Dr. Brian King — the former director of the FDA's Center for Tobacco Products, who was placed on administrative leave in April 2025 as part of the mass HHS layoffs joins the Chuck Toddcast to explain what happens to public health when the agency charged with protecting it gets deliberately dismantled. King walks through the extraordinary progress America made reducing cigarette smoking over decades, and how quickly that's being unwound: the tobacco industry donated millions to Trump's PAC, executives pressured the White House directly, and the payoff has been regulatory capture and mounting pressure on the FDA to bring flavored products back to market. He's clear-eyed rather than absolutist on the science — combustible products are far and away the most harmful, nicotine itself is highly addictive but isn't what's killing people, though it's genuinely not risk-free for the adolescent brain — and he walks Chuck through the comparison to caffeine, the data on whether vaping serves as a gateway back into smoking, and what's actually known about nicotine pouches, where youth usage isn't high but stubbornly isn't declining either. The industry, meanwhile, is spending roughly a million dollars an hour advertising its products while fighting every government action to reduce smoking.

The conversation turns to what actually works and what's being abandoned. King argues the two most effective interventions available are reducing nicotine levels in cigarettes and banning menthol, credits Congress for getting the Tobacco Control Act right, and stresses that Congress — not the FDA acting alone — has to be the one to regulate tobacco, which is precisely why sidelining the agency is so damaging. He and Chuck get into the questions nobody in Washington wants to answer: why are cigarettes legal at all, how are sugary alcoholic beverages not treated in the same category, and where did the money from the 1998 master settlement actually go. King is pointed that the MAHA movement, for all its rhetoric about chronic disease, has done nothing prominent on tobacco, and that the FDA is now actively undermining both the science and the law it was built to enforce. His closing warning is the bleakest note of the episode: America is in a public health apocalypse that will take decades to repair, it will be enormously hard to recruit a next generation into the field, the entire world will be harmed by the collapse of American public health infrastructure — and the impacts are only just beginning to show up.

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Timeline:

(Timestamps may vary based on advertisements)

00:00 Brian King (FDA center on tobacco) joins the Chuck ToddCast

03:45 We made incredible progress reducing cigarette smoking

04:15 Tobacco companies donated and received regulatory capture

05:00 Flavored vapes appeal more to kids & are problematic

06:30 Trump was pressured by executives from tobacco industry

07:15 There were multimillion dollar donations to Trump’s PAC

08:45 What’s the actual health data on nicotine outside of smoking?

09:15 Combustible products are the most harmful

09:45 Nicotine is highly addictive but isn’t causing the harm and deaths

10:30 Nicotine can harm the adolescent brain, it’s not risk free

11:15 Comparing nicotine vs. caffeine

13:00 Vaping typically isn’t a gateway back into smoking

14:15 There’s been pressure on FDA to bring back flavored products

16:45 $1M dollars an hour is being spent advertising tobacco products 

17:30 Industry has been fighting all government action to reduce smoking

19:00 The FDA has been sidelined in the fight against smoking

19:30 Why are cigarettes even legal at all?

21:00 Tobacco farmers have transitioned to other crops in other countries

23:00 Reducing nicotine levels is highly effective 

23:30 Outlawing menthol is also highly effective

25:15 Congress got it right with the Tobacco Control Act

27:00 How are sugary alcoholic beverages not in the same category?

28:00 What is age gating technology and how does it work?

30:00 Do we have good data on usage for people under 18?

32:30 Nicotine pouch usage isn’t high amongst kids, but isn’t going down

33:00 What is the data about health impacts from pouches?

34:30 Nicotine has a strong stimulant effect, helps with attention

35:15 Settlement in ‘98 required tobacco companies to pay costs in perpetuity

35:45 States have diverted those funds to other purposes

36:45 Did the tobacco industry actually take a hit from the settlement?

37:30 If still at FDA, what changes would you implement?

38:00 FDA has been undermining the science and the law

39:00 Effectiveness of banning indoor smoking

40:15 Should preventing underage addictions be the north star?

42:30 Congress has to regulate tobacco, FDA can’t do it on its own

43:15 MAHA hasn’t done anything prominent on tobacco

45:30 Is there litigation that could be pursued here?

46:45 We’re in a public health apocalypse, will take decades to repair

47:30 It will be hard to recruit people into public health

49:15 The entire world will be harmed by collapse of American public health

51:00 The impacts are just beginning to show up, will get worse