Public health’s war on nicotine has spiraled into hysteria—untethered from science and reason. In this hard-hitting GFN Interviews, addiction specialist Dr. Garrett McGovern exposes how ideology, fear, and institutional ego are driving the misinformation crisis around vaping and safer nicotine products—and why it’s time to bring smoking harms back to the center of the debate.
Featuring:
DR. GARRETT MCGOVERN
Medical Director, Priority Medical Clinic Dublin
GP Specialising in Addiction Medicine
@AddictionsPMC
Transcription:
00:10 - 01:14
[Brent Stafford]
Hi, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.tv. It's hard to believe, but the hysteria and moral panic over nicotine keeps growing, unbounded by science and common sense. The explosion of misinformation about nicotine's impact on health and well-being should alarm not only users of safer nicotine products like vapes and pouches, but the wider public who are being systematically misled by doctors and public health. Just how bad is the problem? Joining us today to unpack this troubling trend is Dr. Garrett McGovern, medical director at the Priority Medical Clinic in Dublin and clinical lead with Ireland's HSE Addiction Services. Dr. McGovern, thanks for coming back on the show. Thank you, Brent. Dr. McGovern, we last spoke in June at the Global Forum on Nicotine in Warsaw. You shared concerns at that time about the World Conference on Tobacco or Health. What were those concerns and were they realized?
01:15 - 02:01
[Garrett McGovern]
Yeah, those concerns were realized. I think the narrative has turned away from deadly tobacco and towards the harms of safer nicotine products, so ouches, snus, heated tobacco, and obviously vaping. That was going to be predictable, I think. I didn't expect it to be anything else. There wasn't particularly a huge amount of balance. There was no balance, really, at that conference. So that misinformation sort of roadshow continued, unfortunately.
02:01 - 02:10
[Brent Stafford]
Dr. McGovern, before we dive deeper into the controversy, tell us a bit about what kind of medicine you practice and what's the focus of your work?
02:10 - 05:17
[Garrett McGovern]
So I have been working for the last 27 years treating addiction. The specialty, I suppose we call it, is addiction medicine. So I would have cut my teeth. Some people would say in a deep end back in 1998 treating heroin users. So I treat all sorts of addictions, both psychological, physical addictions and even process addictions such as gambling. And the focus on my work really is not necessarily abstinence. I'm very much a harm reduction kind of focused therapist. So as you may or may not know, harm reduction is a um a spectrum from complete abstinence right up to in some cases you'll have heard of uh you know heroin prescribing clinics needle exchange um safer supply centers and these are things where they're not going to cure one's addiction and but we're trying to make the endeavor of drug use that bit safer i also do treat um smoking dependence. You'll probably appreciate that not so many people will come looking for those services. We don't tend to see what we call the psychosocial fallout from people with a tobacco habit. So consequently, a lot of people don't come for that. But I'm seeing more and more recently, I've been fairly prominent enough in ireland trying to promote alternatives to um just to deadly smoking unfortunately my own the very service that i work for is you said at the top of the show the health service executive their hse quit site anybody can um log into that site for and see the content They've unfortunately denounced vaping. They don't recognise vaping as an acceptable means of quitting smoking, which is unfortunate. The nearest counterpart to the HFC would be the NHS, the National Health Service in the UK. they have taken a completely different approach to this right up to the point of actually in NHS Leicester of giving out vaping equipment to people who really want to try and get away from smoking. So it's unfortunate. So I've got a knuckle-buckle battle in Ireland trying to let people, particularly smokers, know that there is a safer alternative because the narrative over here is that maybe Maybe vaping, you know, the smoke was no better off.
05:18 - 05:24
[Brent Stafford]
How is it possible that there could be such a different approach in England to Ireland?
