Tobacco Asia

November/December 2026 - Vol.30 No.6

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Tobacco Asia 19 tive risks of different tobacco products. "These three objectives are interconnected," Koplow said. "And getting all three right simultaneously is harder than it might seem." For an agency that Koplow later acknowl- edged had been reluctant even to use the term "to- bacco harm reduction," the language was notable. Correcting the message Koplow traced some of today's confusion over e-cigarettes to the dramatic rise in youth vaping in 2018 and 2019 and to the e-cigarette or vaping product use-associated lung injury (EVALI) out- break, which was ultimately linked primarily to vitamin E acetate in illicit THC vaping products. The public health response to rising youth use was understandable, he said, but it also left a legacy. "One of the lasting effects of that period, one we're still contending with, is a widespread and deeply held misperception about what e-ciga- rettes are, and what risks they pose for adults who smoke," Koplow said. He cited survey data showing that the share of adults who correctly understood that FDA- authorized e-cigarettes are generally less harmful than cigarettes declined from about 51% in 2012 to less than 17% in 2022. "That is a striking re- versal and a concerning departure from scientific evidence," he said. CTP is developing plans to better inform adult smokers and healthcare professionals about lower-risk alternatives, Koplow said. Credit: Direct Media StockSnap Complete cessation of tobacco use remains the healthiest outcome, Koplow emphasized. "That's our baseline, and it's unambiguous," he said. "But for many adults who've tried to quit re- peatedly and failed repeatedly, completely switch- ing to a lower-risk, FDA-authorized tobacco product can meaningfully reduce their exposure to the toxic and cancer-causing chemicals that make combusted cigarettes so deadly. That's not a com- mercial claim. It's a scientific one."

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