Grove Mitchell

Some tobacco control groups have repeatedly opposed @FDATobacco's authorizations of lower-risk alternatives to cigarettes—even after those products cleared the agency’s demanding scientific review. Writing in Nature Medicine in June 2024, then-FDA tobacco chief Brian King and colleagues Tracy Smith and Benjamin Toll explained that authorized e-cigarettes “have undergone rigorous scientific review, including toxicologic assessments, and have been found by the FDA to meet the necessary public-health standard.” Yet @TobaccoFreeKids has opposed authorizing any flavored tobacco products, and @LungAssociation has called for removing them all—including FDA-authorized products. What room do such categorical positions leave for scientific findings that support authorization? Individual decisions deserve scrutiny. But reflexive opposition substitutes a predetermined policy position for an assessment of the evidence. FDA needs an increasingly efficient, transparent, predictable process that helps adults move away from smoking while continuing to protect youth. Public health advocacy should support that work through constructive scrutiny—and remain open to scientific findings that challenge established advocacy positions. nature.com/articles/s41591-0…