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R Street Sponsored THR Policy Papers and Presentations

I served as a consultant to R Street from 2012 through mid-2019, shaping much of their tobacco harm reduction (THR) policy and speaking on behalf of such policy to state and local authorities, the American Medical Association and federal authorities. The thrust of my guidance, based on research I had done prior to affiliating with R Street, was anti-smoking, but in favor of THR and, with qualifications, in favor of e-cigarettes as harm reduction modalities.  My reading of the literature left me with the impression that the allegation that e-cigarettes served as a gateway to smoking was incorrect, and, in fact, e-cigarettes diverted teens from smoking. What follows are the approximately 60 Nitzkin Tobacco Harm Reduction policy papers and presentations posted on 2013-2019, as accessed November 5, 2020 .

To access the full text of each item from the R Street web site, please click on the underlined heading to the item

APR 11, 2019, America Trends Podcast

Dr. Joel Nitzkin on the America Trends Podcast

From America Trends Podcast:

While smoking is at an all time low in America, many are concerned that nicotine addiction through vaping and e-cigarettes may provide a gateway for a new…


SEP 14, 2018, Washington Examiner

Wade, C; Nitzkin, JL:: The FDA’s new tobacco plan leaves much room for improvement

ast July marked the first anniversary of the Food and Drug Administration’s Comprehensive Tobacco Plan, intended to weaken the desire for nicotine’s most dangerous delivery device: the…


JUL 16, 2018, CGTN America

Nitzkin, JL: New York hopes new ad in Mandarin will persuade Chinese men to put out their cigarettes

From CGTN America:

Dr. Joel Nitzkin talks about anti-smoking campaigns aimed at Chinese male immigrants
CGTN’s Elaine Reyes spoke to Dr. Joel Nitzkin, tobacco policy analyst at Canada’s R…


FEB 5, 2018, Daily Vaper

Nitzkin, JL: National Academies of Sciences’ e-cig report gets it wrong

The recently released National Academies of Sciences e-cigarette report leads to an incorrect conclusion that e-cigarette use increases the risk of using traditional combustible cigarettes….


JAN 17, 2018

Nitzkin, JL: Is Science or Policy Preference Leading the Way? Comments on the FDA Medicinal Nicotine Webcast

Early afternoon, on Dec. 12, 2017, I sat in on the Duke/Margolis Center for Health Policy’s webcast, “FDA’s New Regulatory Framework for Tobacco and Nicotine: The Role of Medicinal Nicotine.”…


DEC 8, 2017, The Hill

Nitzkin, JL: Tobacco control policy should be based on science, not misconceptions

Despite hype to the contrary, science has nothing to do with tobacco-control policy. The goal of a “tobacco-free-society” that condemns all use of non-pharmaceutical nicotine products regardless…


AUG 29, 2017, Fox And Hounds

Nitzkin, JL: Flavored tobacco ordinance sure to backfire

If San Francisco ultimately implements its recently adopted ordinance to ban the sale of flavored tobacco products, it will do more harm than good, serving to increase rates of tobacco-related…


AUG 18, 2017

Nitzkin, JL: The FDA’s words and actions do not match

In a new paper in the New England Journal of Medicine, newly minted Food and Drug Administration Commissioner Scott Gottlieb and Mitch Zeller, longtime director of the FDA Center for Tobacco…


AUG 10, 2017

Nitzkin, JL: Letter concerning expanded federal campaign to discourage use of e-cigarettes

Commissioner Gottlieb,

Earlier this week, the Food and Drug Administration announced it would expand its public-education efforts to discourage use of e-cigarettes and related vapor…


JUL 14, 2017, Fox And Hounds

Nitzkin, JL: SF take note, e-cigs may be gateway away from smoking

Banning flavored e-cigarettes has been proposed in San Francisco and elsewhere as a way to make these smokeless and nicotine vapor products less attractive to children and teens. While that may seem…


JUL 8, 2017, PubMed Commons

Nitzkin, JL: Comments Re: ‘Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults’

This Soneji meta-analysis dealing with e-cigarettes and subsequent teen smoking,1 summarized data from nine studies, all of which share the same flaws, leading to an incorrect conclusion.



JUN 21, 2017, Washington Examiner

Nitzkin, JL: Youth smoking is down, but thanks to what?

