Shaping Vaping - Effervescent dialogue on nicotine-THR policy. 

Featuring Jim McCarthy, Joe Gitchell, and Cheryl Olson
7/17/25

Jim: Hello friends, it's Jim McCarthy with American Vapor Manufacturers here for another scintillating, enlightening, illuminating episode of Shaping Vaping, our podcast on nicotine and THR policy. I'm going to be joined today as ever by the inimitable Joe Gitchell, and we have a very special guest today that I would like to ask Joe to introduce since it was his good overture and outreach that enabled us to land this incredible get, as they say in broadcast journalism. Joe, I see you're a speaker, although it appears you may be muted.

Joe: Nothing, the button has been pressed. Yes, I'm delighted to join and eager to have Dr. Cheryl Olson join us.

Jim: Tell us all about Cheryl. Some of our listeners will be familiar, no doubt. Why don't you give us a little background on her incredible stellar work?

Joe: Well, first, I'd like to say the fact that I even know Cheryl as a testimony to getting outside your bubble and meeting people. I had attended a TEDMED conference, maybe 2016, randomly met this really nice woman, and she said, oh, you ought to talk to my friend, Cheryl Olson. She has lots of insight.

Joe: I'm like, okay, sure. That led to a chance to collaborate with Cheryl and her husband, Larry. We can have Cheryl give more of the specifics, but Cheryl is an expert with academic training, but real applied experience, particularly around communication, the way, the kind of incentives around our media environment, and I'm just delighted to sit here and revel in the discussion that you're about to lead.

Jim: I can't wait. I can't wait. A lot of her work, her academic work has been on moral panics and hostility to video games, which is a subject near and dear to my heart because I was an early adopter of video games all the way back to the 1970s with the early Atari 2600.

Jim: I'm here to tell you, Joe, I have walked through more side-eye, discontent, scolding, musket fire from people who bought into the myth that video games are somehow deleterious to the health of the youth trademark, and I can't escape the feeling that the public health puritans have really just been following me this entire time and trying to stop Jim McCarthy doing what he pleases.

Joe: We can't rule that out, and I'll let you add, Cheryl, look at you. You're getting good.

Jim: Yes, I see Cheryl there, although Cheryl, I think your mic may be muted, and I hope we have a little time.

Cheryl: Yes, hello, I'm here. I was muted when I came in. It took me a while to unmute myself.

Jim: No worries. No worries. Thank you for clearing the technical hurdles, Cheryl.

Jim: Joe and I are so delighted to have you. It's such a privilege to get a chance to speak with you, so thanks off the top. Joe just gave a little bit of your background, and I sang a hosanna or two about your incredible work on video games, a subject near and dear to my heart.

Jim: It's just so great. Thank you for making time to be here.

Cheryl: My pleasure. I just moved from Silicon Valley to Richmond, Virginia about a week and a half ago, so my life's in a bit of chaos and mess, but it's great to do something normal like this, so thank you for having me.

Jim: All right. Well, it's good to know that you are residing in what I regard as the cradle of liberty, so that's a good omen.

Cheryl: Well, it is strange. In Silicon Valley, they're very pro-harm reduction for everything except nicotine.

Jim: Yeah. I mean, it's so interesting. I did a little homework as I was preparing for this show about various moral panics that have occurred in public, and it is striking how they can, how could I put it, that they can capture such divergent and often odd bedfellow coalitions of people.

Jim: It's not just one kind of person or one sort of political outlook, or it's very tough to categorize. They seem to happen almost like, I don't know, a rash or with a sort of pernicious effect across all demographics.

Cheryl: Yeah. It's like when the liberal coalition will suddenly be against rock music lyrics or something strange like that, and then there's the issue of why do they go away, which I hope we'll get to later. I don't have the answer, but I'd love to speculate on it.

Cheryl: Something like why is the moral panic on marijuana? Why did reefer madness end?

Jim: Yeah. I want to get into that about how those panics sunset and what can be done to help curtail them. Although you're reminding me of a great line from the rock music hearings on Capitol Hill led by Tipper Gore and the deeply misguided Senator Paul Simon.

Jim: One of the rock musicians, I remember, had a great rejoinder to Senator Simon, who had read some of his supposedly offensive lyrics out loud. The rock musician said, do you imagine if I wrote a rock song about mowing the lawn that all these teenagers would get out there with their lawnmowers?

Cheryl: You know, to get into the history of the moral panics, I wrote a book with my husband after I did the video game violence research. We had a million and a half dollar government grant to study the effects of violent video game content on youth when I was on faculty at Harvard Medical School. We wrote a chapter, actually, my husband really gets most of the credit for that one, a chapter in this book called Grant of Childhood about the history of moral panics.

Cheryl: Some of them were wonderful. For example, ratings on things like video games, movie ratings were done in response to a fear of legal regulation, that we better self-regulate quickly. There was all kinds of research on how kids and the ignorant immigrant masses were going to imitate what they saw in films.

Cheryl: When the ratings came out, they were forbidding things like the dynamiting of trains for fear that people would copy. I don't know how they would get the dynamite, but there were a number of things that were prohibited that they thought people might copy from the movies. Then in the 50s, there was a fear about the crime and horror comic books.

Cheryl: If you've seen that book, The Adventures of Cavalier and Clay, stuff like that. There were these wonderful hearings, Senate subcommittee hearings that got into juvenile delinquency, if you remember that phrase, and whether Batman and Robin were a gay couple. There was a Ninja Turtle panic for a while, where there was a fear that kids would not know how to play anymore and lose their imagination because they were just copying Ninja Turtle cartoon scripts.

Jim: It's really astounding. The ones you've ticked off involve advocates and loud voices on the right and the left and the middle. It's really striking just how ecumenical it can be.

Cheryl: Yeah, really. There was a wonderful article that I saved, and I might have sent it to you guys beforehand. It was from the New Republic from, I think, 2013 called The New Puritans.

