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Charles A. Gardner, PhD @chancethegardener.bsky.social · 8h

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 · 8h

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 · 8h

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 · 8h

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.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 8h

Here is CDC & NCI evidence from 2007 vs. 2024. Massive changes in use consistent with product substitution. Lung cancer continues to drop.

That's good news. Not PROOF. Suggestive.

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 · 9h

2/2
Further: What % of the 25 million Americans who smoke now believe - INCORRECTLY - nicotine vapes are as or more harmful than cigarettes? That's >60% now.

Imagine a diabetes med. 100% efficacious but >60% of diabetics have been misinformed about its risks. How would that affect compliance?

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 9h

CDC NHIS found 40.3% of adult nicotine vapers had quit smoking completely
www.cdc.gov/mmwr/volumes...

I agree dual use is bad, but how many of the 59.7% are "on the journey to quit"?

How many are smokers who sometimes try a vape?
How many are vapers who sometimes still have a cig?
1/2 ⬇️

Quickstats: Percentage Distribution of Cigarette Smoking Status

This report describes the percentage of cigarette smokers..

www.cdc.gov

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Reposted by Charles A. Gardner, PhD

Dr Alex Wodak AM @alexwodak.bsky.social · 2d

CAGR of 30.6% for global nicotine vapes from 2023 to 2030! Good luck slowing/stopping this disruptive innovation Luddites! When was last disruptive innovation stopped? @jgitchell.bsky.social @chancethegardener.bsky.social @aliveadvocacy.bsky.social

www.grandviewresearch.com/industry-ana...

E-cigarette And Vape Market Size And Share Report, 2030

The global e-cigarette and vape market size was estimated at USD 28.17 billion in 2023 and is projected to reach USD 182.84 billion by 2030, growing at a CAGR of 30.6% from 2024 to 2030

www.grandviewresearch.com

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 9h

FDA claims it authorized 39 vapes, but that's only 11 devices (most of which are made by Big Tobacco). All the rest is just different nicotine levels and 'flavors' for that tiny handful of 11 devices. This makes 99.9% of products 21 million US adults use to avoid deadly cigarettes "illegal."

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Charles A. Gardner, PhD @chancethegardener.bsky.social · 9h

Lung cancer causes 29% of smoking-related deaths.

Nicotine vapes entered the US market 18 years ago in 2007. CDC data show MASSIVE changes in adult use consistent with product substitution. NIH/NCI data show lung cancer continues to drop. This is not proof. But it IS suggestive.

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

2/2
How many (cont.):
- people who smoke have #ADHD, #BipolarDisorder or
#schizophrenia?
- people who vape nicotine have ADHD, bipolar disorder
or schizophrenia?

WHY THESE TWO QUESTIONS?
Ask how many studies show nicotine patches reduce symptoms of these #MentalHealth conditions. ...I'll wait.

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

Here are the:
- questions public health SHOULD be asking
- answers govt officials SHOULD be giving us

How many:
- adults smoke; how has that changed?
- adults vape nicotine; how has that changed?
- teens smoke; how has that changed?
- teens vape nicotine; how has that changed?
(1/2) ⬇️

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

I don't think #HarmReduction is an abstract idea.

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

It claims "Marketed as safer," which FDA would consider an "illegal health claim," so vape firms NEVER do that. It claims "marketed as a cessation aid"... ditto. It claims "particularly targeting children" and "increasing prevalence among youth," but teen use has dropped 70%.

I could go on...

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

The US public is told: "They target teens."
PROBLEM: I read CDC adult (NHIS) and teen (NYTS) surveys, and the numbers don't support that claim.

IF "they target teens" ...they're not very good at it.

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

I see that, but I don't believe an IPA statement is oracular omniscient truth. Seven years in tobacco control have taught me to question everything.

At a minimum, we must both admit that well-meaning experts now disagree. And I KNOW how ironic that is: Claiming "experts disagree..."

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

Will the calculation of costs to the healthcare system take into account the number of Canadian adults who have quit smoking by vaping? You realize 99% of all smoking-related cancer, heart and lung disease is among adults over the age of 50, right?

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

What if (hypothetically) nicotine vapes are much safer than cigarettes, efficacious for smoking cessation, and the most commonly used smoking cessation tool in America?

And what if teen nicotine vaping dropped 70% over the past 5 years to a 10-year low?

Would ANY of the above change your opinion?

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

I don't understand the alternate reality he inhabits. To Big Tobacco, nicotine vapes cannibalize sales of their main cash cow: deadly cigarettes. So it's strange to call #SaferNicotine alternatives an "evil industry plot."

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

As you know Prof Glantz: "effective" = "efficacy" + use
You KNOW Cochrane's systematic evidence review of 90 efficacy studies. You MUST know CDC's NHIS shows the most commonly used smoking cessation tool now (by far) is nicotine vapes.

What evidence would YOU need to support #HarmReduction?

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

Yes. 'Flavor' bans increase smoking:
jamanetwork.com/journals/jam...
harmreductionjournal.biomedcentral.com/articles/10....
tobaccocontrol.bmj.com/content/toba...
papers.ssrn.com/sol3/papers....
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
onlinelibrary.wiley.com/doi/10.1002/...

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

Someone got a grant to do this study. In China, 50% of men smoke deadly cigarettes. 30% of DOCTORS smoke. The state-owned China Tobacco makes 40% of all the cigarettes on Earth... How was THIS profoundly stupid study that finds the obvious every considered a priority?

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

Who will calculate those healthcare costs? Should that cost estimate consider how many adults have quit smoking by vaping (which dramatically LOWERS healthcare costs)? Asking for a friend.
NOTE: Nicotine vapes are now, BY FAR, the most commonly used smoking cessation tool in Canada and the USA.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 3d

PROBLEM: Some #tobaccoControl advocates oppose #HarmReduction. Some support it.

A whole nuther bunch of people quit smoking with #SaferNicotine alternatives..

Some of them are now self-informed advocates, and they're sick and tired of being accused to working for Big Tobacco.

Charles A. Gardner, PhD @chancethegardener.bsky.social · 3d

Old-school Tobacco Control strategies:

INTERVENTION ETHICS VIOLATION
Stigma Nonmaleficence (do-no-harm)
Coercion (taxes, bans) Autonomy
Harm exaggerations Truth-Telling

Old-school Tobaco Control "experts" reject #HarmReduction because they are zealots.

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