@DrCaliff_FDA's @US_FDA says that e-cigarettes are “potentially less harmful forms of nicotine delivery for adults, [and] many studies suggest e-cigarettes and noncombustible tobacco products may be less harmful than combustible cigarettes.”
fda.gov/tobacco-produc…

THREAD
👇👇👇
(2)
@DrCaliff_FDA's @US_FDA notes further: A Cochrane 2020 systematic evidence review found:

"ENDS [ecigs] may help more people stop smoking for six months or longer than using nicotine patches or gum [&] the overall incidence of serious adverse effects related to ENDS is low."
(3)
@DrCaliff_FDA's @US_FDA notes further: “Existing studies have shown that daily ENDS [e-cigarette] use is associated with significant reductions in combusted cigarette use.”
fda.gov/media/153017/d…
(4) @DrCaliff_FDA's @US_FDA has confirmed and validate the public health concept of #HarmReduction in the field of tobacco control (which the @WHO still, strangely, utterly rejects).

For example...
(5)
@DrCaliff_FDA's @US_FDA has authorized 8 tobacco “snus” products to advertise with this message:

“Using [this] instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema & chronic bronchitis.”
fda.gov/tobacco-produc…
(6)
@DrCaliff_FDA's @US_FDA has authorized 3 nicotine vape (“e-cigarette”) products as "appropriate for the protection of public health" saying...
#HarmReduction
(7)
@DrCaliff_FDA's @US_FDA authorized these 3 nicotine vapes saying, “The manufacturer’s data demonstrates its tobacco-flavored products could benefit addicted adult smokers who switch to these products… by reducing their exposure to harmful chemicals.”
fda.gov/news-events/pr…
(8)
But here's the rub @DrCaliff_FDA. Authorizing ANY nic vape should have implications for the whole product category. They ALL work EXACTLY the same way.

As @CDCgov says, “E-cigarettes expose users to fewer harmful chemicals than burned cigarettes.”
cdc.gov/tobacco/basic_…
(9)
And here's the cold logic @DrCaliff_FDA. IF these gizmos are, indeed, SAFER than smoking, then every day that @US_FDA & @CDCgov delay promoting them for US adult smokers will, literally, CAUSE quantifiable horrible deaths from smoking-related cancer, heart & lung disease.
(10)
So, please explain, @DrCaliff_FDA, why the @US_FDA has rejected MILLIONS of independent nicotine vape products that only adults use, and just authorized only 3 nicotine vapes, made by one Big Tobacco company, that almost NO ADULTS USE.
(11/11)
Finally @DrCaliff_FDA:

Does @US_FDA EVER develop #HIV or drug #HarmReduction policies without consulting SOME people living with those issues? No.

That would be unethical.

Can you list ONE consultation, ever, that FDA has ever had with People Who Use #SaferNicotine?

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More from @ChaunceyGardner

Dec 26, 2021
Truth-telling and "utility" (greatest good for greatest number) are 2 basic principles in healthcare ethics that may come into conflict. For example:

17% of adults are salt-sensitive (more salt => higher blood pressure). 83% can eat as much salt as they like.
THREAD
(2)
The above figure comes from this peer-reviewed paper.
ncbi.nlm.nih.gov/pmc/articles/P…

Now, let's consider how truth-telling and utility come into conflict...
(3)
The dilemma for public health is this: If we tell EVERYONE to reduce their salt intake, this will help the 17% who are salt-sensitive. It may save lives.

But that requires us to violate truth-telling (i.e., it requires public health authorities to lie to 83% of adults).
Read 13 tweets
Dec 25, 2021
Classic ethics thought experiment (updated)

Trolley Problem: You can flip the track and save the lives of 5 adult smokers. But the cost of doing so is one teen becoming dependent on nicotine.

Note: Death is final. Dependence is not (e.g., 2/3rds of teen smokers later quit). Image
...OK. Let's be more accurate. Teens who vape today may later quit. In fact, nearly 2/3rds of them just did quit (over the past two years).

