Former CEO GlobalActiontoEndSmoking, VP Tobacco Control, American Cancer Society, Advisor to US Asst. Sec. for Health & Surgeon General. Consultant on THR
Michigan
Joined October 2008
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New report: "Use of e-cigarettes for smoking cessation remained common from 2018 to 2023. Perceived lower harm and social exposure were consistently associated with this behavior, highlighting the influence of cognitive and social factors on cessation-related decisions among adults who smoke cigarettes."
Link: pubmed.ncbi.nlm.nih.gov/4284…
In other words: Tell the truth. If you give people who smoke accurate information about the fact that nicotine vaping (and use of other noncombustible nicotine products) is safer than smoking cigarettes, they will be more likely to stop smoking through the use of these products.
Today at the 14th Annual Conference of the Vermont Center on Behavior & Health (theme: "Cigarette Smoking in Combination with Other Tobacco Products & Other Addictive Substances"), Dr. Richard Miech shared the latest data from the Monitoring the Future (MTF) survey on U.S. trends in adolescent nicotine vaping, alcohol use, and cannabis use since the COVID-19 pandemic.
Great news: All three categories have simultaneously fallen by at least 40%.
MTF is the gold standard of epidemiological research on youth behavior and public health.
Cliff Douglas retweeted
Mounting legal pressure. An enormous illicit market. Youth vaping sharply down. Is FDA finally waking up to failures in its PMTA process? Tobacco control policy expert Cliff Douglas weighs in. @cdoug @HayppGroup @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine
regwat.ch/RLssmH
Re-upping this post: Importantly, @FDATobacco’s leadership is now owning and promoting the fact that the agency has the responsibility and the capacity to communicate much more effectively and directly to the public about the continuum of risk and the value of switching from combustible cigarettes to the far safer products authorized by the agency. Dr. Bret Koplow just said so. (Note: They didn’t use to say that.)
“There is a gap between the science and the belief.” Very important observation — and lament — from @FDATobacco director Dr. Bret Koplow, who emphasized today in his keynote at FDLI’s annual tobacco and nicotine conference that adults who smoke can significantly benefit their health by switching to reduced-risk products like FDA-authorized vapes. But a majority of Americans, including PHYSICIANS, don’t understand this. He said that FDA will partner with academic researchers, scientific organizations, and other stakeholders in turning this around.
Cliff Douglas retweeted
Is FDA about to rewrite the rules governing nicotine vapes? Tobacco control policy expert Cliff Douglas examines what’s driving this potential shift. @cdoug @HayppGroup @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine @GrimmGreen @LegionVaping
regwat.ch/RLssmH
Cliff Douglas retweeted
Mounting legal pressure. An enormous illicit market. Youth vaping sharply down. Is FDA finally waking up to failures in its PMTA process? Tobacco control policy expert Cliff Douglas weighs in. @cdoug @HayppGroup @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine
Could FDA’s proposed PMTA overhaul mark a turning point? I joined @RegWatchCanada to discuss the prospects for reform—and why success requires both access to a robust marketplace of authorized lower-risk alternatives and accurate information for adults who smoke. Recent moves by newly appointed permanent director of @FDATobacco, Dr. Bret Koplow, suggest essential action in that direction.
Is FDA about to rewrite the rules governing nicotine vapes? Tobacco control policy expert Cliff Douglas examines what’s driving this potential shift. @cdoug @HayppGroup @ChaunceyGardner @alli_vapes @VaporTechAssoc @INNCOorg @GFNicotine @GrimmGreen @LegionVaping
“There is a gap between the science and the belief.” Very important observation — and lament — from @FDATobacco director Dr. Bret Koplow, who emphasized today in his keynote at FDLI’s annual tobacco and nicotine conference that adults who smoke can significantly benefit their health by switching to reduced-risk products like FDA-authorized vapes. But a majority of Americans, including PHYSICIANS, don’t understand this. He said that FDA will partner with academic researchers, scientific organizations, and other stakeholders in turning this around.
Cliff Douglas retweeted
Must watch: Dr. Bret Koplow, Director of @FDATobacco, speaking at the Harvard Club during the New Approaches Summit... saying mostly good stuff.
youtube.com/watch?v=14rC4cxe…
Cliff Douglas retweeted
addiction = dependence + harm
Coffee drinking = dependence-forming; no harm; so not "addictive"
Nicotine vaping: SAFER than cigarettes according to @FDA; EFFECTIVE for smoking cessation according to @cochranecollab.
Vaping REDUCES harm
"Highly addictive" = propaganda tactic, not truth
Cliff Douglas retweeted
FDA CTP Director Dr. Bret Koplow is giving the keynote address—his fourth in the last month—to kick off FDLI.
