Why the nicotine myth might be the most lethal public health lie



An alarming new survey reveals a dangerous blind spot in the medical community: Countless doctors still believe nicotine directly causes cancer. That myth has been repeated for decades, but science says otherwise.

The survey by Povaddo LLC included 1,565 U.S. medical professionals. Nearly half of health care practitioners (47%) and 59% of those treating heavy smokers incorrectly identified nicotine as a carcinogen. Another 19% weren’t sure. The result: Many physicians discourage patients from trying “tobacco harm reduction” products — like e-cigarettes or smokeless tobacco — that contain nicotine but eliminate the thousands of toxins in combustible cigarettes.

It’s time for the FDA to cut through decades of propaganda and tell the truth: Nicotine is addictive, but it isn’t the cause of cancer.

This misunderstanding costs lives. By misidentifying nicotine as the killer, doctors steer smokers away from safer alternatives that could dramatically reduce cancer, heart disease, and lung disease.

Education matters. Health care providers need to know nicotine is addictive, but the real harm comes from the smoke. Until that distinction is clear, patients will remain trapped in the deadliest habit of all — traditional smoking.

Science has already proven the case. A conventional cigarette contains more than 600 ingredients and, when burned, produces over 7,000 chemicals, including arsenic, formaldehyde, tar, and lead. Smoking kills more than 480,000 Americans each year, according to the CDC, making it the nation’s leading cause of preventable death. By contrast, studies show vaping or smokeless products cut exposure to those toxic substances by orders of magnitude.

Even the FDA admits this. In 2017, then-Commissioner Scott Gottlieb said, “Nicotine, though not benign, is not directly responsible for the tobacco-caused cancer, lung diseases, and heart disease that kills hundreds of thousands of Americans each year.” Yet years later, the agency continues to regulate vaping into oblivion while dragging its feet on promoting THR.

The public is ahead of the bureaucrats. A 2024 poll of U.S. voters found overwhelming support for FDA reform and a strong desire to reduce smoking. Congress has noticed too. Former Rep. Larry Bucshon (R-Ind.), a physician, called risk reduction for combustible smoking not “a partisan issue.” Rep. Don Davis (D-N.C.), co-chairman of the Congressional Tobacco Harm Reduction Caucus, added: “As we move from smoke-based to smokeless products … that’s going to reduce the harm [caused by] tobacco across this country.”

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Americans want safer alternatives. Lawmakers in both parties support tobacco harm reduction. The medical community, however, remains misinformed — and the FDA’s mixed messaging hasn’t helped. Every day doctors cling to the nicotine myth, more smokers stay chained to cigarettes.

It’s time for the FDA to cut through decades of propaganda and tell the truth: Nicotine is addictive, but it isn’t the cause of cancer. Doctors need to know it, patients need to hear it, and policies need to reflect it. Mislabeling nicotine has killed enough people already.

If regulators and medical professionals are serious about saving lives, they must stop demonizing nicotine itself and start promoting harm reduction. Millions of lives depend on it.

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Your health premiums are powering the left’s political machine



According to its mission statement, the American Medical Association exists “to promote the art and science of medicine and the betterment of public health.” In practice, the AMA has become a well-funded political machine — one that uses its government-backed monopoly on medical billing codes to bankroll a progressive agenda.

Each year, the AMA collects hundreds of millions of dollars through royalties on its proprietary Current Procedural Terminology codes. These are the codes doctors use to communicate with insurers and federal agencies when they conduct checkups, order tests, or write prescriptions. Hospitals, insurance companies, and medical professionals are all required to use them — and pay for the privilege.

Instead of using its monopoly to support physicians or patients, the AMA has funneled its resources into ideological activism.

In 2023 alone, the AMA raked in nearly $285 million from CPT royalties. That isn’t a side hustle; it’s a windfall. Watchdogs now rank the AMA among the most financially powerful nonprofits in American health care.

The AMA didn’t earn that money through clinical excellence or medical innovation. It profits from what is essentially public infrastructure.