We received some welcome news this week from the Food and Drug Administration: Cigarette smoking by high school students has been cut in half since 2011, from 15.8 percent to 8 percent — a…


JUN 15, 2017

Nitzkin, JL: FDA misinterprets massive victory on teen smoking

As detailed this morning by the Food and Drug Administration, cigarette smoking by U.S. high school students has been cut in half since 2011—from 15.8 percent to 8.0 percent—a remarkable and…


MAY 9, 2017, The Hill

Nitzkin, JL: Trump’s FDA nominee faces steep climb to reform tobacco regulation

As the U.S. Senate weighs whether to confirm Dr. Scott Gottlieb—President Trump’s pick to be commissioner of the Food and Drug Administration—there is an important question that he has not yet…


APR 10, 2017

Nitzkin, JL: Comments to FDA on regulating tobacco-related products as drugs

Cigarettes are the most hazardous and addictive tobacco product. All of the 480,000 U.S. deaths each year attributed by federal authorities to tobacco products are due to a single product – the…


MAR 23, 2017, Washington Examiner

Nitzkin, JL: The government has to change its tune on how to reduce harm from tobacco

A recent report from the Core Team on Tobacco Control drew 120 eminent signatories from the tobacco control community to endorse the proposition that it is possible to end adult cigarette use within…


MAR 20, 2017

Nitzkin, JL; E-cig tipping points vs. FDA deeming regulations

The attached policy study originally was published in Volume 8, Issue 1 of the Journal of Addiction Research & Therapy.

In 2002, writer Malcom Gladwell introduced the concept of “Tipping…


MAR 3, 2017, The Hill

Nitzkin, JL: FDA should get out of the smokeless tobacco industry

The following op-ed was co-authored by R Street Associate Fellow Brad Rodu.

Just days after President Donald Trump’s inauguration, the Food and Drug Administration proposed new…

MAR 3, 2017, RealClearHealth

Nitzkin, JL: Congress, please make smoking less harmful

Legislation introduced recently by Reps. Tom Cole, R-Okla., and Sanford Bishop, D-Ga., would make significant changes to the way the Food and Drug Administration regulates tobacco and nicotine…


FEB 28, 2017, Santa Fe New Mexican

Nitzkin, JL: Vapor devices are not cigarettes

There is a movement afoot in New Mexico to treat e-cigarettes and related nicotine-vapor products as if they pose the same risks for addiction and potentially fatal tobacco-attributable illness as…



DEC 9, 2016, American Spectator

Nitzkin, JL: Lots of smoke, no fire

Surgeon General Vivek H. Murthy got it wrong. Contrary to the claims in this week’s highly publicized report, e-cigarettes and other vapor devices are not a threat to the health of youth, young…


AUG 12, 2016, RealClearPolicy

Nitzkin, JL: FDA’s e-cigarette rules are a public-health hazard

Since they first were introduced in the United States in 2006, electronic cigarettes have helped millions of U.S. smokers to cut down or quit and diverted teens from smoking. But recently announced…


JUL 11, 2016, Nicotine & Tobacco Research

Nitzkin, JL: What drives tobacco-control policy?

This is a follow-up to the presentation by Dr. David Ashley of the Food and Drug Administration’s Center for Tobacco Products (CTP) at the March 2016 meeting of the Society for Research on Nicotine…


MAY 31, 2016

Nitzkin, JL: Should we just take the nicotine out of cigarettes?

The short answer is…not yet.

In the United States, the ultimate goal of tobacco-control programming long has been a “tobacco-free society.” This goal is clearly articulated in the most…


APR 20, 2016

Nitzkin, JL: What drives tobacco-control policy?

The attached policy brief has been accepted for publication by the journal Nicotine & Tobacco Research.

This is a follow-up to the presentation by Dr. David Ashley of the FDA’s Center…


APR 6, 2016

Nitzkin, JL: Letter to Alaska Legislature on e-cigarettes

Dear Alaska State Legislator or Legislative Staff Member:

I am a public-health physician who has been involved in tobacco control since the 1970s. I have been a local health director, a state…


MAR 8, 2016

Nitzkin, JL: Letter to R.I. Senate Judiciary Committee on S. 2107

Dear Sen. McCaffrey:

I am a public health physician who advises the R Street Institute on tobacco-related policy. Detail on my background and how I arrived at my position on the issue of…


FEB 18, 2016

Nitzkin, JL: H.R. 2058 and the regulation of e-cigarettes

H.R. 2058, recently introduced in May 2015 by U.S. Rep. Tom Cole, R-Okla., draws the attention of policymakers to the structure of the Food and Drug Administration’s regulatory regime for tobacco…


JAN 1, 2016

Nitzkin, JL: Comments to FDA on regulating tobacco products as drugs

Summary Recommendations:

FDA should redefine smoking as a behavior, not a disease, and regulate all tobacco-related and nicotine-delivery products accordingly.
FDA should migrate all regulation…


NOV 23, 2015

Nitzkin, JL: Understanding the crusade against e-cigarettes

Two recent public comment letters from Stanton Glantz of the University of California at San Francisco finally lay bare the myth that underlies the public-health crusade against e-cigarettes – that…


