Many Tobacco Control Organizations are Asserting that Quitting Smoking is Not Quitting Smoking if You Use E-Cigarettes to Quit

The American Lung Association has long been trumpeting the falsehood that quitting smoking by switching to electronic cigarettes isn't quitting smoking, a statement that is false on its face. The American Lung Association has been telling the public that "Switching Isn't Quitting." 

Can you imagine a public health organization telling people trying to get off of heroin that "Switching (to methadone) Isn't Quitting"? 

The Rest of the Story

Unfortunately, it is not just the American Lung Association that has been spreading this nonsensical, false, and dangerous rhetoric. Here is a list of other tobacco control groups that have made the same assertion.

Tobacco Education Clearinghouse of California

El Dorado County Public Health

DePaul University Office of Student Affairs

Fresno County Department of Public Health

North Dakota Department of Health

Butte County Health Department

California Tobacco Free Colleges

Kick It California

American Lung Association of Rhode Island

Cuesta College Student Health Services

Fargo Cass Public Health

Healthy UC Davis

Southeast Asia Tobacco Control Alliance

Tobacco Free North Dakota

Shasta County Tobacco Education Coalition

Clearly, there is a major misinformation campaign going on within the tobacco control movement. Many of these groups are using false information to discourage smokers from quitting and entice ex-smokers to return to smoking.

American Lung Association Directs Youth to Complain about Seeing People Use Nicotine Pouches in Workplaces

A campaign being run by youth in Wisconsin who are part of a group called FACT is urging their fellow youth to complain to legislators about having to see people using nicotine pouches in workplaces. Youth are instructed to tell their legislators: "What tobacco products do you still see used in places covered by the smoke-free air law (workplaces like restaurants, hotels, and offices)? Vapes? Nicotine pouches? What bothers you about seeing these products in those places?"

I spent many years of my career lobbying for smoke-free workplace laws. But when I said "smoke-free" I meant "smoke-free." In other words, I was promoting the elimination of tobacco smoke in workplaces. My efforts were based on voluminous scientific evidence of the long-terms harms of tobacco smoke exposure for employees, especially those working in smoky bars and restaurants. 

I have to honestly say that I'm not crazy about banning vaping in public places because I'm not aware of solid evidence that it causes significant health effects but I can at least understand the rationale. People are being slightly exposed to chemicals in aerosol that they did not create. However, I fail to see the rationale behind banning the use of nicotine pouches in public places. The use of a nicotine pouch has absolutely no health effects for bystanders. It doesn't create any kind of smoke, vapor, aerosol, or any other exposure for people who are not actually using the product. So why would youth want to ban the use of this product? It just doesn't make any sense. 

Something else bothers me about the appeal being made by this FACT organization. The appeal does not give youth the option of not being bothered by the use of nicotine pouches in public places. It asks "what bothers you" about seeing nicotine pouches in these places, essentially implying to youth that there is no option other than to be bothered by the use of nicotine pouches.

This sends a bad message to youth. It sends the message that we should be banning individual behavior that has no harmful effect on anyone else. And that we should ban a behavior that actually may be life-saving for people, since many - if not most - adults who use nicotine pouches are doing so in an effort to quit smoking.

This is tantamount to telling kids that they should be bothered by seeing methadone clinics, naloxone distribution programs, or needle exchange programs. It asks youth to oppose life-saving harm reduction policies in the name of regulating people's lifestyle choices that affect nobody else except themselves.

It struck me that there has to be something else behind this organization because youth on their own would not promote such an idea that is totally contrary to public health and also contrary to the way most youth think.

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Well, the truth is that these youth are not acting independently. The organization is actually an initiative of the American Lung Association and is funded by the state health department!

According to the web site: "FACT is ably managed by the American Lung Association, funded by Wisconsin’s Commercial Tobacco Prevention & Treatment Program, and organized with the help of local health alliances." 

The American Lung Association is basically using youth to do their bidding. They are taking advantage of youth in order to try to push their own agenda of banning nicotine pouches. 

