Brownstone Institute
Justice Is Served: Jay Bhattacharya Chosen to Be NIH Director
Martin Kulldorff, Sunetra Gupta, Jay Bhattacharya. Authors of the Great Barrington Declaration
From the Brownstone Institute
By
“At some point in summer of 2020, I decided—what is my career for? If it’s just to have another CV line or a stamp, I’ve wasted my life—that I would speak no matter what the consequences were.”
Many years ago, I was at the wedding of a good friend, a guy who everyone seemed to like. He was/is humble, considerate, kind, and down to earth. I remember telling his mother while at the wedding that I would tell anyone that, “If you don’t like him, then the problem is you.”
I also feel that way about Stanford health economist Jay Bhattacharya. Jay’s nomination by President-elect Trump to be Director of the National Institutes of Health has been a long time coming and is a hopeful signal that national health research policy is headed in the right direction.
Jay was right about all the big things during the Covid pandemic and was an important counter to the destructive hubris of lockdown and mandate-promoting public health leaders and scientists in the US. Along with Martin Kulldorff and Sunetra Gupta, Jay took enormous personal and professional risks in drafting the Great Barrington Declaration in October of 2020. In response to the highly age-stratified mortality of Covid-19 and with the threat of serious collateral damage of continuing lockdowns, school closures, and mandates, the GBD instead promoted the policy of focused protection for vulnerable elderly and infirm people while allowing young and healthy people to live their lives.
The virus was going to infect everyone eventually and establish herd immunity, and there was no evidence that a vaccine (none approved at the time) would stop that natural process. The big question was how to deal with a natural disaster without making the situation much worse. Thus, the debate was focused protection versus unfocused protection—sheltering everyone regardless of their risk of mortality or serious disease until the entire population could be vaccinated with a vaccine of unknown efficacy and net benefit.
At least that’s the debate that should’ve happened. Unfortunately, it didn’t. Jay and his GBD coauthors were attacked, threatened, and slandered. When Jay’s research group published a study showing that the seroprevalence of Covid-19 in Santa Clara County in California was much higher than previously believed, it destroyed the delusion that the virus could be eliminated, that containment was at all possible. Many people didn’t want to hear that, and Jay was subjected to numerous attacks in the media, including a defamatory article in BuzzFeed claiming he was funded by dark money and implied he used questionable methods because he was biased toward the study’s outcome.
The fact that he shortly thereafter authored a paper showing very low seroprevalence in Major League Baseball franchises wasn’t enough to prove his objectivity. The message put forth by the public health establishment would simply not allow any dissent or debate. The policy needed to drive The Science™, and lower-case science could not be allowed to drive the policy.
I signed the Great Barrington Declaration the day it was published on October 4th, 2020. I had seen, and was greatly impressed by, interviews of Jay by Peter Robinson in March and April of 2020 and was heartened by Jay’s calm display of knowledge and humility. Jay described in one of these interviews the uncertainty surrounding the number of people infected and the claims being made by experts like Anthony Fauci regarding the infection fatality rate:
They don’t know it and I don’t know it. We should be honest about that. And we should be honest about that with people who make these policy decisions when making them. In a sense, people plug the worst case into their models, they project two to four million deaths, the newspapers pick up the two to four million deaths, the politicians have to respond, and the scientific basis for that projection…there’s no study underlying that scientific projection.
When asked about the potential for collateral damage to lockdowns, “It’s not dollars versus lives, it’s lives versus lives.” An understanding of the responsibility to avoid collateral harm of lockdowns was essential yet was in extremely short supply. Jay was attacked for this nuanced message. He got emails from colleagues and administrators telling him that questioning the high infection fatality rate was irresponsible. Yet, someone had to do it. However, the interviews went viral, because Jay gave millions of people something they didn’t have and desperately needed. He gave them hope.