05:24 - 07:38
[Garrett McGovern]
It's a great question, Brent. I'm not entirely sure why. I don't think it's very strange, really, in many ways, because the legislation has been fairly similar in Ireland and England up until recently anyway. um disposables were uh freely available and flavors as it stands are freely available and why it's happened in the uk i think i i think probably one of the reasons is is there's been some landmark reports over there we all know about the den public health england the royal college of physicians the whole 95 safer kind of uh evaluation and assessment was done in the uk And I think there was much more of a buy-in. I think that, well, first of all, that smoking is deadly. And second of all, that anything that gets people away from combustible tobacco has to be much better for your health. Over here, it's different. We've had largely a medical profession that is either very quiet on the issue you could say neutral but there are some fairly influential people in prominent positions over here who have managed to push the narrative towards being doubtful at best about the efficacy and the effectiveness of electronic cigarettes and at the other end of the scale that I've I've heard one particular very prominent doctor over here call vaping pernicious. So that's what you're up against. And unfortunately, there's a phrase that I learned many years ago, which I thought was very apt in this case, and that was that this is eminence-based medicine rather than evidence-based medicine. So the more important that the person is who makes the claims, the more likely they are to be believed.
07:39 - 07:42
[Brent Stafford]
When it comes to your patients, have you recommended vapes to them?
07:45 - 10:54
[Garrett McGovern]
I've gone large on recommending vapes. In fact, I'm very, very lucky because a number of years ago, friend, a vaping company came to me and asked me would I conduct some research among my patient cohort. Now, it was something I just didn't have the time to give to it. There would have been ethical considerations with ethical approval, and I just didn't have the time to give it. But one of the really positive things about that interaction with this company was they left me with a room full of the best vaping equipment you could lay your hands on. So I have, when my patients come in and I inquire about smoking, I'm able to get the conversation going about vaping. And I'm able to say to them, do you know that I have the best equipment, free of charge, and I can get you going? And I'll get patients say to me, oh, but isn't that not worse than smoking? I'll say, certainly not. And I'll give them the resources to read up all the good stuff. And I tell them that's all scaremongering. I said that vaping doesn't kill anybody. Vaping doesn't disimprove your health. Vaping doesn't take years off your life. It does exactly the opposite. It gives you your life back. Combustible tobacco is what will kill you. And if you don't get away from that habit, you're not going to be on this earth as long as you might think you will be or intend to be. So I've been able to, I'm nearly clearing out that room So that will give you some indication of the number of people, many of them recently actually. I thought actually I'd run out of them, and I actually found another box hidden under a set of towels in the room. So I'm really delighted about that, that I've been able to give. And the feedback has been absolutely phenomenal. I saw one girl today who said, not only am I off cigarettes, and this girl has COPD, She says, I'm actually not vaping as much as I did than I did at the start. I'm even vaping less now. You know, it's, you know, contrary to what a lot of people think. They think that people who are pro vaping like me probably want people to keep vaping. I have no view on this. My view is get the hell away from combustible tobacco. And if you also get off electronic cigarettes, well, well and good, that's great for you. But if you can't, you can't. But it's great to be able to be in that position to do that. And I've got a good position on this because I've done a good bit of stuff myself in terms of, you know, op-eds and that type of stuff in relation to it. So I say, listen, look, either Google my name or I can give them. you know, many of the great experts that you've had on your show and many of the great resources. You have to remember when you're trying to convince a patient of switching, you've got to keep it simple. You know, they're not going to read loads of research and stuff like that. They may want to, but I like to keep it snappy. And, you know, there's so much good stuff out there now.
10:55 - 11:02
[Brent Stafford]
Yeah, so the keep it simple idea also works for those that are peddling the misinformation.
11:02 - 11:58
[Garrett McGovern]
Yeah, it does, unfortunately. And, you know, it is true to say, actually, on that, now that you bring this up, that if you are, if you were to Google, even tonight, just Google, don't Google, don't do a leading question on a running point. Just say, what is the impact of vaping? Something neutral, because it can be a positive impact and a negative impact. Sadly, the that most of the searches will be drowned out by the harms of vaping. And a lot of it will be to do with nicotine and developing brain and kidneys and stuff. All the things basically that are really sort of background noise to the real issue here. And that's the sadness of this actually, Brent, is that the real story, the real success story of vaping is drowned out by the misinformation.
11:59 - 12:04
[Brent Stafford]
Why is it that safer nicotine products are being demonized so thoroughly?
