Thread by @mikepesko

At last count, #COVID19 has killed nearly 800k Americans over approximately 2 years, or approximately 400k a year. Less well known is that smoking is estimated to kill nearly 480k per year. 1/21

There has been significant media focus on a minority of people with inaccurate beliefs about #masks and #vaccines. Finding ways to persuasively communicate accurate health information to these individuals remains a public health priority. @selenasd @CassSunstein 2/21

However, little attention is paid to an inaccurate belief that perpetuates the nearly 480k per year that die of smoking: the belief that #ecigs are just as dangerous as combustible tobacco products. E-cigarettes are in fact substantially safer. 3/21

natlawreview.com/article/20ew-p…

According to government-collected @NCIHINTS data, 90% of Americans don’t know that e-cigarettes are safer. 4/21

And 13% actually believe that e-cigarettes are more dangerous. 5/21

Why is this bad? If people believe that ecigs are equally or more dangerous than combustible tobacco, then adults are less likely to quit smoking by using ecigs, and kids are more likely to smoke (they may think: if both are equally bad, why not just do the real thing?). 6/21

What explains inaccurate e-cigarette risk perceptions? There are many factors, but one big one is the naming of an outbreak of lung injuries in 2019, “E-cigarette, and Vaping Use Associated Lung Injury” (or #EVALI), despite these lung injuries being caused by #THC products. 7/21

One poll found 2/3rds of people believe commercial e-cigarettes like Juul are to blame for #EVALI, and only 28% know that #THC products are the cause. 8/21

morningconsult.com/2020/02/05/ele…

This belief that commercial e-cigarette cause lung injuries is echoed by the highest levels of media. The @NYTimes recently ran an Op-Ed falsely attributing Juul to these lung injuries. @nytopinion @ekp 9/21

filtermag.org/media-vaping-e…

The result? Smokers that would have switched were perhaps less likely to do so, and others that had switched went back to smoking. In the year immediately following #EVALI, cigarette sales rose for the first time in 20 years. @ScottNeumanNPR. 10/21

npr.org/sections/coron…

THC users may also have died because they did not know THC products were to blame for these lung injuries. Until the name #EVALI is changed, #THC consumers may be unaware of risks that could have deadly implications. DM me if you’re aware of any specific cases. 11/21

For these reasons, 75 experts from across the world, including seven individuals who have served as president of the @srntorg, have formally asked the @CDCgov to change the name #EVALI, and this effort was endorsed by @AGIowa. Here is our letter: bit.ly/3GchUrV. 12/21

Unfortunately, the CDC denied our petition: bit.ly/330I2Yu. They provided a few vague reasons, all of which we addressed in our original letter, including conducting an original review of the scientific evidence: qeios.com/read/ZGVHM7.3. 13/21

The letter also seems to suggest that the burden is on nicotine products to prove they aren’t the cause of EVALI, rather than the @CDCgov needing to prove they are the cause. This is analogous to being assumed guilty unless proven innocent. That’s concerning. @ACLU 14/21

Surprisingly, the @CDCgov gave the initiative leader a medal! This illustrates the disconnect between the CDC and the scientific community that could be a warning sign of the CDC operating in a bubble. 15/21

cdc.gov/media/releases….

The CDC has been having a difficult time communicating accurately about tobacco in other contexts. Here is an example of @CDCTobaccoFree taking down an inaccurate Tweet at my request:

https://twitter.com/mikepesko/status/1436596541020590083

. 16/21

The CDC also missed several studies in their 2016 Surgeon General report, and as a result forecast that higher e-cigarette use would lead to higher smoking among kids. Instead, youth smoking rates fell to record lows. bit.ly/3ndRJZJ @Surgeon_General 17/21

If the CDC can’t communicate accurately about tobacco, it raises questions about their leadership and organizational health, and ability to communicate accurately in other contexts such as COVID. @CDCDirector 18/21

If you are concerned, write to [e-mail] to request that the CDC reconsider their response to the CDC Expert Petition on EVALI. Encourage the director to appoint an outside commission, since the CDC itself has conflicts that would be difficult to mitigate. 19/21

The media could play an important role here as well in holding the CDC accountable to communicating accurately to the American people. Please add others I’ve missed. @maloneyfiles, @lauriemcginley2, @MarcGunther, @alexnorcia, @brentstafford. 20/21

Finally, @JoeBiden @WhiteHouse has pledged to lead with "science and truth." Accurate messaging about e-cigarettes, which has the ability to substantially mitigate the 480k that die annually due to tobacco, is key to fulfilling this promise. @SpeakerPelosi @SenSchumer 21/21