Cheryl: The subtitle was When Did Liberals Become So Uptight? It was by Mark Oppenheimer. He was apparently a newish parent at the time, and looking at what is it with all of the liberals, what he called left-wing Puritans, drawing on this mixed of righteousness and the fear of contamination, which maybe is a uniquely American mix, and a fear of like, oh, there's sugar in the cupcakes.

Cheryl: I can't let my child eat that. Oh, there's ALR on the apples. I can't let my kid have that.

Cheryl: The same parents were concerned about, oh, I can't let my child watch television or video games. It's bad. It's like, well, video games are a medium.

Cheryl: Would you say, I cannot let my child read books? It's a pretty broad range of things that are covered by any medium.

Jim: It's so interesting. I want to just, for Joe's benefit, mostly state my bona fides, that I have often tried to get my friends in the conservative movement to sober up on things like the Teletubby Panic. There's an organization in Alexandria, Virginia that does terrific media criticism on all sorts of flaws in journalism.

Jim: In addition to that, they also go on these tangential jags about which one of the Teletubbies is the gayest. I'm just like, guys, would you please just keep your head in the ballgame here? So I do chastise my friends on the right for that.

Jim: But I must say, Cheryl, I am really struck, and I'm hoping this will provoke Joe's to jump in here. He's suspiciously quiet. Well, I mean, Joe's very gracious about our dialogue, and we each try, he better than I, to let one another have our say.

Jim: But I must say, I'm struck at how a lot of the panics you're describing, especially those in nutrition, food, beverage, consumption, are driven by progressive interest groups. And I think that's true of several of the ones you mentioned, ALAR and Apples, which happens to be a matter I worked on with the ag industry.

Cheryl: The fear of vaccines really started with the more left-wing, you know, like Marin County, California types.

Jim: It did. Yes, that's quite right. In fact, there's a whole, there's an entire, believe it or not, entire public relations agency in Washington, D.C., and an associated advocacy group, I'm talking about Fenton Communications and Environmental Working Group, that do nothing, nothing all the live long day except gin up these kinds of panics about different kinds of consumer products. And I'm talking everything from movie theater popcorn to delivery pizza to, you know, vitamins to children. I mean, the laundry list is just staggering to behold. And they absolutely feast on sparking those brush fire panics.

Jim: And it just shows you how, you know, prevalent that is among progressive activist groups. And I, I don't know, I wonder if you've noticed that kind of that aspect.

Cheryl: Oh, gosh. You know, I guess I haven't paid attention to the, aside from the politics of video games, which I did look into. Yeah, I haven't paid as much attention.

Cheryl: I mean, what was fascinating with the video games was the way a number of politicians used games to distract from their problems, like Rob Blagojevich in Illinois. They were, you know, they were passing and then Arnold Schwarzenegger as well. You know, they were, there are people passing, trying to pass state laws when they couldn't, you know, didn't get a national thing trying to say, oh, we're going to, we're going to, you know, protect your dear children from violence by passing this law.

Cheryl: And in the, you know, in this case of California, they ended up going to the Supreme Court and they were, and the Supreme Court was like, no, I don't think so. And it was so funny because Schwarzenegger, of course, had made money off games that used his voice or based on his violent movies.

Jim: Yeah, it's really, it's really astounding. But, you know, therein, I think between the lines is an insight, which is those politicians and those advocacy groups know correctly, they intuit correctly that the news media is going to pick up and push and join in that pinata party when they spark the brushfire. And that I think is really that that's, as you may tell, is my own, you know, pet peeve focus about this is that the news and journalism institutions that we count on for sober, factual, set the record straight coverage, not only fail to do that, they join in the moral panic.

Joe: So, so, so, Jim, you agree that markets are a useful way of looking at the world, right? Undoubtedly. And the demand for information has a pronounced negativity bias.

Joe: We evolve to pay attention to things that concern or frighten us.

Jim: Yeah, I see that too.

Joe: So that's an important dynamic that shapes this. And that evolutionary result does not know ideology. Yeah.

Joe: So as convenient and happy as it makes you think that if only, you know, the folks who see the world through a different lens and have care and fairness as their sacred values would just wake up, the problem would not go away, it would change. But this is a fundamental reality of the way that we humans prioritize and process information.

Jim: I take your, I take your point, Joe.

Joe: And I think you could say you take and you and wow, Joe, you're right.

Jim: Well, let me, let me add, let me just finish that. You're correct. And let me see if I can enhance the point.

Jim: As I said, I think the conservatives, you know, have much to answer for in in sparking these kinds of moral panics, no doubt. But I'm talking about the prevalence of it. I mean, you know, there are Yankees fans that live in New Mexico, but most like Yankees fans are in the Bronx.

Jim: You know, I'm not suggesting it's binary one or the other, but it does seem to me and to others who study this closely, I'm thinking of Noah Rothman, who had that terrific new book, I'm sure you read, Cheryl, Rise of the New Puritans last year. And they ascribe the prevalence of these kinds of panics, particularly on lifestyle, food, beverage, medicines, to, you know, predominantly progressive interests.

Cheryl: Well, maybe there's, you know, this sort of Puritan thing about, you know, fear of contamination and protecting the youth. I guess, I guess those are in some ways more, you know, left side of the aisle issues, as opposed to sort of the general, you know, freedom, you know, don't regulate me focus of the other side, perhaps.

Jim: I'm happy to, I'm happy to look at it in that light, Cheryl. And I think that actually, Joe, might even be more instructive. I mean, you know, roughly speaking, Puritans versus, you know, let's call it liberty, liberty lover, libertarians, or, you know, people that value that prioritize individual freedom, you know, as opposed to...

Joe: And, yes, I'm willing to walk along this path, especially as Puritanism, and Cheryl's rightly grounding this in the notion of trying to protect against contamination, that what is a contamination has ideological valence, but the fear of contamination is also a human thing, not a right left thing.