12:05 - 13:00
[Garrett McGovern]
I don't know why. I've often thought about this. Why would people who should know better demonize a product that can help people get away from deadly tobacco? Either they don't appreciate how deadly tobacco is, either they believe genuinely they've been reading the wrong stuff, the wrong research, uh they really do genuinely believe that these products are evil and horrible and then other people say there's ulterior motives um you know it is true to say that you know you look at something like tobacco control you know if vaping is revolutionary as i think it is and safer nicotine products are revolutionary the game is up on tobacco control because they're making a living there's a lot of people being employed in there and who are laying the boot into vaping. And that's the real, that's the majority of their work now.
13:00 - 13:41
[Brent Stafford]
Yeah, it's the, I think I've called it the tobacco control industrial complex, because there certainly is one. It's got to be hundreds, if not several billion dollars a year that just supports the research. And, you know, in every community, there's somebody in tobacco control, every state, you know, federally. you know, and then times out by how many countries are out there. That's a lot of people whose job is to control tobacco. So would you agree then that misinformation around nicotine has particularly gotten out of control over just like the recent last couple of years?
13:43 - 18:16
[Garrett McGovern]
Yeah, it's very interesting about nicotine because nicotine is like, um, has really been demonized in a way that we all remember the nicotine cartoons many years ago. And most people didn't really bat an eyelid. Because the knowledge base and the understanding of smoking and smoking harms, they weren't quite what they were. That nicotine figure has come around again, hasn't it? It's all about nicotine in the developing brain. and nicotine addiction and the newer generation of nicotine addicts. It is interesting to say, though, and this will probably maybe center this to what's going on here. I never remember, and I'm old enough to be able to go right back well before vaping was a thing, but I don't know if you're aware of this, Brent, But I never heard of nicotine in the developing brain in all the years with tobacco smoking when nicotine wasn't invented. I never heard about nicotine in the developing brain. I heard, you know, the only time you ever heard about nicotine was nicotine is addictive. Nicotine stained fingers. You used to hear a lot about that. But I never heard about nicotine in the developing brain. I mean, obviously you didn't hear about newer nicotine generation of addicts. Nicotine brain damage? I mean, nicotine doesn't damage the brain. I mean, this is the other thing that really gets me, is that they talk about nicotine damages the developing brain, and the actually evidence that that's true There's a paucity of any real evidence that that's true. I don't even know where this research is coming from. I mean, if anything, you know, nicotine is shown to have some positive properties. I mean, it's probably comparable in terms of its harm to caffeine, and it helps some people like to use nicotine. I have treated a couple of Swedish patients over the last couple of years with alcohol problems. One lady is quite interesting. When she comes in, she puts a little pouch... in her gum. And she likes properties of nicotine. Now, is it harmful? Well, I think it depends on what harmful actually means. I mean, anything can be harmful. But I think it's fair to say that nicotine is relatively harmless. I don't... I often say to people, well, if nicotine causes the harm that you say it causes... I remember I was in a radio slot and I asked the... I actually... the interviewer wasn't going to ask the question, so I decided to ask the question. The other person in the other corner was a respiratory specialist, a respiritologist, I think they call it in the States. And I asked him, have you ever seen a nicotine-causing disease? In other words, nicotine-only, nicotine absent of cigarette smoking. And, of course, he conflated it and went, I've seen many people over the years have treated lung cancer. Either he was just been been trying to be humorous with me or frivolous. But I said, no, you know what I'm talking about. I'm talking about nicotine on its own. And he couldn't cite one case of a nicotine-causing illness. With all seriousness, I've never seen a nicotine-causing illness. I've never seen anybody in bed. I've never seen a report of a nicotine-causing illness. And just in case people are you know, wondering what I'm talking about. NRT, traditional NRT, gums, patches, inhalators, have been around for a long, long time. And I ain't seen anybody present to an emergency department, a primary care physician, a respiratory specialist, with any problems relating to NRT. So how can nicotine, suddenly because it's now been vaped, be a problem when it's never been a problem before? in any of its forms, including in tobacco. It's not nicotine, as we know, that causes the birth and the disease. It's the inhaled tobacco that causes the strokes, the heart diseases, the cancers, and the lung disease.
18:17 - 18:40
[Brent Stafford]
So you mentioned the one that we hear all the time is that nicotine harms the developing brain. The other one is that nicotine causes cancer. And it's frightening, actually, because in the U.S., there was just a study a couple of months ago that was released that says two-thirds of all medical practitioners in the U.S. believe that nicotine either causes cancer or they don't know enough to say it doesn't.
