The Real Smokescreen is Nicotine Disinformation

The head of the American Lung Association (ALA) recently penned a letter to the editor (LTE) in The Washington Post in response to an article about Zyn, an oral nicotine pouch that is growing in popularity. In the letter, he argues that Zyn is an unsafe tobacco product intentionally marketed to youth. He also claims there is no safe nicotine product—never mind the tranche of smoking cessation therapies approved by the U.S. Food and Drug Administration (FDA) to deliver nicotine without combustion (which the ALA supports). The real smokescreen here is that tobacco control advocates like the ALA have shifted from a strategy of misinformation to one of disinformation; that is, intentionally spreading false information to influence public opinion.

To be clear, concerns about youth using any tobacco or nicotine products are valid. It’s why, at the peak of the youth vaping epidemic, Congress passed legislation raising the legal age to purchase tobacco and nicotine products to 21. But there is no evidence that the use of nicotine leads to major health issues in healthy adults, and the safety profile of nicotine pouches is equivalent to other FDA-approved nicotine replacement therapies. Moreover, by using “the children” to fearmonger, the ALA continues a long-standing national tradition of promoting “abstinence for all” over solutions that can save lives.

An estimated 30 million Americans who smoke cigarettes cannot or will not quit; among those, half a million will perish each year from smoking-related diseases. We need every possible tool to help people move away from smoking, yet disinformation like this jeopardizes efforts to help these folks transition to lower-risk options for consuming nicotine. The reality is that some adults enjoy nicotine products, and that substance prohibition never works at the population level.

Some policymakers have used similar tactics to crusade against the availability of nicotine pouches. But oral nicotine product use remains low in those under the age of 21. In fact, nowhere in the study referenced in the LTE does it conclude that Zyn is “mostly sold to the adolescents who are not represented in the sample.” The author might be confusing the study with a separate article in which a coauthor speculates on possible reasons for increased sales.

Public health officials should focus on educating adult consumers about both the relative and actual risks associated with the use of any tobacco and nicotine product, allowing them to determine which products align with their personal health goals.

Rather than finding new ways to help smokers kick the habit, the ALA is hell-bent on toppling Big Tobacco to meet its strategic imperative to create a tobacco-free future (which apparently now includes nicotine), though there is not a single precedent for full abstinence from any substance across the history of humankind.

While public health organizations like the ALA continue their quest toward abstinence for all, we’ll continue to make the case for access to harm reduction tools that can save lives. Should there be a successful strategy for eliminating substance use, the ALA should bring that forward—but we won’t hold our breath.