Cheryl: Yeah, and the fear of losing control, I think, too. I think a lot of, I think, with both video games and vaping, I would argue that, I mean, a lot of this is sort of a protect the youth impulse, but also, you know, these are forces I don't understand. It's a new technology.

Cheryl: With video games, for example, if I'm concerned about what's in a movie, or, you know, or a book, I can flip through that book, I can get a DVD or, you know, fast forward to that movie. With a video game, I don't know how to use the controller. I don't know how to get, I know there's lots of content in there.

Cheryl: I don't know how to get, what might happen after they play for five hours, and this thing happens. And, you know, so there, and with vaping, I think, again, it was this, oh, there's these little, there's these things that look like, what is it, flash drives, thumb drives, what do you call these? And they can put them on their backpacks, and I don't know what that is, and they're hiding it from me.

Cheryl: And then there's the nicotine, and then there's the addiction issue.

Jim: Right. It has a number of different elements, yeah, that sort of trigger that. But just to loop back to the earlier point, you know, can we agree that the news media, which ought to have, and claims to have, a mitigating, fact-based, sober assessment of these kinds of things, instead often and typically fuels these kinds of panics?

Jim: Is that, I mean, am I alone in that thought?

Cheryl: Well, when you think about the modern media environment, people are looking to click on things. And I haven't looked at this field, you know, all of these data in depth lately, but my understanding is that, you know, anger and fear are more likely to cause you to click on something.

Jim: Well, think about it this way. I mean, you know, we looked at, the three of us in prep for the show, looked at articles from about 30-odd years back, where then Surgeon General C. Everett Koop came out with a pronouncement that the video game, Pac-Man, was causing mental health problems in America's children and urging legislative action about it.

Jim: Now, if he said that at a dinner party, you'd look at him correctly as a kind of half-baked kook.

Cheryl: Maybe he's had a glass too many, you would be thinking.

Jim: Yeah, yes, but when that pronouncement gets printed in the Associated Press and the New York Times, as indeed it was, to an ordinary American, it's conferred with some kind of, you know, authority and credibility and gravitas. You know, the New York Times and the AP will not shut up about how they hold public officials accountable and their role in society is to shoot straight and just the facts and be a neutral arbiter, but here they are parroting what is absolute lunacy.

Cheryl: Yeah, because it's an authority figure and they don't have any reason. I guess it's more they have no basis on which to not parrot it or to contradict it, at least not at that level. And he was saying himself, you know, that he assumes the data will come, the data weren't there, hadn't been collected yet, but it fit the pattern perfectly of all of these new media of, you know, hey, this suddenly my kid is gathering down at the pizza parlor or the arcade, wherever these machines are, and why aren't they outside playing?

Jim: Yeah, well, maybe the New York Times could change its masthead slogan from news that's fit to print to when in doubt, when in fear, when in doubt, run in circles, scream and shout.

Joe: Oh boy, so I think we also need to be mindful of our potential selection bias we're talking about here, because lots of urgent, breaking, scary news actually ends up being something that we are glad we attended to and took seriously. And that's why the idea, I'm going to get to quote Jonathan Rauch and the Constitution of Truth, the defense of knowledge again, but that's why we need to follow the processes and approaches that can lead to reliable knowledge generation. And I know you're not suggesting, Jim, that every hair on fire account is to be dismissed, right?

Jim: No, but I think they'll be taken more seriously if the public has confidence that they've been vetted and assessed soberly.

Joe: And so that's the challenge and opportunity. Completely agree.

Jim: And I would give a lot more grace to these journalists, Joe, if down the road, when these kinds of situations turn out to be complete 100-proof bunk, like Pac-Man's going to give you depression, that they row it back and say, oh gosh, it turns out the studies or the analysis that Dr. Coop was talking about, turns out it actually doesn't. And you see that over and over again, especially in the coverage of vaping, which I want to pivot to here, Cheryl, is that you know, these scare stories that the press runs about, I don't know, popcorn lung or e-valley is obviously a huge example, but there's many others too that are debunked in like entirely refuted in the scientific literature. And you never hear a syllable from these writers that had touted them on the front page.

Jim: And so, you know, at that point, any benefit of the doubt or grace they might otherwise get for being vigilant is just out the window in my eyes.

Cheryl: Well, the other thing here is, I mean, there's a nature of news. News is things that are new and the news cycle that moves on. And, you know, it's not really a reporter's job to go back and say, did we cover that exactly right?

Cheryl: They're covering the new news.

Jim: Well, I think that's right. But, you know, hang on. There have been a lot of, in the nutrition space, for example, there've been a lot of 180 reversals on things like, I don't know, trans fats, for example, and margarine versus butter, or, you know, when new science and data evolves, especially on issues and topics that are, you know, pet causes of the press, oh, they're glad to update it.

Cheryl: Yeah. Sometimes. Boy, it took a long time.

Cheryl: Remember how long it took for eggs to not be the bad guys?

Jim: Yeah. Right. Yeah.

Jim: Good example. Yeah, that's true.

Joe: Well, so, but so let's not forget the negativity bias, right? It's the, and you called it, I now owe you, it's only going to be 750 milliliters, Jim, but we can work out the details of your preferred Irish whiskey. But given that Courtney et al paper that was published on Monday night of researching, comparing nicotine vaping to monotherapy NRT among Australian people who smoke experiencing social disadvantage.

Joe: And your thinking was, boy, this could appeal to a lot of the mainstream media, given their focus on folks who are down on, you know, haven't been dealt the best hand from fate.

Jim: Yeah.

Joe: And look at this, it's a promising result. And shouldn't that be of interest to people? So one, it's a positive story.

Joe: It's not a negative story. So that's a barrier that has overcome. And two, it does not fit in the framework and the mindset that a lot of these people looking at these issues and trying to curate information out to the public they don't know what to do with this.

