Charles A. Gardner, PhD's Threads

Apr 17 • 6 tweets • 2 min read

Welcome to How to Lie with Percentages 101
This seems like a minor point in @FDATobacco Director King's recent Op/Ed in Nature. Here is a quote:

"In 2021, 11.3% of high-school students used e-cigarettes, compared with 4.5% of adults."

It's misleading in 4 ways.
(1/6) 👇

(2/6)
First, it's not 2021 anymore. The latest data from the @CDCgov NYTS and NHIS surveys are easily available to the authors.

In 2023, 10% of US high school students vape nicotine "at least once in the past month." And 7% of adults do so "daily or some days."

Apr 2 • 14 tweets • 8 min read

Humans have been burning leaves of the tobacco plant, and inhaling the smoke, for well over 8,000 years now.

It had ceremonial purposes, presumably when nicotine's psychoactive effects were needed: increased focus, attention and memory.

THREAD 👇

(2)
For thousands of years, tobacco leaf smoking was only a thing in the Americas.

In the Old World plenty of people smoked, but not tobacco leaves. THEY smoked cannabis or opium.

Mar 21 • 18 tweets • 9 min read

Congratulations. You have invited PAVE to tell you about the dangers of vaping. Here's a head's up on what they are going to tell you....

THREAD
👇👇👇

(2)
"Middle school use is up."

#FactCheck: MISLEADING. Middle & high school nicotine vaping dropped 61% over the past 4 years. 1.9% of teens vape nicotine daily, so may be 'hooked' (down >50% in the past 4 years).

2019:
2023: cdc.gov/mmwr/volumes/6…
cdc.gov/mmwr/volumes/7…

Jan 6 • 17 tweets • 7 min read

Consider "the Standard Narrative" *pushed* by tobacco control:

• Whole new generation addicted to nicotine
• E-cigarettes are a gateway to smoking
• Ecig use increased exponentially, especially among teens
• They target teens
• Nicotine harms developing brains

(1/X) 👇🧵👇

(1a) Where is this "whole new generation addicted to nicotine"?
In the USA, teen nicotine USE is lower today than at any time in the past 50 years.
#FactCheckMe: @CDCgov and @NIH survey data

Dec 18, 2023 • 10 tweets • 5 min read

Daily Brain Harm News
15 past-Presidents of the top professional society in tobacco control call "nicotine brain harm" claims "speculative" because there is no human evidence.

Yet @CDCgov continues to tell the public "nicotine harms developing brains" is a known fact.

THREAD 👇

(2)
How do we sort that all out? First, we should consider what actually can, tragically, cause permanent life-long harm to developing brains.

- under-nutrition
- toxic stress factors (neglect, abuse, loss of parents,
and exposure to violence)

Oct 8, 2022 • 9 tweets • 7 min read

This VERY common "mistake" is a direct consequence of the way CDC & FDA present teen vaping data.

It confuses journalists, the public and members of Congress.

@CDCDirector Walensky & @FDACommissioner @DrCaliff_FDA: I demand you STOP reporting Daily Use as a % of 'current use'.

(2)
Here is example #2 @CDCDirector Walensky and @DrCaliff_FDA. Another "trusted" source telling the public 1 in 4 teens use ecigs daily.

The reason this is happening is clear: You present the data in a deliberately confusing way (daily use as a percentage of 'current use').

Jun 24, 2022 • 6 tweets • 7 min read

@NoahSCosi Good thread Noah. The public has many misperceptions. One is JUUL. Only 0.6% of US high school students use that product, so banning it will have little impact on teen vaping.
#FactCheckMe here:
cdc.gov/mmwr/volumes/7…
THREAD
👇👇👇 @NoahSCosi 2
Another is the "whole new generation addicted to nicotine." US teen nicotine use is lower today than at any time in the past 50 years. This is easily fact-checked from @CDCgov's National Youth Tobacco Survey and @NIH Monitoring the Future survey.

It is a fact.

May 11, 2022 • 7 tweets • 5 min read

It's pretty simple to ask any of the millions of adult smokers who have switched to nicotine vaping how they're doing. Like this (not scientific; just a social media survey).

But it borders on medical #malpractice that this is not a higher priority for the research community.