As the year went on, Jay became the face of the opposition to unfocused protection, appearing in countless interviews and writing countless articles. He became an advisor to Florida Governor Ron DeSantis, who vowed to not lock down the people of Florida again after an initial wave of closures. When waves of Covid inevitably hit Florida, Stanford students papered the campus with pictures of Jay next to Florida death rates, implying Jay’s nuanced message was responsible for the deaths of thousands of people. When the age-adjusted mortality rate of Florida ended up being rather average compared to other states, including lockdown and mandate-happy California, no one apologized.
YouTube censored a public forum with Jay and Martin Kulldorff and Governor DeSantis, where they made claims about the hazards of continuous lockdowns, school closures, and mandates that months before wouldn’t have been at all controversial. After the GBD was published, Jay and Martin were invited to the White House by Covid advisor Scott Atlas to discuss the idea of focused protection with President Trump. Despite that meeting, the political battle continued to be an uphill fight.
The response of federal officials was shameful. Fauci and White House Covid Advisor Deborah Birx boycotted the meeting. Then NIH Director Francis Collins called for a “swift and devastating takedown” of the GBD’s premise and called the authors “fringe epidemiologists.” There simply was no appetite at the highest levels for a nuanced message or any debate whatsoever. Media coverage of Jay and other Covid response critics continued to be toxic.
Yet Jay’s appearances and message continued to inspire millions of people and give them hope. I began writing in support of focused protection and against the constant doom-saying that was harming everyone, especially children. I met Jay in the fall of 2021 because of my writing, at a conference organized by Brownstone Institute. “I think we are making a difference,” he said after shaking my hand. Like many other people he had inspired to take a stance against Covid hysteria, I needed to hear that.
The next day, Jay was preparing to give his speech in front of a small crowd in the ballroom, and I sat next to him while he reviewed his notes during the previous speaker’s talk. Although he was dressed in a suit and tie, when glancing down, I noticed Jay had a hole in his dress shoe. This truly wasn’t about money or even status. He was simply doing what he believed was morally right.
Later on, Jay helped spearhead a couple of Covid-related projects I was also involved in (I was there largely due to his influence). First was the Norfolk Group, which produced a resource document for the US Congress titled “Questions for a COVID-19 Commission” and the second was Florida’s Public Health Integrity Committee formed by Governor DeSantis and led by Florida Surgeon General Joe Ladapo. Both groups attempted to bring accountability for the US public health response, and I believe they were successful in spotlighting just how wrong and harmful lockdowns and mandates were for the very public they were supposed to help.
During the initial Norfolk Group meeting, Jay often talked about the moment of no return, “crossing the Rubicon,” as he put it, the moment that each one of us made a conscientious decision to stand up against the mob. He later recalled in an interview with Jordan Peterson: “At some point in summer of 2020, I decided—what is my career for? If it’s just to have another CV line or a stamp, I’ve wasted my life—that I would speak no matter what the consequences were.”
The world has benefitted from Jay’s crossing of the Rubicon. His nomination, after years in the wilderness and on the “fringe” of public health and health policy, restores a sense that there is in fact justice in the world. Now he moves on to the significant task of reforming health research policy. We should be cheering him on all the way.
And if you don’t like Jay, then the problem is you.
Republished from the author’s Substack
Author
Brownstone Institute
Bizarre Decisions about Nicotine Pouches Lead to the Wrong Products on Shelves
From the Brownstone Institute
A walk through a dozen convenience stores in Montgomery County, Pennsylvania, says a lot about how US nicotine policy actually works. Only about one in eight nicotine-pouch products for sale is legal. The rest are unauthorized—but they’re not all the same. Some are brightly branded, with uncertain ingredients, not approved by any Western regulator, and clearly aimed at impulse buyers. Others—like Sweden’s NOAT—are the opposite: muted, well-made, adult-oriented, and already approved for sale in Europe.
Yet in the United States, NOAT has been told to stop selling. In September 2025, the Food and Drug Administration (FDA) issued the company a warning letter for offering nicotine pouches without marketing authorization. That might make sense if the products were dangerous, but they appear to be among the safest on the market: mild flavors, low nicotine levels, and recyclable paper packaging. In Europe, regulators consider them acceptable. In America, they’re banned. The decision looks, at best, strange—and possibly arbitrary.