The federal government made it so. In the 1980s, Medicare and Medicaid began requiring CPT codes for billing. In 1996, the Health Insurance Portability and Accountability Act made CPT codes the federal standard for electronic health care transactions. That mandate gave the AMA control over an indispensable part of American medicine.

Hospitals, providers, and insurers can’t opt out. But instead of using its monopoly to support physicians or patients, the AMA has funneled its resources into ideological activism.

On gun control, the AMA has pushed bans on so-called assault weapons, supported raising the legal age of ownership to 21, and opposed allowing teachers to defend themselves in the classroom.

On climate policy, it has declared climate change a “public health crisis,” called for slashing U.S. greenhouse gas emissions in half by 2030, and demanded “carbon neutrality” by 2050. The group even promotes plant-based diets — not to improve patient health, but to cut emissions. One AMA paper noted that producing a single serving of red meat releases 200 times more carbon dioxide than growing a serving of beans.

During the 2020 George Floyd riots, the AMA declared that racism was “an urgent threat to public health,” pledged to dismantle “racist and discriminatory policies,” and released a video in which its board members solemnly recited these mantras. The group also called for sweeping police reform, claiming “a correlation between policing and adverse health outcomes.”

This is political advocacy, not public health. And it’s not limited to official statements — it’s backed by millions of dollars the AMA collects thanks to its government-protected monopoly.

In 2024, the AMA spent nearly $25 million on lobbying — more than the AARP. By contrast, the National Rifle Association spent just $2 million. The beef and dairy industries, which stand to lose if AMA-backed climate plans move forward, spent far less.

Through lobbying and political donations, the AMA is using your money — your premiums, your tax dollars — to advance its political goals.

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Photo by Erik McGregor/LightRocket via Getty Images

That pipeline of influence may be in jeopardy.

According to recent reports, allies of Robert F. Kennedy Jr. have explored transferring CPT oversight from the AMA to the Centers for Medicare and Medicaid Services. It’s a smart move that the Trump administration should take seriously.

A working model already exists. Health care providers use ICD codes — International Classification of Diseases — to document diagnoses. These codes are freely available, globally standardized, and cost nothing to use. There’s no reason procedural codes like CPT couldn’t operate the same way.

Stripping the AMA of its CPT monopoly wouldn’t just break a political racket. It would free American health care from a rent-seeking gatekeeper that has long since abandoned its original mission.

CPT codes are public infrastructure now. A private group with a political agenda shouldn’t be allowed to control access to them — especially not one that spends its royalty checks advancing the left’s culture war.

The Trump administration, with RFK Jr. at the Department of Health and Human Services, has a real opportunity here: End the royalty scheme, move CPT into the public domain, and cut off the AMA’s cash flow.

It’s time to let doctors get back to medicine — and take politics out of the exam room.

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The ‘conservative’ 5th Circuit just shielded Biden’s radical gender agenda



How does Title IX, which prohibits sex-based discrimination, justify forcing doctors to violate the Hippocratic Oath and perform castrations to accommodate transgender ideology? No rational legal mind could reach that conclusion.

Yet the judiciary has become so politically compromised that even the supposedly conservative Fifth U.S. Circuit Court of Appeals upheld an interpretation of the law that forces doctors to perform these procedures — or risk losing Medicaid and Medicare reimbursements.

If doctors must wait until they are punished to challenge a rule, why don’t Trump’s directives get the same deference? What happened to legal consistency?

As part of the Biden administration’s relentless effort to impose transgender ideology nationwide, the president issued an order last year interpreting Section 1557 of the Affordable Care Act as a mandate for doctors to perform irreversible castrations. Originally designed to prohibit sex-based discrimination under the 1972 law, Section 1557 has now been twisted into the prior administration’s legal justification for these procedures.

Yes, the deeply flawed Bostock v. Clayton County decision — thanks to Justice Neil Gorsuch — expanded the 1972 law to include protections for transgender individuals. But on what basis does an anti-discrimination law create a right to force doctors to perform procedures they believe cause harm?

Bostock involved an employee fired for cross-dressing at work. Biden’s order, by contrast, does not merely prohibit discrimination — it compels employers to provide not just dresses but irreversible medical procedures.