Joe: They don't know there's a Cochran review. And obviously, this is where you and I differ. You think there's, and if I can put words in your mouth, but your interpretation is that these people are too smart.

Joe: They're very aware of enough of the information and yet they still continue to create a narrative and support it that doesn't jive with the available evidence. Okay. So I'm paying attention to you, buddy.

Jim: What I hear you saying.

Joe: And it is so, you know, the challenge is we're fundamentally trying to get good news out in trying to advance the world of nicotine without smoke for the people who currently smoke. And that's a burden when people are like, yeah, but that doesn't frighten me.

Jim: But hang on a sec. If you look at the coverage of the, let's just say the pharmaceutical drug therapy industry, often, which is covered by these very same reporters that we're talking about at outlets like NPR and the wall street journal and the Washington post and AP, the writers that cover vaping issues at FDA also cover the drug industry, pharmaceutical therapies. And anytime there is some even modest clinical trial that shows improvement in, I don't know, Alzheimer's, let's say, or high blood pressure or, you know, any of a number of other ailments or it's a pharmaceutical that they, you know, hold dear to their heart, like methampristone.

Jim: I mean, any clinical development in that, no matter how obscure or tendentious gets front page coverage, that's good news coverage. And yet in our space, when a study like the one you point out comes out showing that nicotine vaping is more effective than any other therapy for helping poor and marginalized people, they toss it right in the pear cage.

Cheryl: You know, I wonder if I could step back a minute, look at the kind of explaining how moral panics work. There's a wonderful article that was just published in 2024 in the International Journal of Drug Policy by Liam Michaud and colleagues called mapping a moral panic. And it's they're looking at the news media narratives on basically youth drug use in Canada.

Cheryl: And I think the Canadians are a little more level headed than the Americans about some of these things right now. And, and it's, and they go went through eight steps of a moral panic. And I think I can do this quickly and not annoy anybody.

Cheryl: But it's fascinating, because we can look at each one and say, yeah, here's how that applies to vaping. So they said, you know, the first thing is to, you know, sort of mobilizing the idea that this is an unprecedented, you know, crisis, you know, accompanied by the threat of spread and contagion. And you and you really, and you really saw that with vaping, the sense that, oh, this is a new threat to youth, this has never happened before.

Jim: Epidemic.

Cheryl: And, you know, their example with, you know, drug use in youth was sort of an avalanche, a new supply, a plague, particularly among the young and flooding into our streets. And very much what happened with with vaping, this unprecedented idea. The second feature of the moral panic is the absence of formal evidence to support the claims that are being advanced by what they're calling moral entrepreneurs.

Cheryl: Interesting. And the absence of the and the undermining of contradictory evidence. I mean, you think about the early vaping and the, you know, dueling and all this, and it was, it was all anecdotal.

Cheryl: And these moms rushing their kids out onto the local news to say, Oh, I've been horribly affected by this. And, and also, and these authors say, notably published and publicly available health system data that could have denied or confirmed such claims was not cited. You know, they, they don't want to look at the data.

Cheryl: I think there's something about the evolution thing, like Joe's saying, where once you get that fear of, oh, my God, there's an unprecedented threat, you get tunnel vision. And that and those dryer published data just sort of don't come into your scope of view. Yeah, so it's really, you know, it's the anecdotal stuff and the ignoring of the existing published evidence that can contradict a number of these moral panics historically have happened when the whatever the problem was, is actually getting less like, you know, street violence is getting less or right, you know, other kinds of things are less, but then the panic, it's like it is independent of data. And then the third, should I keep going?

Jim: Please?

Cheryl: Yes. The third feature they mentioned moral panics is the prominent role of news media and amplifying and recirculating claims made by these. I love this phrase by moral entrepreneurs, this feedback loop through which specious or unverified claims get legitimacy and political currency, you know, so they can basically they kind of create a new reality for the public.

Cheryl: Oh, my God, vaping. I remember talking to friends about, you know, when I was I got my, my doctor in public health in the 90s. And I remember talking to friends about if we if we were dreaming up in class, what would be an ideal thing to save lives quickly from smoking?

Cheryl: You know, what, you know, to get people away from this thing, something like vaping would have been probably what we would have come up with, you know, the features of the product and the low risk and all that kind of thing. But because of this context, it just was, it somehow just destroyed that rational mindset that would have been there. So a fourth feature of moral panics is the identification of vilified group.

Cheryl: And the scapegoating of that group is the origin of the threat to tobacco.

Jim: That's us. That's my guys.

Cheryl: Even though we know, you know, vaping was invented by a Chinese pharmacist. And I know you guys will know no more details on that. But it became somehow the ploy of big tobacco to keep people addicted and to a new generation, no matter that it was originating from people who smoked, who wanted to save their lives.

Jim: And never mind that my AVM, we're independent vape manufacturers. We are we have we have scorching criticism for the tobacco industry. And, you know, so it's a particularly galling when they when they accuse us of being, you know, big tobacco.

Cheryl: Oh, she has. So three more to go. A fifth criterion about moral for assessing moral panics is the relation to their effect on public sentiment and a redirection toward punitive restriction or reactive policy responses.

Cheryl: Yeah, that's right. That's kind of clear with vaping. I mean, it's still going on.

Cheryl: I know I just saw a friend of mine in Minnesota where I grew up said, oh, we just they just passed a law in Minneapolis where vaping products have to cost at least twenty five dollars to keep the youth out of them. You know, this is still going on. Yeah, this this is overly reacting.

Cheryl: And how are the low income folks who smoke going to get into the game? And the sixth feature of the moral panic is the enlistment of broader societal and societal anxieties or fears organized around symbolic events or narratives. You know, and this I think this got into this whole you know, they mentioned with public drug use in Canada, concerns about youth mental health, you know, public defecation or, you know, all kinds of things, drug litter.