This is not the first time I have exposed tobacco control organizations using kids as a pawn in their efforts to support their own agenda in a way that is far from transparent. While anti-nicotine groups have the right to try to ban life-saving harm reduction products, they should not be manipulating youth into promoting these misguided policies for them. This is why I find what the American Lung Association is doing in Wisconsin so disturbing.

Misinformation from Anti-Vaping Groups is Causing Increasing False Beliefs among Policy Makers

The role of the tobacco control movement should be to increase the public's and policy makers' understanding of the health effects of smoking and tobacco use. Instead, data from a new survey by ECigIntelligence reveal that among members of the European Parliament (MEPs), an increasing percentage of policy makers fail to understand that smoking is more hazardous than vaping.

In 2000, a similar survey showed that 68% of MEPs correctly understood that smoking is more hazardous than vaping. However, in 2025, that percentage is down to 60%. The percentage of MEPs who believe that smoking is less harmful than vaping remains at about 8-9%; however, the percentage who believe that smoking and vaping are equally harmful doubled from 12% to 24%.

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These surprising and unfortunate results are no accident. They are the direct result of a concerted misinformation campaign by anti-vaping organizations to mislead the public and policy makers into falsely believing that vaping is essentially just another form of smoking and offers no health advantages.

Ironically, it is the tobacco industry that is actually accurately conveying the relative health risks of vaping compared to smoking.

All I can say is that I never thought this day would come. For decades we have been condemning Big Tobacco for its long-standing campaign of deception and misinformation. Now, it is the mainstream of the tobacco control movement which is waging a campaign of deception while the tobacco companies are the ones being honest in their communications regarding the relative risks of smoking compared to vaping.

New Data from New York State Show that Youth Smoking is at Its Lowest Level in Recorded History; Anti-Nicotine Groups Continue to Claim that Vaping is a Gateway to Smoking

New data from the New York State Department of Health show that youth cigarette smoking is at its lowest level in recorded history (meaning ever since youth smoking prevalence began to measured in surveys). Only 2.4% of high school students in New York State reported smoking cigarettes in 2024. E-cigarette use among high school students continued its sharp decline, dropping from 27.4% in 2018 to 18.7% in 2022 to 13.1% in 2024. Overall "tobacco use" (which is actually a measure of tobacco use plus non-tobacco e-cigarette use) dropped from 30.6% in 2018 to 17.0% in 2024.

Meanwhile, many nicotine researchers and anti-nicotine organizations continue to tell the public that youth vaping is a gateway to the initiation of cigarette smoking and that youth vaping is leading to a new epidemic of smoking that is undermining the progress we have made over the past two decades. 

For example, if you go to the Johns Hopkins Medicine website, you'll find an article entitled "Will Vaping Lead Teens to Smoking Cigarettes?" The article answers the question affirmatively. In the article, a professor of medicine at Hopkins states that: "I think perhaps the #1 concern about vaping right now is the so-called gateway effect." And he claims that: "We might be causing the next smoking epidemic through young people getting addicted to electronic cigarettes early in life." 

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The claims of many nicotine researchers and anti-nicotine groups, including the conclusion expressed by this Johns Hopkins physician, are not consistent with the actual data. If it were true that youth vaping was a gateway to smoking, then the large increase in youth vaping that peaked in 2018 would certainly have resulted in an increase in smoking in subsequent years and would have been very apparent in surveys conducted over the past six years. Instead, just the opposite is happening. Youth are smoking in lower and lower numbers than ever before.  

If anything, the data show that as electronic cigarette use among youth took off, the rate of decline in smoking accelerated. These data refute the contention of so many anti-nicotine groups and researchers that vaping is problematic because it leads to kids turning to cigarettes. The evidence demonstrates that vapes are largely a substitute for cigarettes, not a gateway to cigarette smoking.

The question is: When will these researchers and groups stop making these claims that have now been definitively disproved? When more data comes out showing that youth smoking is on its way out? Probably not. The fact that even with the scientific evidence we have now they are still making these unsupported claims suggests that no amount of scientific evidence will change their public statements. 

This is so disappointing to me because public health is an evidence-based field and we are supposed to change our opinions and positions if the evidence changes. 