NOV 2, 2015

Nitzkin, JL: Modeling the health effects of expanding e-cigarette sales

A modeling study by Sara Kalkhoran and Stanton A. Glantz published in the Oct. 1, 2015 edition of JAMA Internal Medicine can reasonably be interpreted as demonstrating the possibility that promoting…


OCT 2, 2015

Nitzkin, JL: No, e-cigarettes aren’t recruiting teens to smoke

Writing in the Sept. 8 edition of JAMA Pediatrics, Dr. Brian Primack and team reported on a portion of the data from a national survey of U.S. teens and young adults, concluding that “use of…


SEP 30, 2015

Nitzkin, JL: Endgame proposals and a wake-up call to the tobacco-control community

The recent endgame review by Patricia McDaniel and her team in the Aug. 28 edition of Tobacco Control demonstrates a major flaw in thinking within the tobacco-control community.

The McDaniel paper…


SEP 28, 2015

Nitzkin, JL: E-cigarettes and recruitment of teens to nicotine addiction

Writing in the Aug. 18 edition of the Journal of the American Medical Association, Adam Leventhal of the University of Southern California and his team survey teens about past and recent e-cigarette…


SEP 17, 2015

Nitzkin, JL: Letter to National Park Service on e-cigarette policy

This note is in response to the National Park Service news release dated Sept. 14, 2015, about subjecting electronic cigarettes to the same rules imposed on combustible tobacco products.

There is…


AUG 27, 2015, Global Health Now

Nitzkin, JL: Need for dialogue on tobacco harm reduction

What is now needed, if we are to ever secure the personal and public health benefits that e-cigarettes and tobacco harm reduction can offer, is honest and sincere dialogue on this topic between the…


MAY 8, 2015, Delaware State News

Nitzkin, JL: E-cigarettes are a friend to public health

Delaware lawmakers are now considered H.B. 5, a bill that would ban e-cigarette use everywhere smoking is prohibited. Experience as a public health physician has taught me to consider both direct and…


MAY 6, 2015

Nitzkin, JL: Nitzkin testimony on Delaware HB 5

My name is Joel Nitzkin.

I am a public health physician, board certified in preventive medicine as my medical specialty. I have been a local health director, a state health director and president…


APR 29, 2015

Nitzkin, JL: Letter on e-cigarette provisions of Minnesota tax bill

I am a public health physician who advises the R Street Institute on tobacco-related policy. Detail on my background and how I got to where I am today on the issue of e-cigarettes is provided in the…


APR 16, 2015, New England Journal Of Medicine

Nitzkin, JL: More on hidden formaldehyde in e-cigarette aerosols

This letter was co-authored by Dr. Michael Siegel of the Boston University School of Public Health and Dr. Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Athens, Greece.

The data…


R Street’s Harm Reduction program aims for integrated harm reduction with tobacco, opioid and sexual behavior as central elements. We believe that “abstinence only” approaches to risky behaviors will not work on a population-wide basis. As such, we emphasize harm-reduction approaches that accept that harmful behavior may continue even as we seek to mitigate – if not eliminate – the harms involved.


MAR 9, 2015

Nitzkin, JL: Statement on e-cigarettes at FDA workshop

The attached statement on e-cigarette regulation was delivered by R Street Senior Fellow Dr. Joel Nitzkin to the March 9, 2015 FDA workshop in Hyattsville, Md.


FEB 27, 2015

Nitzkin, JL: THR statement to Preventive Medicine 2015 conference

The attached statement on tobacco harm reduction was delivered by R Street Senior Fellow Dr. Joel Nitzkin to the Preventive Medicine 2015 conference in Atlanta, Ga., on Feb. 27, 2015


FEB 9, 2015

Nitzkin, JL: Letter to Oregon Legislative Assembly about HB 2546

I submit this comment and request to amend H.B. 2546 in my capacity as a public health physician and my role as senior fellow for tobacco policy with the R Street Institute. I hope to assist in…


SEP 26, 2014

Nitzkin, JL: A modest proposal to the e-cigarette community

At the Sept. 24, 2014 IQPC ECig USA Industry Conference in Las Vegas, I opted to abandon my previously anticipated presentation in favor of the following, based on…


SEP 24, 2014

Nitzkin, JL: Presentation to Ecig USA Industry Conference


The attached presentation was delivered by R Street Senior Fellow Joel Nitzkin at the IQPC Ecig USA Industry Conference, held in Las Vegas, Nev. from Sept. 23-25, 2014.


JUL 31, 2014

Nitzkin, JL: Letter to Gov. Nixon on veto of tobacco harm-reduction bill

Gov. Jeremiah Nixon
P.O. Box 720
Jefferson City MO 65102
Re: Veto of Missouri Senate Substitute for S.B. 841

Dear Gov. Nixon,

As a public health physician, with…


JUL 9, 2014

Nitzkin, JL:  E-cigarettes: A life-saving technology or a way for tobacco companies to re-normalize smoking in American society?


