Institutional Courage: What It Would Take for Public Health to Admit It Was Wrong
Public health institutions have made errors in nicotine communication—the EVALI messaging, the systematic understatement of relative risk, the exclusion of consumer voices. Admitting error requires institutional courage. The courage has not been forthcoming.
The CDC has never acknowledged that its EVALI messaging conflated nicotine vaping with illicit THC cartridges and misled the public. The FDA has never acknowledged that its communication strategy has systematically understated the risk differential between smoking and vaping. **Admitting error requires institutional courage—the willingness to acknowledge failures, accept criticism, and change course. Public health institutions, like all institutions, resist this. But the resistance costs credibility—and credibility, once lost, is very hard to regain.**