John Maynard Keynes is quoted as having said: "When the facts change, I change my mind - what do you do, sir?" With regard to most of the anti-nicotine groups--the mainstream of the tobacco control movement--I think we have our answer.

Why is Dr. Glantz Calling a Letter from an Independent Public Health Practitioner an "Aggressive Lobbying Effort" by the Tobacco Industry?

Yesterday, I discussed what I believe is a mischaracterization by Dr. Stan Glantz of the scientific evidence on the relative risks of smoking vs. vaping as well as an inappropriate attack on independent scientists who happen to favor harm reduction in tobacco control. When I read the piece, I noted that Dr. Glantz accused the tobacco industry of organizing an "aggressive lobbying campaign" to "convince delegates to the 11th Conference of the Parties for The WHO Framework Convention on Tobacco Control to embrace e-cigarettes and other so-called smoke free tobacco products as part of tobacco control." I failed to click on the link because I assumed that this was a true statement. Why would Dr. Glantz call it an aggressive lobbying effort by Big Tobacco if it weren't?

After reading comments from some colleagues, I went ahead and clicked on the link to discover what this big lobbying effort of the tobacco industry consisted of. To my surprise, I found out that this "aggressive lobbying effort" by the "tobacco industry" consisted merely of a letter from one of my colleagues -- Clive Bates -- who has no affiliation with the tobacco industry, urging the delegates to the convention to embrace the idea of promoting electronic cigarettes as a safer alternative to smoking. Clive was transparent in the letter and noted that he has "no conflicts of interest regarding tobacco, nicotine, or pharmaceutical industries."

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In retrospect, the claim that this letter represents an aggressive lobbying effort by the tobacco industry turns out to be false. It is a letter from one person who has no affiliation with the tobacco industry. It appears that this is an attempt to malign the character and intent of Clive, who is a colleague of Dr. Glantz's in the effort to reduce morbidity and mortality associated with tobacco use. 

For six years, Clive headed up Action on Smoking and Health UK. While with ASH, Clive worked to counteract and restrict tobacco marketing, promoted tobacco product and packaging regulation, cigarette tax increases, reduction of tobacco smuggling, and smoke-free places, and he worked to increase the availability of treatment for addiction and to advance harm reduction in the tobacco control movement. He also "worked on development of the WHO's first international treaty - the Framework Convention on Tobacco Control."

There is nothing in Clive's career to even suggest that he has done anything other than to fight Big Tobacco. In fact, the tobacco industry did lobby aggressively against the Framework Convention on Tobacco Control, which Clive promoted. 

Notably, an international effort to promote e-cigarettes as a substitute for tobacco would harm the tobacco industry because it would divert people away from tobacco products and toward non-tobacco products that are much safer. The sale of tobacco would decline, not increase. So if Clive is lobbying for the tobacco industry, he's doing a really poor job!

I find this ad hominem attack disturbing because it's completely unnecessary, untrue, malicious, and arguably defamatory. There's no room for that kind of nonsense in public health. If the facts in support of Stan's position are so weak that he has to resort to character assassination in order to promote his viewpoint, then it doesn't say a lot for the strength of his arguments.

Sadly, I have been the target of defamatory attacks like this several times in my career. Ironically, the most vicious attacks against my character came not from the tobacco industry but from some of my closest colleagues in the tobacco control movement. For example, one of my colleagues - with whom I published a paper expounding the dangers of secondhand smoke - publicly accused me of being a paid hack of the e-cigarette industry. (After I questioned him about why he made this statement, he sent me an email asking whether or not I have taken e-cigarette money, to which I responded: "Shouldn't you have asked me that question before you publicly smeared me in front of an auditorium-full of people?" Incidentally, this is the same researcher who also publicly claimed that e-cigarettes cause popcorn lung.)

We are living at a time when civil discourse is under attack. While there is certainly a place for exposing corporate lobbying that is harming the public's health, making false accusations weakens our credibility. And issuing such attacks against private individuals chills much-needed civil discourse among public health practitioners about a very important scientific question that affects millions of lives.