2
It's pretty simple to ask any of the millions of adult smokers who have switched to nicotine vaping how they're doing. Like this (not scientific; just a social media survey).

But it borders on medical #malpractice that this is not a higher priority for the research community.

Apr 22, 2022 • 16 tweets • 7 min read

OK, so... unlike nicotine:
- alcohol (and cannabis) intoxicate
- alcohol abuse actually DOES harm developing brains
- teen binge drinking causes 3,500 deaths every year

THREAD
👇👇👇

(2)
FAR fewer teens vape than drink. FAR fewer teens vape nicotine daily than binge drink.

It's very clear here, that vape firms do a FAR better job keeping their products away from teens than alcohol companies do.

So why the irrational #MoralPanic over teen nicotine vaping?

Mar 5, 2022 • 11 tweets • 10 min read

@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."

Dec 26, 2021 • 13 tweets • 7 min read

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...

Dec 25, 2021 • 4 tweets • 2 min read

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).

...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.

Dec 7, 2021 • 18 tweets • 8 min read

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…

Nov 15, 2021 • 5 tweets • 3 min read

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…

Nov 11, 2021 • 7 tweets • 5 min read

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.

Nov 8, 2021 • 5 tweets • 7 min read

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

Nov 2, 2021 • 12 tweets • 8 min read

Lets explore @FDATobacco infographics. These data come from @CDCTobaccoFree's National Youth Tobacco Survey.

US teen nicotine vaping increased in 2018 (to twice what it is today), so FDA's infographic focused on the percentage increase.
@DrWoodcockFDA

THREAD
👇👇👇

(2)
In 2019, US teen vaping increased again, but it's not clear WHAT they were vaping. @CDCTobaccoFree forgot to ask that in 2019, so much of this "increase" may be THC vaping, not nicotine.

This time there's a graph, huge letters saying "ALARMING," and an absolute number.

Oct 5, 2021 • 24 tweets • 15 min read

THREAD
👇👇👇

The death toll from smoking is staggering (including my own father). 8 million people die every year from smoking
who.int/news-room/fact…
...including 480,000 in the USA
cdc.gov/tobacco/data_s…

2
Harm reduction can reduce that death toll, according to 15 past-Presidents of the world's leading professional society in tobacco control.
ajph.aphapublications.org/doi/pdf/10.210…

...and over 70 respected scientific and public health organizations around the world.
drive.google.com/file/d/1Ty7pgR…

Sep 29, 2021 • 19 tweets • 11 min read

THREAD
So... Here is the @US_FDA's original infographic. Let's take a good look at what they told the public about the National Youth Tobacco Survey 2020 (specifically March 2020, so just before the pandemic).

First, US high school vaping had dropped 29%
fda.gov/files/ctp-nyts…

(2)
Next... Unless you read this VERY carefully, you will not understand frequent use, and daily use, are given as a percentage of "current use."

Sep 28, 2021 • 10 tweets • 8 min read

THREAD
@truthinitiative embraces tobacco #HarmReduction, but paints it as a tobacco & vape industry plot.

11 million US adults use #SaferNicotine vapes daily/regularly to quit or reduce smoking. We don't work for industry.

@robinkoval should talk to us.
truthinitiative.org/our-top-issues… (2)
@truthinitiative paints tobacco #HarmReduction (THR) as a tobacco & vape industry plot.

15 past-Presidents of the Society for Research on Nicotine & Tobacco embrace THR. They are veterans of the fight against big tobacco. Not part of a "plot."
ajph.aphapublications.org/doi/pdf/10.210…

Sep 7, 2021 • 7 tweets • 3 min read

Drug Abuse Resistence Education (D.A.R.E.)

A school-based education program. How well did it work? In 2001, US @Surgeon_General David Satcher placed the D.A.R.E. program in the category of "Ineffective Primary Prevention Programs."
en.wikipedia.org/wiki/Drug_Abus…

THREAD
👇👇👇 School-based drug "education" mistake, now being repeated with vaping.

1992: "Researchers at Indiana University found that those who completed the D.A.R.E. program subsequently had significantly higher rates of hallucinogenic drug use than those not exposed to the program."

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