Questions of standing — and bad precedent

For any Republican-appointed judge, this should have been an easy decision. In 2022, Judge Matthew Kacsmaryk, a Trump appointee in the Northern District of Texas, ruled in favor of the physician plaintiffs. He issued a declaratory judgment stating that the administration had completely misinterpreted the Affordable Care Act’s anti-discrimination provision. He also affirmed that physicians had clear standing to sue over the order.

In December, a three-judge panel of the Fifth Circuit, including two Republican appointees, ruled that doctors lacked standing to sue the Biden administration.

“The plaintiffs do not consider their actions to be gender-identity discrimination, nor do they provide evidence that HHS would view them as such,” the court stated.

“Plaintiffs have failed to show they are actually violating the Notification, much less facing a credible threat of enforcement," Judges Edith Jones, Catharina Haynes, and Dana Douglas wrote in their per curiam opinion.

Last week, despite a 12-5 Republican-appointed majority, all but one judge — James Ho — refused to hear the case en banc, allowing this precedent to stand.

This case highlights how judges selectively apply standing based on political considerations. The left rarely struggles with standing. During Trump’s presidency, his executive orders faced immediate legal challenges, and liberal judges routinely granted standing.

For instance, blue states successfully sued over Trump’s order on anchor-baby citizenship, yet red states were repeatedly denied standing to challenge Biden’s immigration law violations.

The inconsistency is blatant. Doctors facing potential loss of Medicaid reimbursements supposedly do not have a “justiciable case,” but Trump’s executive orders were routinely enjoined before they even took effect.

The idea that doctors cannot sue over a regulation that threatens their Medicaid reimbursements until after they suffer consequences defies legal precedent.

A terrible double standard

Meanwhile, Trump’s executive orders have been blocked before even appearing in the federal register. How can courts enjoin a presidential directive before it becomes an official regulation?

If doctors must wait until they are punished to challenge a rule, why don’t Trump’s directives get the same deference? What happened to legal consistency?

The idea that doctors who have not yet faced punishment but could lose Medicaid reimbursements for refusing to perform castrations lack a ripe, justiciable claim is absurd given what happens in the courts daily.

I’m all for a minimalist judicial approach, but why does that never apply to those suing Republican presidents? Indeed, the courts have become a one-way ratchet for the left.

In a spirited dissent from his 16 colleagues — something he has grown accustomed to — Judge Ho argued that refusing to provide sex hormone therapy is not the same as categorical discrimination. A doctor who declines to prescribe hormones for gender dysphoria is not refusing to treat a transgender patient for a broken bone.

The Supreme Court already ruled in Geduldig v. Aiello (1974) that denying coverage for pregnancy does not constitute sex-based discrimination. “While it is true that only women can become pregnant, it does not follow that every legislative classification concerning pregnancy is a sex-based classification,” the justices ruled.

On the question of standing, Judge Ho criticized the majority for basing its argument on the notion that a podiatrist wouldn’t offer “transition” services anyway, so not every doctor should have standing to sue. He called this absurd, pointing out that Dr. Susan Neese, the plaintiff in this case, practices general internal medicine.

“She is fully capable of providing such services to minors,” Ho wrote. “She just thinks it’s wrong to do so.”

“If there’s a plausible basis for theorizing that it’s somehow outside of Dr. Neese’s specialty to simply make a referral of a minor patient to another doctor who specializes in the field, the United States has not offered one,” he concluded.

Trump is likely to overturn this policy anyway, but as Ho warned, the Fifth Circuit’s decision allows a bad precedent to remain in place for future cases.

“By denying rehearing en banc, our court today leaves on the books a published, precedential ruling that overturns the district court’s dutiful efforts and validates administrative overreach in an area of profound sensitivity,” he wrote in a footnote.

One can only speculate, but given the left-wing political attacks on the Fifth Circuit, some worry that the judges are softening their stance to avoid appearing too conservative. Whether that’s better or worse than siding with the ideological left outright is debatable. Either way, Trump should make a point of appointing more judges like James Ho in his second term — jurists who not only hold sound legal principles but also have the courage to rule accordingly.