The attached study appeared in the June 30, 2014 edition of the Food and Drug Law Institute’s Food and Drug Policy Forum.

Electronic cigarettes, commonly referred to as…


JUN 26, 2014, RealClearPolicy

Nitzkin, JL: The case for e-cigarettes

There are about 46 million smokers in the United States, and an estimated 480,000 deaths per year are attributed to cigarette smoking. Despite our best efforts, these numbers have not budged in the…


JUN 24, 2014

Nitzkin, JL: E-cigarette primer for state and local lawmakers

Cigarettes kill an estimated 480,000 Americans each year. An estimated 46 million Americans smoke cigarettes, the most hazardous and most addictive of tobacco products. Despite our best efforts,…


JUN 20, 2014

Nitzkin, JL: The case in favor of e-cigarettes for tobacco harm reduction

This paper has been accepted for publication in the International Journal of Environmental Research and Public Health.

A carefully structured Tobacco Harm Reduction (THR) initiative, with…


JUN 16, 2014

Nitzkin, JL: Comments to FDA on e-cigarette deeming regs

This note is in response to the April 2014 FDA Docket No. FDA-2014-N-0189 requesting comment on proposed regulations for extending the authority of the FDA Center on Tobacco Products (CTP) to a…


FEB 23, 2014

Nitzkin, JL: Response to ANR fact sheet: Electronic cigarettes and secondary aerosol

This note is in response to the so-called “fact sheet” entitled “Electronic Cigarettes and Secondhand Aerosol” produced by Americans for Nonsmokers Rights (ANR) February 20, 2014 [1] in…


DEC 4, 2013

Nitzkin, JL: Letter to U.S. Preventive Services Task Force

This memo urges USPSTF to expand their consideration of options for smoking cessation to include tobacco harm reduction, alternative health education interventions not involving use of…


NOV 21, 2013

Nitzkin, JL: The promise of e-cigarettes for tobacco harm reduction

Nicotine vaporizers, usually referred to as e-cigarettes, show substantial promise as a vehicle for tobacco harm reduction (THR). Skyrocketing sales of e-cigarettes, consumer advocacy for these…


OCT 7, 2013

Nitzkin, JL: Letter to Kathleen Sebelius and Richard Durbin on e-cigarette flavoring

Dear Secretary Sebelius and Senator Durbin:

I write to you as a public health physician self-employed as a policy consultant. I have been a local health director, state health director, and…


SEP 4, 2013

Nitzkin, JL: Statement from Dr. Joel Nitzkin on Duluth e-cigarette ordinances

The attached letter to the City Council of Duluth, Minn. is in response to introduced ordinances that would extend restrictions on smoking in indoor and outdoor areas to e-cigarettes. The definitions…


JUN 1, 2013

Nitzkin, JL: FDA lifts restrictions on OTC nicotine replacement therapies

In a truly stunning announcement, April 1, the U.S. Food and Drug Administration announced its intention to lift many restrictions on labeling of over-the-counter Nicotine Replacement Therapy drugs;…


APR 8, 2013

Nitzkin, JL: FDA lifts restrictions on OTC nicotine replacement therapies

In a truly stunning announcement, last week, the U.S. Food and Drug Administration announced its intention to lift many restrictions on labeling of over-the-counter Nicotine Replacement Therapy…


MAR 20, 2013

Nitzkin, JL: Dialogue, stakeholders and the future of tobacco control

In a Jan. 31 BMJ blog post, Dr. Ruth Malone, editor of Tobacco Control, excoriated the Food and Drug Administration for proposing “facilitated dialogue” with the “tobacco industry.” This assertion…


MAR 14, 2013

Nitzkin, JL: Reducing smoking: A guide for state policy makers

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A review of public health literature related to smoking cessation suggests smoking bans and efforts to stop minors from smoking can be very effective. They help in two ways:…


MAR 13, 2013

Nitzkin, JL: A response to ‘Stubbing Out Cigarettes for Good’

Earlier this month, the New York Times published and op-ed penned by Richard Daynard of Northeastern University titled “Stubbing out Cigarettes for Good.” Professor Daynard is president of…


JAN 22, 2013

Nitzkin, JL: Comment to FDA on e-cigarettes: A public health perspective and plea for common sense

If properly regulated and promoted, e-cigarettes have the potential to substantially reduce risk of tobacco-attributable illness among current smokers; enhance future total abstinence from tobacco…


JAN 3, 2013

Nitzkin, JL: R Street policy on tobacco harm reduction

Tobacco Harm Reduction (THR) is a policy and process by which smokers who are unable or unwilling to quit smoking are enabled and encouraged to switch to a lower risk tobacco/nicotine product to…

Updated January, 2021

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