Cheryl: And with vaping, it's very much it's, you know, I think the vaping litter thing is more of a, you know, UK thing. But the the youth mental health, you notice, remember how the tobacco free kids folks went into vaping is going to, you know, with no data support or with contradictory chicken and egg data support going into this youth mental health crisis.

Jim: Yeah, right. Yeah.

Cheryl: Yeah. Wow. This article is wonderful.

Cheryl: I'm just loving this. The seventh feature of moral panic is the key role of experts in the legitimate legitimate legitimation of the panic with subs and substantiation of claims made by those moral entrepreneurs, this attempt to do this, you know, come up with some kind of data and create evidence, you know, even though these, you know, they're saying what distinguishes this stuff is that it the claims don't engage available clinical and scholarly evidence. They, you know, they just kind of try to embroider the anecdotal stuff. And this I saw this with with the video game violence all the time where I'm saying, Wait a minute, if we're saying that video games cause school shootings here, which we had, so my husband, I would, it seems like every week for a few years, some journalist was contacting us for a quote, when they found, oh, you know, oh, there was a gun in some that some kid got, and they were playing Nintendo at the time. And it's like, okay, it turns out there was a grandma who had left a gun in her handbag, and the kid got ahold of it. It's like, I don't think you can blame the Nintendo here.

Jim: Yeah, right.

Cheryl: But because that that framing was there, and everything, they were just completely wrapped up in this, this way of looking at the issue.

Jim: Yeah, yeah.

Cheryl: And then the final, they're saying the eighth and final feature of moral panics is the is the contribution to legislative, legislative momentum or action on the issue in question. You're trying to trying to go into this whole larger set of legislation. And we all know that so well, with that's enough said.

Cheryl: So please, everyone, you know, who's interested in this, look for this wonderful article in the International Journal of Drug Policy. I was able to get the full text on Google Scholar called mapping a moral panic.

Jim: We'll, we'll put that link in the in the in the thread. And you're reminding me of a great saying that our friend Megan McArdle at the Washington Post has about that last one, the legislative impetus. And she says, the logic goes like this, something must be done.

Jim: This is something, therefore, we must do this.

Cheryl: Oh, gosh, that should be embroidered on a pillow somewhere.

Joe: Oh, so Cheryl, thank you for that review. It's great that now my reading cue is even longer, and I'm even more behind. So I can't begin to thank you.

Joe: Well, okay, fair, but that sounds, I mean, it does almost feel like you did the outline of a very thoughtful critique that should appear somewhere in terms of what are parallels here to help people contextualize where we are. And I think I'd love to read this in terms of understanding how they can describe these moral entrepreneurs. And I think an important thing and this is going to push push some of your buttons, Jim.

Joe: But the these are good people believing they are helping. And in many cases, they are helping where things break down is where our capacity to converge on truth breaks down. When you have censorship, when you have exclusion, when you have groupthink, those are flashing amber lights, that we could be wrong.

Joe: I commend the Boston Globe column from Cat Rosenfield from last year on Dr. Henry Cotton, as an example, with so many parallels here. And it lets me also make a pitch for my other favorite Thursday podcast, the Why Should I Trust You, which is such a good exploration of how have we as a society lost this tether, and what are ways to get it back. And one of the key things, it usually doesn't start with you're a moron who is committed to hurting people.

Joe: Now, can I help you? Yeah. And, and the tension is that sometimes that's all we have left, because it just feels like that's where we are.

Joe: But I don't want to give up on any of these folks. You know, know my comments on the Danny Blum story from last week in the New York Times, they did not get New York Times picks. But that's a goal.

Joe: This is a, it's a journey of many steps, not of any one step.

Jim: Well, let's, I want to touch, if I may, Cheryl, on one of the earlier of the indicators that you said, which was the, the data and the science and perhaps often the lack thereof. And in the vaping space, as our listeners will well know, the notion that there was a, quote, epidemic of youth vaping was a key lever that, you know, turbocharged hostile coverage in the press. And what I want to zero in on is after that, that began, you know, around 2018, 2019.

Joe: Though, Jim, there were, that was not new in 2015. And I would commend everyone, I'll put this in the chat and shut up more. So we have the benefit of more what Cheryl has to add.

Joe: But Peter Salmon's critique of the MNWR and the Associated Communications effort on the National Youth Tobacco Survey results, I think, of that year. And Peter Salmon declared it like a promising candidate for worst public health communication of the year. And so, like, it certainly achieved new heights in 2018, 2019.

Joe: But this was, the script had been written.

Jim: Fair enough. And that's good context. The point I wish to make is that subsequent to that, the rates of youth vaping, according to those same, you know, national surveys, plummeted significantly by more than 70% year over year, consistently trending downward.

Jim: And I remember, Cheryl, we had the head of the FDA's Center for Tobacco Products on this podcast at the time. And he asked him exactly that, like, hey, wait a second, these rates of youth use are falling off a cliff year over year. Why are the government, why is our government health agency still calling this an epidemic?

Jim: And he responded that, oh, well, I'm an epidemiologist, you know, by training, don't you know. And I certainly can see that, you know, it doesn't fit the definition of an epidemic. And the point I'm making here is, Jo, that that's a knowing, that's a knowing position.

Jim: He is aware that the data doesn't support it. And yet, FDA, although they themselves discontinued using that word, did nothing. Let me underline that.

Jim: Zero zip nada to set the record straight in public communications or even with their colleagues at CDC, that that was a false characterization of what was happening in the epidemiology. And so, you know, again, I'm glad his heart's in the right place. But that like that awareness to me disqualifies any benefit of the doubt he might get.

Joe: Well, so science is a social project. It's executed by humans operating within social structures. And the reality is, as clearly as FDA leadership expressed the continuum of risk, really reaching its peak in July 2017 through early 2018, that did not forge a reliable, cohesive consensus around there is a meaningful continuum of risk across these products, and it should be the basis for regulation.