18:41 - 20:02
[Garrett McGovern]
Yeah. The latter is a real... a typical ploy, isn't it? We see it with vaping all the time. We just don't know. And what we just don't know, they don't realize the damage that causes in terms of denting the consumer confidence in something like vaping. When a smoker hears, I just don't know, they go, right, we'll chalk off that one. And if nothing else has worked for them, they'll probably continue to smoke. So the nicotine, I often say to people about nicotine causing cancer is simple. All our search engines now, particularly Google, will have an AI or chat GPT, whatever, but it has an AI thing. And when you put in a question like that, the AI version of it comes up often now. And even the AI version will scotch that one straight away. And yet, as you say, You know, almost 70% of doctors believe that to be the case. I don't know why they do that. Are they truly ignorant? These are meant to be, you know, bright, intelligent people. I mean, a cursory glance at any decent source will tell you that nicotine does not cause cancer.
20:03 - 20:08
[Brent Stafford]
Are these smears against vaping and nicotine dangerous, in your opinion?
20:10 - 22:56
[Garrett McGovern]
Yeah, I think they are because... Anything that discourages people away from a safe alternative to smoking is dangerous. I don't think they either care how dangerous that is or they believe it isn't dangerous. And it's funny, you know, we're talking about this because I've heard a few radio conversations with doctors about vaping. I remember listening to one particularly. And the doctor, I actually know the doctor, he's a GP, very good GP, but she was asked about, they had some voice notes that were coming in of people who'd vaped and had got all the cigarettes. And one of them was a really great story. You know, your typical story, we've heard them all before, Brent, you know, that two pack a day habit. Now I'm vaping and I haven't smoked for five years and my lungs are much clearer and all that sort of stuff. And the interviewer asked the doctor, what do you think of that? And he says, well, each to their own. But then contradicted that phrase, each to their own, and said, this is not recognized by our health service. This wouldn't be a recognized method. We just don't know the long-term effects of these devices. And this is the real killer. They said that there are proper evidence-based uh you know established interventions such as nrt and varenicline and all these medications that i would be advising people to to to try now a number of things really struck me about that first of all she was mistaken vaping you're twice as likely to successfully quit cigarettes as any other method the number of vapors has proliferated immeasurably over the last 10 years Many people are having a life without smoking, which is absolutely wonderful. But also, she also neglected to sort of say that, well, hold on a sec, you know, what about, maybe the interviewer didn't ask, but I wasn't involved in the show, and I would have put the poser to the, you know, so we could have discussed it. What about the ones who have tried Verena Clean and NLT and all the other things, and hypnotherapy and all those other things, and it's failed for them. And they are now vaping. Would that not be beneficial? Now, I've heard this with other doctors, and I've heard them say, no, I still would say don't do it. It's just astonishing. It really is astonishing. I mean, it just flies in the face of science.
22:57 - 23:28
[Brent Stafford]
Dr. McGovern, I want to call attention to a particularly egregious example of mainstream media misinformation. In a recent CBC News story, a senior tobacco control officer said, It hurts my soul to say that we've talked to some students who are using tobacco as a form of cessation from vaping because there's less nicotine in a cigarette or a pack of cigarettes than there is in that vile substance they're using in e-cigarettes.
23:29 - 24:17
[Garrett McGovern]
Isn't this another example of spreading misinformation? This is, as you say, Brent, this is egregious. This is outrageous. It's like an alternate universe that I'm looking at here. The idea, you know, it's bad enough that kids we don't know the truth of the story but it's bad enough that people you know evaping cessation by smoking i mean it's that's outrageous enough but for them for this middle-sex doctor to double down on that and say you know so bad is this bile horrible substance with high nicotine that uh kids are turning to smoking it's
24:18 - 24:29
[Brent Stafford]
I'm almost speechless. Almost speechless. And the CBC is sanctioning this. There's no attack on this. This fits the CBC narrative.
