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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

I hate conspiracy theories: Just ask "how many would have to be in-on-it?" If that's 1,000s, "conspiracy" is BS.

Today, 2 unaccountable foundations collectively spend >$250m/yr to *push* "THEY TARGET TEENS!"

Big Tobacco now actively reinforces their claims (to kill it's competitors)...

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

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One reason is that informed ex-smokers who quit with #SaferNicotine alternatives are excluded from all debate and discussion. For example, LITERALLY physically thrown out of FCTC COP meetings.

This is like setting HIV/AIDS policies while ignoring voices of PLWHA. It is PROFOUNDLY UNETHICAL.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

Establishing common goals is a 1st step in settling disagreement. From then on, well-meaning experts SHOULD be able to hold respectful discussion and debate about strategies and tactics to achieve those goals.

In tobacco control, this does not happen. One reason is that informed...
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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

Teens with anxiety, stress or depression are more likely to use #SaferNicotine vapes. Decades ago, they would have been smoking deadly cigarettes.

They are self-medicating. #DealWithIt. 40 years of research and 1,000s of studies show nicotine reduces anxiety, stress and depression.
#nootropic

Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

I think "stigma" violates "do no harm" (Nonmaleficence).

Stigmatizing people who do things YOU don't like is a needless venomous harm. HELPING people quit smoking is Beneficence (do good) and a social justice issue.

I used to teach Healthcare Ethics to med students. :-)

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

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"Justice" = treat everyone equally and fairly.

25 million US adults smoke (teens don't smoke anymore). But note: Most are low-income or adults with #MentalHealth issues or American vets or #LGBTQ or #unhomed or #AmericanIndians.

Rich & educated Americans don't know anyone who smokes.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

People who smoke KNOW it's harmful. You would have to be living under a rock for the past 4 decades not to know that.

I don't smoke. But I feel strongly it is profoundly immoral to shun and stigmatize people who do.

Justice is a fundamental moral principle in healthcare ethics...
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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

I get that. Consider:
Smokers vs. People Who Smoke
HIV-infected vs. People Living with HIV/AIDS

But many #neurodiversity people do NOT like person-first. So, for example, informed "people with ADHD" prefer to be called "ADHD people." I think people with Downs Syndrome have similar views.

Reposted by Charles A. Gardner, PhD

Kathleen Bachynski @bachynski.bsky.social · 1d

Reshma Ramachandran “said the sequence of events is the antithesis of how the FDA is supposed to function.

“What we’re seeing here is, ‘We believe this and we’re going to find the evidence to support that’ …That’s just inherently wrong in terms of how a scientific agency like the FDA operates.”

Inside FDA, career staffers describe how political pressure is influencing their work

Current and former FDA staff said the level of involvement of political officials in nitty-gritty regulatory matters is unprecedented.

www.statnews.com

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

Stigma violates a fundamental moral principle in healthcare ethics: Do no harm (Nonmaleficence).

Professionals who work with people who use ILLICIT drugs now reject stigma. They reject the words "addict" and "addiction," and use "people first" language.

Tobacco control embraces the opposite.

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

That's the opposite of what you said, but this is splitting hairs. Both "EVALI" and the "popcorn lung" myth are just weaponized propaganda tactics, debunked a million times by some of the top tobacco control experts in the world...

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 1d

Knowing that, yet still being unable to take the next logical (and ethical) step is... weird.

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

Étrange. On ne voit pas ça ici aux États-Unis.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

All the best Spoopy, but vitamine E acetate (VEA) caused "EVALI" six years ago (almost entirely in the USA). 68 deaths. VEA was a cutting agent used by some bootleg THC vape oil dealers to stretch their product.

"Popcorn Lung" is caused by diacetyl, which almost no nicotine vapes contain.

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

Sometimes it IS sensible to base your entire worldview on just watching your own grandchildren (Piaget).

Sometimes it IS sensible to base your entire worldview on the obvious: scientific "truth" changes because new evidence emerges (Kuhn).

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

That man, like many of his #HarmReduction denialist compatriates, blocks me on all social media. I am often blocked for simply saying "Thank you for sharing that information, but here is what official government surveys actuall show" (followed by links to the official surveys).

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Reposted by Charles A. Gardner, PhD

Dr Alex Wodak AM @alexwodak.bsky.social · 3d

Q: Who said: “Sweden has attained the lowest prevalence of smoking among any nation, largely because of the major shift that has occurred from smoking to snus use in men”?

A: Simon Chapman (pmc.ncbi.nlm.nih.gov/articles/PMC...)

@chancethegardener.bsky.social @algore09algor.bsky.social

Falling prevalence of smoking: how low can we go?

A sustained international initiative to fund major public awareness campaigns in nations that could never afford to run such campaigns would make a huge difference to nations in which such awareness r...

pmc.ncbi.nlm.nih.gov

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

Future health historians will excoriate them for their dogmatic objections to #HarmReduction and stubborn adherence to stigma and coercion as the only "approved" way to "help" smokers. Future health economists will quantify how many deaths they caused by discouraging smoking cessation.

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

We all learned cigarettes KILL PEOPLE in the early 1960s. 1962 Royal College of Physicians report. 1964 US Surgeon General report.

So helping people who smoke QUIT is a super-good public health goal. ETHICALLY: How do we achieve that goal?

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

Heh heh... Lung cancer deaths drop because treatment keeps getting better (more effective).

Lung cancer incidence (new cases) should increase because detection tech keeps getting better (more sensitive).

When someone quits smoking cold turkey, it takes about 10 years for cancer risks to drop...

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

What are the consequences if you are wrong? You say dual use as a key problem. But dual use is caused and perpetuated by violating Truth-Telling, and actively misinforming people who smoke about relative risks. No?

FDA is alarmed about that misinfo. As am I.
www.fda.gov/tobacco-prod...

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

I assume we both agree: Reducing DEATH is a good goal. Can you see how well-meaning people might view #HarmReduction as a disruptive innovation? A paradigm shift?
Adult Use: www.ncbi.nlm.nih.gov/pmc/articles...; www.cdc.gov/nchs/data/se...
Lung cancer: seer.cancer.gov/statfacts/ht...

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

Evidence from the United States does not support what the WHO and you just claimed. Not even close.
ADULTS wwwn.cdc.gov/NHISDataQuer...
TEENS
2019: 4.5% smoked; 20% vaped nicotine (5% daily)
cdc.gov/mmwr/volumes...
2024: 1.4% smoked; 5.9% vaped nicotine (1.6% daily)
www.cdc.gov/mmwr/volumes...

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

It's easy to see how pandemic lockdown affected teen nicotine vaping (public CDC reports). Easy to see from NIH's MTF survey how lockdown affected teen use of illicit drugs (everything dropped). All confused by the well-funded effort now underway to make the public think teen vaping is increasing.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 2d

You have opinions. But CDC has facts. In 2024, 5.9% of US middle and high school students vaped nicotine "at least one time in the past 30 days" (70% lower than five years ago).

1 in 4 of THOSE vape daily so MAY be 'hooked' = 1.6%. And California teen use is ~30% lower than the national avg.