Adult smoking shortens the lives of 50% of lifelong smokers by ~10 years. So that's not certain either. But death remains final. Image
So... Why 5 to 1?

4.6 million US adult vapers have quit smoking completely (this does not include smokers who quit with ecigs and later quit vaping).
cdc.gov/mmwr/volumes/6…

0.5 million US high school students vape nicotine daily.

>2.3 million lives saved vs. 0.5m 'hooked'?
Read 4 tweets
Dec 7, 2021
What happens when a smoker quits by switching to nicotine vapes ("e-cigarettes")?

THREAD
👇👇👇
(2) when a smoker switches to nicotine vapes

Excess lifetime cancer risk drops >10,000-fold, and is “lower than guideline values defined by EPA and WHO.” 2nd hand vapor risks are obviously even lower than that.
sciencedirect.com/science/articl…
(3) when a smoker switches to nicotine vapes

A more conservative estimate found lifetime cancer risk drops “only” 99.5%. Lifetime cancer risk from smoking is 18%. 0.05% of that = 9 in 10,000 (a risk so low it would be difficult to measure).
tobaccocontrol.bmj.com/content/27/1/10
Read 18 tweets
Nov 15, 2021
1/2
@CJBoyd_Research: No one vapes THC in "ENDS." THC vs. nicotine vapes = different devices.

Your study found “wheezing or whistling” in teens who vaped THC. And it found that teens who vape nicotine ("ecigs") have no respiratory symptoms. None.
sciencedirect.com/science/articl…
2/2
So, consider the logic of your statement on @CNN:

"Without a doubt, e-cigarettes are unhealthy and not good for lungs." ["Of course, we couldn't find any harms from nicotine vaping ('e-cigarettes'), but it just stands to reason there must be some."]
cnn.com/2021/03/03/hea…
PS: I cannot state strongly enough how the community of millions of adult ex-smokers who use #SaferNicotine to avoid toxic forms of tobacco HATE the term "ENDS."

And how much we hate @CDCgov's insistence that some people vape THC in "Electronic NICOTINE Delivery Systems."
Read 5 tweets
Nov 11, 2021
REMINDER
If nicotine vapes ("e-cigarettes") are, in fact, safer than smoking, and help smokers quit, they are (obviously) profoundly different from recreational drugs like alcohol, caffeine & cannabis.

So, what if we just ask ex-smokers who vape how they're doing?

THREAD
👇👇👇
(2)
Among ex-smokers who quit by switching to nicotine vapes, 93% say their health improved. 62% say "improved dramatically." The 5% who said "no change" said "I was healthy to begin with."

Healthier. This is so different from daily screaming headlines.
(3)
Among ex-smokers who quit by switching to nicotine vapes ("e-cigarettes"), 90% say they now have fewer and less sever lung infections. We're healthier. Does no one care?

Confirmed by these peer-reviewed studies.
nejm.org/doi/full/10.10…
omicsonline.org/open-access/ch…
Read 7 tweets
Nov 8, 2021
LED candles (tea candles). No combustion. Our passive protest against #COP9FCTC efforts to - literally - kill us and other #SaferNicotine user like us.

From London, Day one of @MikeBloomberg-funded @WHO @FCTCofficial fiasco Image
LED candles (tea candles). No combustion. Our passive protest against #COP9FCTC efforts to - literally - kill us and other #SaferNicotine user like us.

From London, Day one of @MikeBloomberg-funded @WHO @FCTCofficial fiasco. Image
LED candles. No combustion. Our passive protest against #COP9FCTC efforts to - very literally - kill us and other #SaferNicotine user like us, plus 1.1 billion smokers.

From London, Day one of @MikeBloomberg-funded @WHO @FCTCofficial debacle.
@INNCOorg Image
Read 5 tweets

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