Joe: That is still where we are. That is not a shared truth across this field across experts who comment on it. And absent absent that shared truth.

Joe: Yeah. That greatly constrains a public health official in terms of what they can do. They they are not omnipotent.

Jim: We just so I'm baffled by what notice how Cheryl say Cheryl saying yes, yes.

Joe: Well, yes, Joe, you're saying Jim, you're so wrong.

Jim: Am I mistaken? Am I mistaken to fault the head of the Center for tobacco products for failing to make that clear?

Joe: I'm going to let Cheryl.

Cheryl: I think I think another rabbit hole. I mean, one of the things that makes this this, the vaping issue different is, and I'll get to like five different things. And you have to reign me in as necessary.

Cheryl: But one of the things there was a bad element to it. You remember the Tide Pod eating thing that was briefly mean that fads happen. And there was a bad element of vaping with that, which caused it could quickly go up and down.

Cheryl: But but the larger contextual issues with vaping, I mean, first of all, there was if you look back at press releases from the government health authorities from like 2013, 14, smoking had become stagnant, and everybody was worried about how are we going to get to keep going down again. And then when vaping started to affect the data, if we'd all been clear headed, we would have been looking at and say, why is smoking starting to go down again? Oh, my gosh, maybe it's this thing with vaping.

Cheryl: But please hold the thought that we have to come back, I think, and have a discussion about the fear of addiction and fear of nicotine, this contamination, or I don't know what you call it. But but other other things that that affected, you know, why aren't they saying better things with the data? I mean, one of them is like the lag time and the data collecting this stuff, it lags and you don't you know, you don't get ahold of it, you don't publish it for quite a long time.

Cheryl: Another thing was the way that they wrote the questions. When they were first writing questions about what are you know, what, why do you vape with the teens? There were maybe five response options.

Cheryl: You know, I do I create surveys as part of my livelihood. So I'm very sensitive to this. And then they jumped on one of the responses was like, I like the flavors.

Cheryl: And it was like, oh, flavor. And then that kind of took the panic in a whole new direction. Like, oh, it's the flavors, ignoring that vodka comes in like 30 flavors.

Cheryl: And you know, these other things, you know, bubblegum, popsicles, but it gave a channel for the panic to flow into a new channel. And as you know, now, when they added other other response options to the survey, it becomes clear now that hey, the kids who are testing at doing it once a month or ever vaping, it's because their friends do it. And the ones who are doing it regularly, you know, most days of the month is because of stress or depression, you know, very much like what they would be doing with smoking.

Cheryl: But you know, so there's that. And that touches on the other issue of the way they categorize, you know, the youth users often versus the adults. And Arielle Selly has written about this a lot, too.

Cheryl: The idea that with youth often they're looking at ever users of something like like vaping or past month users. And when as opposed to the ones who are using, you know, and kids, hey, they experiment with things. It's part of the job description of being a teenager to test stuff out.

Cheryl: And so we really need to look at and be concerned about the ones who are doing it most days. And with adults, that's what we do look at.

Jim: Well, let me ask Cheryl, this might be a good time for us to see. I'm hoping that you may have a an additional bullet point, you know, criteria slash solution on how do we help the public snap out of these moral panics? How do they end and how can we hasten their shelf life?

Jim: Excuse me, hasten their demise.

Cheryl: You know, I can. Some of this, I think, is people have to die off. Yeah, I swear with you.

Cheryl: Well, that's a bit of a cynical flip response. But I know I looked at I thought about that with video games and I thought about it with marijuana, you know, with video games. I think part of it was that it became normalized and spread through the society that the generations who grew up playing video games started to, you know, take positions of authority, get advanced degrees, go into politics, what have you.

Cheryl: And they were like, hey, it was fine. And some of that may be what also happened with marijuana. The sense that, you know, the hippies and the next generations grew up and they're like, you know, hey, it was fine.

Cheryl: And nothing happened. And those I remember seeing videos back in school of like, like rattlesnakes, you know, equating it's like, what are these interesting sounding drugs that they're talking about? So I think some of it is, is as people get more information from their own experience and, and see that this what I was hearing is not the case, and something becomes normalized.

Cheryl: Now, I think that's probably what's likely to happen with things like vaping. It's the difference with vaping is that there was that aggressive false narrative from government things where they said they were only targeting young people, and they were doing the, you know, the worms under the skin, these crazy things that had nothing to do with data. And then there was another complication that's unique to vaping was the valley thing, where they had people getting, you know, developing serious, real serious illnesses.

Cheryl: And it was trumpeted that Oh, this was because they were vaping. And then later, it becomes clear they're vaping THC, or, you know, and that, and then because people are concerned about confused about terminology, they don't understand you can vape different things. And what does it mean to vape and it may not be nicotine and all that kind of thing.

Cheryl: I mean, confused, confused terminology, by the way, is one thing I saw with the video game violence issue, where they were talking about these games cause aggressive behavior, aggressive behavior, right. And there was actually one article that I love called, you know, violence in a rated game. So he rated is like for little kids.

Cheryl: And they would say, Oh, with Kirby threw a puff ball at another pink fluffy thing. That was violence.

Jim: Oh, gosh. Oh, my gosh.

Cheryl: And the thing is, a lot of academics only read the abstracts, just like a lot of positions, a lot of busy people everywhere. So if they think they're looking at the research, if they're only looking at the abstracts, they're not seeing how are they defining this stuff? What are they?

Cheryl: How did they operationalize this? You know, where did they get these data? What is really going on here?

Cheryl: And I think that's another of the things we face now is this, the confusion, you know, vapes are complex products. I get confused all the time. And then now with heated tobacco coming, other things coming, you know, it's just getting, you know, increasingly great options, but increasing confusion for people who don't understand the area.