On the PMTA rule: “We’ve understandably learned a lot since [the 2021 rule became effective].” He says revisions could provide “greater clarity and predictability to applicants,” but process improvements only go so far: CTP currently has just nine scientific review teams, meaning a newly filed PMTA cannot enter substantive scientific review until a team finishes another application.
I’m speaking at #FDLI's Tobacco and Nicotine Products conference, Oct. 6–7, in Washington, DC and virtually.
Our panel, “Litigation Update: PMTAs, Preemption, and Regulatory Pressure,” will examine litigation reshaping nicotine regulation and its public health implications.
Appreciate this thoughtful coverage by @2FirstsNews of my talk at #NewApproaches2026.
My central proposition:
“The continuum of risk should not simply describe the marketplace. It should play a central role in organizing it.”
The overriding public health goal: reduce exposure to combustion as rapidly as we can.
And “authorization alone is not a public health strategy.” We need a broader ecosystem of science, regulation, enforcement, accurate risk communication, youth protection, and responsible innovation—capable of accelerating the displacement of combustible cigarettes.
Thank you to New Approaches and 2Firsts for capturing the argument so thoroughly.
2firsts.com/news/nas-2026--c…
#TobaccoHarmReduction #TobaccoControl #PublicHealth #NicotinePolicy
Very encouraging talk today by @FDATobacco’s Center for Tobacco Products Director Dr. Bret Koplow at #NewApproaches2026. Former Iowa Attorney General Tom Miller told him (and the entire audience) that “It’s a breath of fresh air.”
I agree.
Director Koplow emphasized that tobacco harm reduction should not be controversial. It is an essential approach to helping more adults stop smoking. It is, in fact, what the PMTA process is all about. In essence, he confirmed that this is exactly what Congress had in mind when it passed the Tobacco Control Act in 2009.
He also noted his and FDA’s understanding that adults prefer non-tobacco and non-menthol flavors. This is and will be taken into account in reviewing product applications.
Critically, he confirmed that public misunderstanding is widespread, and to stay tuned for FDA *action* focused on better educating adults who smoke, medical associations, and others who need to be accurately informed about the continuum of risk and nicotine.
Again, a breath of fresh air.
Great quote about older adults who smoke from Dr. Annie Kleykamp (@akleykamp) today at the #NewApproaches2026 Summit at the Harvard Club of New York City:
“Older adults do not have less to gain. They do have less time to wait.”
As a co-author of the recent landmark paper in @JAMA_current on Nicotine E-Cigarettes for Cigarette Smoking Cessation, she made crystal clear that “Vapes help more people quit smoking than other methods.” jamanetwork.com/journals/jam… And she noted that “Prioritizing younger populations introduces bias that has driven tobacco research and policy — at a steep cost.”
@FDATobacco
@TobaccoFreeKids
@AmericanCancer
@LungAssociation
@American_Heart
@MikeBloomberg
I agree.
Now what?
We are here to help.
FDA Center for Tobacco Products Director Bret Koplow:
“We can authorize products. We can enforce against illegal products. But if the adults who could benefit most from switching don’t believe there is a meaningful difference, or if their doctors won’t recommend switching to FDA-authorized products, we lose much of the public health value of the regulatory work that is so much a focus of our time and effort.” #GTNF26
Cliff Douglas retweeted
"Nicotine" and "tobacco" and "smoking" are three different words with three different meanings. But for decades now, Tobacco Control researcher publications and public messaging has used them as synonyms.
@cdoug
cliffdoug.substack.com/p/whe…
This is a very important message — heartfelt, evidence-based, and obviously relevant to all of us (especially older) guys.
Every September we mark Prostate Cancer Awareness Month. This year it’s more personal for me.
More than 330,000 American men this year will hear the words we did last spring when I was diagnosed with prostate cancer. By the time we found it, it had already spread to my bones.
When prostate cancer is caught early, the five-year survival is close to 100%.
So have the conversation with your doctor. Don’t put it off.
If you're at average risk, that conversation should start around 50, and the guidelines now say screening every 2 to 4 years. If you're a Black man, start it at 45 or earlier. You are nearly 70% more likely to get this disease and 2 to 4 times more likely to die from it. Which is an outrage in the richest country in the world.
If your father or your brother had prostate cancer, start the conversation at 45, and even earlier if more than one of them did.
I am deeply grateful to the doctors, nurses and other medical professionals who helped to control my cancer and who continue to take such good care of me. Their skill, dedication, and compassion mean so much. The radiation treatment from last fall worked as intended, and I continue to do the things I care about, like finishing my memoir.
Thank you to everyone who has reached out and continues to keep me and my family in your prayers. We appreciate every single one of you.
It’s my hope and prayer that by sharing our experience and being part of this important conversation, we can help save lives. Talk to your doctors. Ask the hard questions. Do it for yourself, and do it for the people who love you.
And no matter what, keep the faith. God bless you.