24:31 - 27:24
[Garrett McGovern]
Yeah. This will tell you how much there is a war on vaping. I don't know where this war has come from. I don't know why they are waging war on the very thing that can help smokers. I think in many ways they are using children to malign vaping. The other thing they're using to malign vaping now is the environment and disposables. So they're using every tool in the book. They are using kids to actually malign vaping. Their real concern isn't about the kids. I don't believe they're just... know if you look at the evidence and these are not stupid people they're able to read evidence the numbers of people and all the evidence is there the number of kids who regularly vape i.e the ones we should worry about because these are the ones who would otherwise be smokers if you look at say the s-pad study which looked at school kids between i think age 12 to 17 They showed that the sample who were using these products regularly were less than 5%. And that equated to, I think, less than 1% of the entire adolescent population in Ireland. That's been depicted, Brent, as an epidemic. So they either don't know what the word epidemic means, or they want vaping to be harmful. I'm beginning to believe that now. These people want vaping to be harmful. They want people's heads to blow off, their lungs to explode. They don't want these products to be safe at all. They will pick any junk article out of a tabloid newspaper of somebody's lungs exploding, checking no bona fides of whether the story is true. highly unlikely it is, and they will run with it. And it's distasteful. It really is, because we're letting smokers down. The medical profession, particularly, knowing what they've seen for decades upon decades of cigarette smoking, should be getting behind this technology and saying, you know what? Maybe there are some problems. Let's be open-minded about that. But by God, they are in the ha'penny place compared to smoking. If that's what we need to do, let's go big on this. Let's get everybody to switch over. If they don't want to vape and NLT works for them or cold turkey works for them, well and good. But let's really get behind everybody And really, whatever works for them, we're going to support them. But no, we get this rubbish.
27:25 - 27:32
[Brent Stafford]
So if the problem, and I think a good deal of it, is with the medical community, how do you fix that?
27:33 - 31:45
[Garrett McGovern]
Well, look, as you probably know, and it takes time to do these things, but we're trying to set up a doctor's group. And I don't want a doctor's group to be elitist, like doctors are important. But there is so much misinformation among medical professionals that I just like to redress the balance. And we've got to be very careful how we do this because if we set up a group that just is pro-vaping right away, we're probably going to alienate people. One of the things that I do notice with doctors is they, and this is for, you know, for many years I was part of the doctor's union and we had some contentious issues that we had to sort out. One of the things I noticed about many doctors, and maybe this is true of life in general, Brent, I don't know, is that they tend to be terribly afraid to support a cause. So if it's, let's say, we want to promote safer nicotine products, I often find that people who are aligned to someone in a very important position who detests vaping, even if they believe vaping to be safer than smoking, I mentioned be safer than smoking, They're too afraid to open up about that. It's just kind of appalling that people are afraid to say what they really think because somebody is so domineering and so influential. I just, you know, is that what the world has come to? You're not able to tell the truth. You've got to lie. We're seeing it more and more, unfortunately, that people will tend to back a person rather than back to truth. If the person is telling lies, it's OK, because I've got to be seen to be supporting them. So I would like to be able to get doctors involved, but I would like to center it around tobacco harms. Nobody with any degree of credibility could honestly make the claim that vaping comes anywhere near the harms of smoking. So anybody who says that is so removed from, they're departing from reality. In psychiatry, we say people become psychotic when they depart from reality. They develop psychosis. This is what it sort of seems like. And I have heard doctors say you're no better off vaping than continued smoke. People really, really learn, people who have treated tobacco-related harm for years, respiratory specialists, heart specialists, and they're making the claim that you're no better off. I mean, based on what exactly? I mean, vapour. with some products, some of them that are in tobacco smoke at a much lesser concentration, but no combustion whatsoever. How can they make the claim that non-combustion is the same level of harm? It's not based by any, no science. There's nothing that would back that up. And to be honest with you, one of the things I'd like to do, Brent, sounds very simple and straightforward and widely think of it before. I'd like to take vaping off the agenda a little bit and put smoking harms back on the agenda because in ireland i i can't speak for other countries but i'm guessing it's not too different since vaping and safer nicotine products we don't hear much we don't hear an awful lot about smoking harms 95 at least maybe even more of the articles you're going to see in a newspaper relating to nicotine is going to be safer nicotine products not tobacco. It's not sexy. And I'd like to start putting it back on the map as to how deadly tobacco is. Because I think people have somehow forgotten that.