Jim: Well, maybe, I mean, I'm hoping you can, can lend Joe and I some guidance because we, you know, live and swim and work in this world all the time. And we're often in a position where we're having to try to straighten out a lot of these distortions and alarmism. And we're of we're of different schools of thought, Joe and I about how to go at that.

Jim: And I so let me just push all my chips forward here. You know, when I interact with press about this sort of stuff, I try to really be firm with them and say, you know, what you're reporting here is misleading and it's, it's doing public health harm. And if you persist in it, I'm going to, I'm going to take issue with it publicly.

Jim: And Joe is, you know, a little bit, a little bit closer, closer to, closer to the light than I am, take some, take some more educational, engaging and understanding approach with them. And you could call it honey and vinegar. And I wonder how you manage that when you interact with journalists or other public voices on these kinds of issues and which of those two approaches, if either, you think is the best way to do it.

Cheryl: I guess I hate to say, but I guess I'm leaning more towards some of the things that Joe said, where I do think you have to, you know, give it one of the ways that journalists think, you know, my husband was a reporter for many years in addition to being a psychologist and other things. But, you know, there's always this, there's this, this tendency often to do the, okay, we want to get both sides of the story.

Jim: Right.

Cheryl: And it's like, okay, well, you know, if you would take your, your approach, it's the, oh, well, okay, you're the, of course, well, of course, and you're being paid to say that, or you're, you're the other side, you're the, you know, we got the industry side there, whatever. Whereas I think, I think, I think coming in to break that thinking a little bit can help to come in and say, you know, people, I have sincere concerns about this, they see this thing that's new, and they see teenagers who they think might have not ever used something using, you know, using an addictive chemical, and it's, and they, and they get worried. And let me, you know, let me just pull back and give you a little larger context as to how I came to see this differently.

Cheryl: I think it often starts to talk a little bit, if you can, about your journey of how you change your mind, if you did, I mean, and that's something that I mean, I came to this, I was, when I was a public health student, I was, you know, firmly in the camp of all people smoke, because they are brainwashed by big tobacco and advertising. And I hadn't thought to look at, well, kind of weren't there smoking, smoking was happening before there were billboards. And before there was anything, this guy, you know, it's just, you know, and I didn't know people who smoked.

Cheryl: And that's, that's one of the big things that we fight against here is that people, and this is something you can say to journalists is that, hey, people in power, people with good health insurance, they know teenagers, but they often don't know people who smoke, because that tends to be clustered among vulnerable populations, key phrase, with who have mental health issues are low income, lower education, you know, have experienced trauma. And so they, those folks tend not to be in positions of power, because they're struggling.

Cheryl: And so of course, it's natural to look at, you know, to focus on protecting teenagers, if those are the people in front of you. But hey, you know, it's our job to think, to speak for the vulnerable and look at what about the people who smoke, a pathway like that, that's going to push a lot of good buttons on public health folks and, and journalists who want to do good.

Jim: Joe, your thoughts.

Joe: So I do want to reiterate my point about how the knowledge generation process has really been hobbled in this field. And that I think is the root cause of so much of the struggle that we have. And the challenge is there is a well established, credible, and accepted narrative of manichean struggle between good guys and bad guys here.

Joe: And that's the basic framing, look at Dr. Wen's column in the Washington Post just this week. And I think our challenge and opportunity is to interest the reporters, the commenters on these topics, to probe a little more deeply. Why is it that, you know, I understand the story, and reporters are pressed for time.

Joe: And these are all these dynamics that we are suffering from. But someone's gonna say, have I done enough of my diligence here? Do I really understand is this story that fits so elegantly into what I can communicate?

Joe: Is that the whole story? And somebody is gonna say, wow, it really, I had no idea that there's a Cochran review, I had no idea that Health Canada funded a review last year, that made these recommendations, all starting from the notion that there's a substantial difference in risk across these products. And it's an important tool to try to improve health.

Joe: Until that becomes the foundation that coverage is based on, we are never gonna see the kind of progress of even faster declines in smoking, that we all see.

Cheryl: Picking up on what you're saying, Joe, you know, journalists are busy, if you can get one thing in there, you know, one angle that I haven't seen people look at is, why is it in England's public health service, they offer vaping right alongside gum and patches, to people who are, you know, in the hospital, you know, seriously ill from smoking, you know, just put, you know, find one thing that's like a wait, what? You know, that's a concrete example.

Joe: And your coffee spits your coffee spitter, Jim.

Jim: Well, I know, and I to try to introduce, I think one of the most effective things Cheryl is to introduce those journalists to ordinary vapors, and vape shop owners who have this real world experience in their own first person voice, and that often helps, in some cases, snap them out of it. But I have to say, I, you know, and maybe this is where, let me back up, let me start with where Joe and I can agree. I think there's a groupthink dynamic that's common across all these moral panics, and especially the way the press covers them.

Jim: It kind of, in public relations, my industry, we often call that the lead steer. If you can get the one cow running down the street, all the other cows are going to follow it. And that's a strategy that a lot of PR firms use to try to get, you know, publicity or a focus on a particular issue or product.

Jim: But it happens in the other direction, too. It happens in moral panics, too. And there's a sensibility, I think, in the way the national press looks at vaping, where they all have a kind of groupthink outlook.

Jim: And it can be very tough to get one of them to break away and strike a new posture with that. Now, where Joe and I part ways is on, you know, how to dialogue with them about it. And I just, it's frustrating.

Jim: I can't, I just, I hear what you're saying, Cheryl, and I, your expertise eclipses my own by far, but it just troubles me to think that we have to wait until these reporters retire or move on to other beats. I would rather grab them by the lapels and show them the error of their ways.

