidence tends to be drowned out by sensationalist claims. So in various countries, majorities of people who smoke have been misled into believing, for instance, that vapes are at least as harmful as cigarettes. That couldn’t be further from the truth.

In March, an organization that supports tobacco harm reduction unveiled what’s intended as an antidote. Knowledge-Action-Change (KAC), based in the United Kingdom, has produced a free online course, titled “Understanding Tobacco Harm Reduction.”

“There’s only one eligibility requirement, which is a desire to reduce smoking and tobacco-related harm.”

“Participants will gain a solid introduction to THR, its evidence base and its context among other long-established areas of harm reduction,” a press release stated.

The course is “open to everyone,” emphasized Gerry Stimson, KAC’s cofounder and emeritus professor at Imperial College London.

“There’s only one eligibility requirement, which is a desire to reduce smoking and tobacco-related harm,” Prof. Stimson continued. “Maybe you smoke, or someone you love does. Maybe you work with clients or patients whose tobacco use impacts their lives. Maybe you’re interested in new ways of tackling social issues.”

The course takes two or three hours to complete, its creators say, including an assessment at the end. By then, they write, “you will be able to understand the global landscape of tobacco smoking, define tobacco harm reduction principles, identify safer nicotine products and their regulatory needs, evaluate critiques and challenges, and dispel common myths about tobacco harm reduction.”

You can take the full course here—or dip a toe in by trying a few simple questions in the quiz below:

David Mackintosh, one of KAC’s directors, told Filter that he and his colleagues developed the course because they “became very aware of the interest and the demand for information about THR.” 

Researchers and medical professionals were among the experts who contributed to its development. “We believe this delivers high-quality, credible information in a way that is accessible,” Mackintosh said.

He added that over 1,000 people had already registered to take the course in its early days—“without any real promotion,” as yet—and about two-thirds had completed it. “It is clear that many professionals and individuals want to understand more about tobacco harm reduction and its potential to save people from smoking-related disease and premature death.”  

The course can be seen as one significant element of a multi-pronged response to a problem with glaring and severe impacts on global health.

Uptake for the course will need to be substantial to make a dent in THR misperceptions, given just how pervasive these are. Almost 80 percent of doctors worldwide—people whose job it is to present accurate health information—wrongly believe that nicotine causes lung cancer, according to a 2023 survey from Global Action to End Smoking. 

But the course creators hope it will be impactful not only in terms of numbers of participants but also through word-of-mouth, when people who take the course will then be in a position to influence others in their professional and personal lives.

Happily, too, KAC is not the only organization that has made tackling THR misinformation a priority. The course can be seen as one significant element of a multi-pronged response to a problem with glaring and severe impacts on global health.

“Amongst all the noise and poor information,” Mackintosh said, “Understanding Tobacco Harm Reduction provides an opportunity for people to explore the evidence and see the potential.”  

Photograph by Thea via Unsplash

The Influence Foundation, which operates Filter, has received grants and donations from KAC. Both KAC and The Influence Foundation have received grants from Global Action to End Smoking. Filter‘s Editorial Independence Policy applies.

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