What the Market Shows
My October 2025 audit was straightforward. I visited twelve stores and recorded every distinct pouch product visible for sale at the counter. If the item matched one of the twenty ZYN products that the FDA authorized in January, it was counted as legal. Everything else was counted as illegal.
Two of the stores told me they had recently received FDA letters and had already removed most illegal stock. The other ten stores were still dominated by unauthorized products—more than 93 percent of what was on display. Across all twelve locations, about 12 percent of products were legal ZYN, and about 88 percent were not.
The illegal share wasn’t uniform. Many of the unauthorized products were clearly high-nicotine imports with flashy names like Loop, Velo, and Zimo. These products may be fine, but some are probably high in contaminants, and a few often with very high nicotine levels. Others were subdued, plainly meant for adult users. NOAT was a good example of that second group: simple packaging, oat-based filler, restrained flavoring, and branding that makes no effort to look “cool.” It’s the kind of product any regulator serious about harm reduction would welcome.
Enforcement Works
To the FDA’s credit, enforcement does make a difference. The two stores that received official letters quickly pulled their illegal stock. That mirrors the agency’s broader efforts this year: new import alerts to detain unauthorized tobacco products at the border (see also Import Alert 98-06), and hundreds of warning letters to retailers, importers, and distributors.
But effective enforcement can’t solve a supply problem. The list of legal nicotine-pouch products is still extremely short—only a narrow range of ZYN items. Adults who want more variety, or stores that want to meet that demand, inevitably turn to gray-market suppliers. The more limited the legal catalog, the more the illegal market thrives.
Why the NOAT Decision Appears Bizarre
The FDA’s own actions make the situation hard to explain. In January 2025, it authorized twenty ZYN products after finding that they contained far fewer harmful chemicals than cigarettes and could help adult smokers switch. That was progress. But nine months later, the FDA has approved nothing else—while sending a warning letter to NOAT, arguably the least youth-oriented pouch line in the world.
The outcome is bad for legal sellers and public health. ZYN is legal; a handful of clearly risky, high-nicotine imports continue to circulate; and a mild, adult-market brand that meets European safety and labeling rules is banned. Officially, NOAT’s problem is procedural—it lacks a marketing order. But in practical terms, the FDA is punishing the very design choices it claims to value: simplicity, low appeal to minors, and clean ingredients.
This approach also ignores the differences in actual risk. Studies consistently show that nicotine pouches have far fewer toxins than cigarettes and far less variability than many vapes. The biggest pouch concerns are uneven nicotine levels and occasional traces of tobacco-specific nitrosamines, depending on manufacturing quality. The serious contamination issues—heavy metals and inconsistent dosage—belong mostly to disposable vapes, particularly the flood of unregulated imports from China. Treating all “unauthorized” products as equally bad blurs those distinctions and undermines proportional enforcement.
A Better Balance: Enforce Upstream, Widen the Legal Path
My small Montgomery County survey suggests a simple formula for improvement.
First, keep enforcement targeted and focused on suppliers, not just clerks. Warning letters clearly change behavior at the store level, but the biggest impact will come from auditing distributors and importers, and stopping bad shipments before they reach retail shelves.
Second, make compliance easy. A single-page list of authorized nicotine-pouch products—currently the twenty approved ZYN items—should be posted in every store and attached to distributor invoices. Point-of-sale systems can block barcodes for anything not on the list, and retailers could affirm, once a year, that they stock only approved items.
Third, widen the legal lane. The FDA launched a pilot program in September 2025 to speed review of new pouch applications. That program should spell out exactly what evidence is needed—chemical data, toxicology, nicotine release rates, and behavioral studies—and make timely decisions. If products like NOAT meet those standards, they should be authorized quickly. Legal competition among adult-oriented brands will crowd out the sketchy imports far faster than enforcement alone.
