Pediatrics just published the final version of my paper "Tobacco Use Among Middle and High School Students: 2025 National Youth Tobacco Survey." They key observations are: Overall youth tobacco use is continuing to decline The two most commonly used products are e-cigarettes and nicotine pouches The decline in overall tobacco use is manifest across all products, except nicotine pouches, which doubled from 2021 through 2025…

In 1994 when I worked with the UCSF Library to put the original collection of about 10,000 pages of internal documents from the Brown and Williamson Tobacco company on the internet, I had no idea that the project would grow not only to the Truth Tobacco Industry Documents Library that contains 20 million tobacco industry documents, but the much larger…

Roengrudee Patanavanich, her Thai colleagues, and I just published "Patterns of e-cigarette use by sex and age in Thailand: The National Health Examination Survey 2024–2025" that provides detailed statistics on cigarette and e-cigarette use in Thailand, a country that does not allow import and sale of e-cigarettes. We found current e-cigarette use among 5.3% of youth (age 10-19), 8.3% of young adults (20-29) and 1.0% among adults (30+).

Tobacco companies are embedded in influential U.S. business groups worldwide, giving the industry a powerful channel to undermine public health.

In April 2025, as part of its attack on the federal government’s tobacco control efforts, the Trump Administration pulled the plug on data collection for the 2025 National Youth Tobacco Surve…

In April 2025, as part of its attack on the federal government's tobacco control efforts, the Trump Administration pulled the plug on data collection for the 2025 National Youth Tobacco Survey (NYTS), a large national survey of middle and high school tobacco use the CDC -- later joined by the FDA -- had been running since 1999. In past years, the CDC (later with the FDA) published the topline results in the CDC…

In 2004, when Richard Sargent, Robert Shepard and I published "Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study" reporting that hospital admissions for heart attacks dropped when Helena, Montana passed its smoke-free law, it was controversial. Since then, many studies have confirmed and expanded this conclusion (Institute of Medicine…

The UCSF Industry Documents Library has released a very useful new Juul Labs Collection Content Guide on the IDL website that provides a wealth of information and links to key documents to help people get started in searching the Juul documents. It is specifically built around the Multistate Juul Labs Collection, which includes materials disclosed through litigation and settlement agreements with the attorneys general of California, Colorado, Illinois, New Mexico, New York, Massachusetts, and the District of Columbia.

Yeon Wook Kim and colleagues' new paper "Electronic cigarette use after smokingcessation and lung cancer risk" shows that smokers who switch to e-cigarettes have about a 50% higher risk of developing lung cancer and about a doubling of risk of dying from lung cancer than smokers who just stop smoking. Most important, this paper is direct high-quality evidence against e-cigarette advocate and tobacco company claims that switching from cigarettes to e-cigarettes would reduce lung cancer risk…

Nature Human Behaviour - Ever since electronic cigarettes (e-cigarettes) were first marketed in 2004, they have been promoted as ‘tobacco harm reduction’ on the basis of the assumption...

On April; 26, 2026, FDA announced that it added 18 compounds to its "Harmful and Potentially Harmful Constituents" (HPHC) list to assess toxicity of tobacco products. This was the first update of the list since it was first released 14 years ago in 2012. The updated list includes several things, most notably propelyne glycol (PG) and vegetable glycerine (VG, listed as glycerol), which are important components of e-cigarette liquid and heated tobacco products.

The California Attorney Genera maintains an official "unflavored tobacco product list" to facilitate implementation and enforcement of the state's flavored tobacco product ban. The AG proposed "readopting" an undated list. We support that proposal and made a few suggestions for improving it. A PDF is available here. This is an excellent model for other states, particularly since President Trump has finished off the job of…

Pam Ling and I recently published "E-cigarettes increase harm and should be discouraged" in Nature Human Behavior that summarizes the current evidence on e-cigarettes. The Introduction sums up the paper: Ever since they were introduced, arguments that e-cigarettes reduce tobacco harm have hinged on three assumptions: (1) nicotine aerosol from heating a liquid rather than burning tobacco substantially reduces disease risk; (2) smokers would quit or switch completely from cigarettes to e-cigarettes; and (3) e-cigarettes would not appeal to youth.

My colleagues and I just submitted this public comment to FDA opposing its proposal to allow sales of flavored e-cigarettes and other electronic nicotine delivery systems (ENDS) on the grounds that benefits to adults would outweigh harms to kids. It also presents evidence that two-way communication between ENDS and external agencies (that could include ENDS manufactures or their agents) is exceptionally dangerous because it could allow control of the device to increase addiction and should be prohibited not encouraged.

On April 23, 2026, Michael Smerconsih interviewed me about the UK Generational Smoking ban. I surprised him by arguing that generational smoking bans are bad public policy because they divert resources from more effective tobacco control policies that had faster public health benefits. I am also skeptical that they will be maintained in the long term as people age into them.

The evidence that comprehensive flavor bans are followed by drops in tobacco consumption keeps piling up. A new study by Giovanni Appolon, and colleagues, Local Flavored Tobacco Bans and Youth Electronic Nicotine Delivery Systems Use, of 2.8 million California middle and high school students across 483 local jurisdictions found that local flavored tobacco bans that took effect before California's state ban were followed by reduced youth e-cigarette use over time.