Cheryl: Yeah, I don't think it's the reporters so much as, you know, sometimes the people in power, you know, the people who are really, you know, I guess, the stand and glance types. I mean, I used his statistics textbook as a grad student, but somehow we got, there are some people who are able to move on from the noble crusade against big tobacco and smoking and look at where the data were going and go, huh, that's funny. And some people were like, no, this is more of the same.

Cheryl: This is more of the same. This is just don't listen to it. They're just going to, because there was some really nefarious behavior, you know, and some serious undermining of the truth going on.

Cheryl: And so people keep, I think that's one of the things that makes the nicotine issue unique is there really, there really was people were dying, you know, but what's lost now is people are still dying. And that's where I think they're, you know, it's like, Hey, why don't, how come they're not saying it's like X many jumbo jets of people dying every day from smoking? Like they used to, cause they still are.

Cheryl: Why don't we know about it?

Jim: I mean, we see that phenomenon you're describing in so many of the, uh, academics and experts in nicotine in the nicotine field. I'm thinking of, I mean, you mentioned earlier, Ariel Selye, who talks very movingly about how earlier in her career, she bought into a lot of these assumptions. And then, you know, based on analysis changed her mind.

Jim: I think of one of my heroes in the field is Dr. David Abrams at NYU school of public health, who again was highly skeptical of vaping when it came out and has been a lifelong tobacco control scientist and yet had a real conversion based on his, his academic analysis. And there are many others besides. And so you see that happen, um, quite a lot.

Jim: And I, I'm going to, I don't know if you'll Joe, Joe, if you'll indulge me to be included, but look at, I smoked Marlboro cigarettes for 25 years. I was subjected to all the, you know, advertising you talked about, Cheryl. And you know what, I really liked them.

Jim: I like smoking Marlboros and I was, you know, quote unquote addicted. So you'd think if anyone would be, you know, clinging with his cold dead hands to the, to that outlook, it'd be someone like me, but I was able to switch to vaping and, um, in no small part because of, you know, uh, my, my own individual review of it. So that, that counts, I hope in a small way, but that change is possible.

Jim: I just, it's so frustrating to see the people that you describe who've gotten in these positions of authority and power that, you know, have a stranglehold on the policy and the rest of us have to suffer their obstinance and ignorance.

Cheryl: Yeah. It's very hard not to get angry and frustrated, but I think unless you start from a place of empathy and, and I mean, maybe one, maybe there are a few, a couple of people out there who are, who are, you know, just obstinate and self-centered, but I really didn't, most people want what's good for others. And you, and if you start from there, that way you have a chance, it's a matter of kind of, kind of find a little gap, open up their minds a little bit and insert a, a wait, what, or a huh, or that's, or a story.

Cheryl: I think what converted me in some ways was I was working on this project with what used to be Philip Morris USA on quit assist. They approached me in the early two thousands and a colleague who I got involved on an advisory board. I started who was at Boston university and worked with a lot of low-income smokers.

Cheryl: He talked about what smoking meant in the lives of his patients. And I, when he started to talk about how they felt about and how they dealt with it and what nicotine did for them. And I started to become really ashamed of myself because I realized I was not seeing these folks as people.

Cheryl: I was seeing them as stats and data, or maybe even dupes if I admitted it to myself. And I wasn't thinking about the role of this in their lives and God forbid, the role of pleasure and the stress relief and other things. I mean, that never got talked about in my public health education, these, these things, why people might be attracted to it other than ads fooled them.

Jim: Right. Well, let me, we're getting, we're getting close on closing on our hour. Let me close.

Jim: I want to give Joe the last word, but Cheryl, I want to close by asking you a question we ask of a lot of our guests, which is as a student of moral panics and how their arc of their, you know, instigation evolution and, and sunset, are you optimistic or pessimistic about where we're headed on vape policy?

Jim: I think I'm optimistic in that more and more rational voices are starting to get out there and say, Hey, look at, look at these data, you know, like the people you mentioned and many more, uh, you know, the thing, the thing I'm concerned about is how are we going to come to terms with nicotine in, in our society? How will we come, will we come to view it as sort of a caffeine like thing? How will we, you know, how will we struggle with, and with the addictiveness and how we feel about nicotine?

Jim: I think that's going to be key to where things go.

Jim: Jill, let the record show that Cheryl favored your approach. And, uh, if there were a scorecard, I would be losing heading into the second half. No, that's okay.

Jim: You're not the only one, Cheryl. You're far from alone in that.

Jim: But I respect your anger.

Jim: Well, and the last word before we close, I would just say, I'm grateful. Thank you, Cheryl, for making some time to share your perspectives. Um, and I'd like to think that these kinds of discussions are a model for the way that we can get a little closer to truth.

Jim: Um, and yes, it's the Monica Guzman. I never thought of it that way. How can we be sufficiently curious ourselves to try to really understand the people who see the world differently?

Jim: Because I do agree with Cheryl. Most people are doing this for all of the right reasons. And that's actually a basis for hope.

Jim: And I think probably where the optimism stems. Um, so, uh, I'm going to keep trying though, uh, uh, always entertained by your perspective and it makes me think, uh, sometimes too hard, Jim. So thank you.

Jim: All right. Well, Cheryl, standing offer. If I can ever help, uh, if I can ever help you with the media relations interaction or a reporter that's colored outside the lines, I will put that cat in the bathtub.

Jim: So, um, uh, standing off. And in the I feel like we could have really talked all day. It's just, it's so fascinating, your insights.

Jim: And so we appreciate you sharing them with us.

Jim: Well, this, this made my day. It was a lot of fun. Yeah.

Jim: I feel like I could go for another five hours, but I'm not going to we'll make the convo to be continued in our threads.

Jim: And here's hoping we get a chance to chat again. Um, this has been Jim McCarthy with American vapor manufacturers, uh, for shaping vaping, uh, Cheryl Olson, Joe Gitchell. Thank you both for joining us.

Jim: Thanks, Jim.

Jim: Take care.

Jim: Thanks guys. Bye.