The Bottom Line
Enforcement matters, and the data show it works—where it happens. But the legal market is too narrow to protect consumers or encourage innovation. The current regime leaves a few ZYN products as lonely legal islands in a sea of gray-market pouches that range from sensible to reckless.
The FDA’s treatment of NOAT stands out as a case study in inconsistency: a quiet, adult-focused brand approved in Europe yet effectively banned in the US, while flashier and riskier options continue to slip through. That’s not a public-health victory; it’s a missed opportunity.
If the goal is to help adult smokers move to lower-risk products while keeping youth use low, the path forward is clear: enforce smartly, make compliance easy, and give good products a fair shot. Right now, we’re doing the first part well—but failing at the second and third. It’s time to fix that.
Addictions
The War on Commonsense Nicotine Regulation
From the Brownstone Institute
Cigarettes kill nearly half a million Americans each year. Everyone knows it, including the Food and Drug Administration. Yet while the most lethal nicotine product remains on sale in every gas station, the FDA continues to block or delay far safer alternatives.
Nicotine pouches—small, smokeless packets tucked under the lip—deliver nicotine without burning tobacco. They eliminate the tar, carbon monoxide, and carcinogens that make cigarettes so deadly. The logic of harm reduction couldn’t be clearer: if smokers can get nicotine without smoke, millions of lives could be saved.
Sweden has already proven the point. Through widespread use of snus and nicotine pouches, the country has cut daily smoking to about 5 percent, the lowest rate in Europe. Lung-cancer deaths are less than half the continental average. This “Swedish Experience” shows that when adults are given safer options, they switch voluntarily—no prohibition required.
In the United States, however, the FDA’s tobacco division has turned this logic on its head. Since Congress gave it sweeping authority in 2009, the agency has demanded that every new product undergo a Premarket Tobacco Product Application, or PMTA, proving it is “appropriate for the protection of public health.” That sounds reasonable until you see how the process works.
Manufacturers must spend millions on speculative modeling about how their products might affect every segment of society—smokers, nonsmokers, youth, and future generations—before they can even reach the market. Unsurprisingly, almost all PMTAs have been denied or shelved. Reduced-risk products sit in limbo while Marlboros and Newports remain untouched.
Only this January did the agency relent slightly, authorizing 20 ZYN nicotine-pouch products made by Swedish Match, now owned by Philip Morris. The FDA admitted the obvious: “The data show that these specific products are appropriate for the protection of public health.” The toxic-chemical levels were far lower than in cigarettes, and adult smokers were more likely to switch than teens were to start.
The decision should have been a turning point. Instead, it exposed the double standard. Other pouch makers—especially smaller firms from Sweden and the US, such as NOAT—remain locked out of the legal market even when their products meet the same technical standards.
The FDA’s inaction has created a black market dominated by unregulated imports, many from China. According to my own research, roughly 85 percent of pouches now sold in convenience stores are technically illegal.
The agency claims that this heavy-handed approach protects kids. But youth pouch use in the US remains very low—about 1.5 percent of high-school students according to the latest National Youth Tobacco Survey—while nearly 30 million American adults still smoke. Denying safer products to millions of addicted adults because a tiny fraction of teens might experiment is the opposite of public-health logic.
There’s a better path. The FDA should base its decisions on science, not fear. If a product dramatically reduces exposure to harmful chemicals, meets strict packaging and marketing standards, and enforces Tobacco 21 age verification, it should be allowed on the market. Population-level effects can be monitored afterward through real-world data on switching and youth use. That’s how drug and vaccine regulation already works.
Sweden’s evidence shows the results of a pragmatic approach: a near-smoke-free society achieved through consumer choice, not coercion. The FDA’s own approval of ZYN proves that such products can meet its legal standard for protecting public health. The next step is consistency—apply the same rules to everyone.
Combustion, not nicotine, is the killer. Until the FDA acts on that simple truth, it will keep protecting the cigarette industry it was supposed to regulate.
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