The New York Times recently highlighted how many "Make America Healthy Again" influencers are promoting the benefits of nicotine, including reversing Alzheimer's Disease and improving cognition. While we don't know what role the tobacco companies are playing in this latest resurgence of claims that nicotine is a beneficial substance that poses little or no risk, we do know that…

The FDA is required to maintain a list of "Harmful and Potentially Harmful Constituents" (HPHC) in tobacco products. The original list was released in 2012 and was mostly toxicants in cigarette and other tobacco smoke and smokeless tobacco. In particular, this list did not include important compounds in e-cigarettes and other "new" tobacco products. In 2019, FDA proposed adding 19 compounds to the list that were in these products.

Jagdish Kaur from WHO and several colleagues from India's new paper "E-cigarette use and subsequent tobacco smoking initiation: an umbrella review with Bayesian model meta-analysis" provides the most comprehensive summary of evidence that e-cigarettes promote cigarette smoking in nonsmokers available to date. They also show that e-cigarette use in former smokers promotes relapse to smoking. Kaur and colleagues searched the literature for earlier reviews and meta-analyses of the association between e-cigarette use and subsequent smoking.

Nicotine pouches (like ZYN and on!) are being touted by some advocates as a "harm reduction" alternative to smoking cigarettes. Kelvin Choi and colleagues examined whether this happens in real life in their new paper "Patterns of tobacco product use among US adults who use nicotine pouches and the association between nicotine pouch use and tobacco product use cessation…

Bernard Stewart and colleagues from Australia just published "The carcinogenicity of e-cigarettes: a qualitative risk assessment" in Carcinogenesis. This review (summary) of the literature cites 116 papers, 15 of which were published in 2025. The fact that so many of the citations are recent is important because the evidence on the health risks of e-cigarettes is rapidly accumulating.

In April 2025, the Trump Administration shuttered the CDC Office on Smoking and Health and stopped collecting data for the 2025 National Youth Tobacco Survey. Later, the Administration announced it was restoring the NYTS and transferring is administration to the FDA Center For Tobacco Products, which had been partnering with CDC since 2021. On March 4, 2026, FDA quietly released…

Last year California passed AB 3218 to tighten up and simplify compliance with and enforcement of California's ban on the sale of flavored tobacco products. Part of this was to have the Attorney General establish and maintain an Unflavored Tobacco List (UTL) that included those tobacco products that could be sold legally in California. to protect the public health by removing flavored tobacco products from the market.

Using e-cigarettes (vaping) has been promoted as a much safer alternative to smoking cigarettes. However, a new head-to-head comparison of actual disease in e-cigarette users compared to cigarette …

Objective The merging of US smokeless tobacco (SLT) and cigarette industries in the early 2000s was highly predictable based on cigarette manufacturers’ long-standing interest in developing SLT produc...

Using e-cigarettes (vaping) has been promoted as a much safer alternative to smoking cigarettes. However, a new head-to-head comparison of actual disease in e-cigarette users compared to cigarette smokers published in Public Health Reports shows that this assertion is wrong.  This new analysis of 124 studies on the association of e-cigarette use with disease outcomes in the general population demonstrates that for some diseases there is no detectable difference in the odds of disease for current e-cigarette users compared to cigarette smokers.

E-cigarette advocates, global warming deniers and social media companies continue to sidestep the implications of research showing dangers of their products by, among other things, retreating behind the high walls of claims that the evidence is not "causal." To put these claims in context, it is worth re-reading the last couple paragraphs from our book The Cigarette Papers (University of California Press, 1996, pages 441-442) on the original set of Brown and Williamson documents that were sent to me from "Mr.

On February 9, 2026, as required by Epstein Files Transparency Act, the Department of Justice gave members of Congress access to the unredacted Epstein files, but just made four computer terminals at available. This reminded me of a similar situation back in 1999, when the British American Tobacco (BAT) company opened its Guildford Depository to make the documents it produced in the Minnesota lawsuit against BAT and other tobacco companies public while allowing only one organization (up to just 6 people) allowed to search the documents at a time.

Shortly before the 11th WHO Framework Convention On Tobacco Control Conference of the Parties in November 2025, Vitoria Borges Spinola, Lucas Porto Santos, Hamilton Roschel, Bruno Gualano, and Megan E. Roberts published "Weak enforcement of Brazil's E-cigarette ban and the expansion of a dangerous illicit market" in The Lancet Regional Health – Americas arguing that Brazil's ban on importation and sale of e-cigarettes has been a failure based on their estimated 600% increase in adult e-cigarette use between 2018 and 2023.

The issue of redactions – both redacting names of victims and not redacting participants in Jeffery Epstein’s “social circle” --  documents has been in the news.  There have also been questions about why it took so long for DOJ to release around 3.5 million pages of documents, plus about 2,000 videos and 180,000 images. Working with the UCSF Library, I created the first collection of previously secret tobacco industry documents in 1995, which consisted of a few thousand pages of internal…

As the SFMTA works to fill a budget gap for its operating costs in FY26/27, a dangerous option is being considered: diverting $40 million in capital funding designated for street safety projects. ...

Last year the Trump Administration eliminated the CDC Office on Smoking and Health and fired the FDA Center for Tobacco Products leadership, paving the way for FDA to even more closely embrace the tobacco industry’s “harm reduction” marketing messages. OSH ran the effective “Tips from Former Smokers” advertising campaign, supports state health department tobacco control efforts, runs a media resource center to help states share anti-tobacco advertisements, prepares Surgeon General Reports, runs important surveys including the National Youth Tobacco Survey, and more.