Usually Eating in America is about what we eat and what people like RFK, Jr. are doing or not doing to make it healthy. But EiA is near the end of four-part series on cannabis, something Kennedy and Trump could help make less of a threat to health, and today we touch on another big failure of Kennedy and the current administration, this time with regard to a smokable substance with strongly negative health effects: tobacco.
Look for the final part of my cannabis series in two days, on April 21. We get into black market cannabis, the effect of big money in cannabis, and policy ideas to move forward balancing public health and public opinion.
First, the smoking gun.
A lot has been going on with Trump, RFK, Jr., and public health in America since the new administration began last year, so it went somewhat unnoticed that in April’s decimation of the CDC, all 120 Office on Smoking and Health staff were fired. The federal government has effectively ended its effort to prevent initiation to tobacco and reduce use.
Meanwhile, nearly a half-million Americans continue to die annually from tobacco use.
The obliterated Office had been formed in 1978 and has led effective national anti-smoking campaigns, written the Surgeons General’s many reports on tobacco, and run and analyzed the annual National Youth Tobacco Survey, a key tool to monitor smoking among adolescents and older youths. The Surgeons General’s reports had to be restored to public access by court order but are now deep-sixed in an archive, including the last one, 2024’s “Eliminating Tobacco-Related Disease and Death: Addressing Disparities.”
Fortunately, the National Youth Tobacco Survey data from 2025 has been released by the FDA, although without comment or analysis that was usually provided by the Office of Smoking and Health.
Statnews reported that former Office of Smoking and Health Director Tim McAfee called the closing of the office “the greatest gift to the tobacco industry in the last half century.”
Foundayo
Good news in the world of GLP-1s, the new daily orforglipron pill from Eli Lilly got very fast fast-track approval on April 1 from the FDA. Eli Lilly, confident that their application would be approved, had started manufacturing the drug months ago, and it is already available for purchase.
The pill, brand name Foundayo, can be taken without regard for time of day and with or without food. The other new GLP-1 pill, Novo Nordisk’s Wegovy, must be taken first thing in the morning a half-hour before consuming anything. For those of us who cannot cope with waiting 30 minutes for their first cup of coffee, that might be a deal breaker.
The Wegovy pill became available in January. Trials showed average weight loss of 16.6% with Wegovy, about 3% more than the average loss achieved with Foundayo. Side effects are typical of GLP-1s with both pills, but the effect profiles may be better with the Wegovy. Their head-to-head costs are competitive and somewhat less expensive than the injectable version of Wegovy or Eli Lilly’s Zepbound.
Both manufacturers are optimistic about uptake on their pills. There is speculation that the pills might work out as a weight maintenance option for many people who create their weight loss with an injectable Wegovy or Zepbound regimen for some months or years but would prefer to take pills for lifelong maintenance of the weight loss.
The Gorske dilemma
When I was a young man and beginning to collect random ideas about healthy eating, NPR played a story in which a farmer declared he was a vigorous 98 years old and had eaten bacon every day of his life. I was happy to realize eating fried, fatty, salted pork would not automatically result in my death warrant going out to the grim reaper.
