Brownstone Institute
The Illusion of Consensus
From the Brownstone Institute
Science is the process by which we learn about the workings of material reality. Though modern innovations – built on the fruits of science – would look like magic to people living only decades ago, they result from the time-tested scientific method.
Contrary perhaps to media portrayals of science, the scientific method depends not on the existence of a mythical consensus but rather on structured scientific debates. If there is a consensus, science challenges it with new hypotheses, experiments, logic, and critical thinking. Ironically, science advances because it believes it has never arrived; consensus is the hallmark of dead science.
One of us is a college student with an unpremeditated career in alternative indie journalism. The other is a professor of health policy at Stanford University School of Medicine with an MD, a Ph.D. in economics, and decades of experience writing on infectious disease epidemiology. Despite the wealth of differences in our backgrounds and experiences, we converge on foundational scientific and ethical principles that public health authorities abandoned during the Covid pandemic. Principles like evidence-based medicine, informed consent, and the necessity of scientific debate serve as the bedrock on which the public can have confidence that science and public health work for the benefit of the people rather than regardless of it.
The illusion of scientific consensus throughout the COVID-19 pandemic led to disastrous policies, with lockdowns the primary example. It was clear even on the eve of the lockdowns in 2020 that the economic dislocation caused by them would throw tens of millions worldwide into food insecurity and deep poverty, which has indeed come to pass.
It was clear that school closures – in some places lasting two years or longer – would devastate children’s life opportunities and future health and well-being wherever they were implemented. The emerging picture of catastrophic learning loss, especially among poor and minority children (with fewer resources available to replace lost schooling), means that lockdowns will fuel generational poverty and inequality in the coming decades.
And the empirical evidence from places like Sweden, which did not impose draconian lockdowns or close schools and which have among the lowest rate of all-cause excess death in Europe, suggests that lockdowns failed even narrowly to protect population health during the pandemic.
The illusion of consensus around the proper use of the Covid vaccines was another major public health disaster. Public health officials everywhere touted the randomized trials on the Covid vaccines as providing complete protection against getting and spreading Covid. However, the trials themselves did not have the prevention of infection or transmission as a measured endpoint.
Rather, the trials measured protection against symptomatic disease for two months after a two-dose vaccination sequence. Prevention of symptomatic infection is obviously a distinct clinical endpoint from prevention of infection or transmission for a virus that can spread asymptomatically. In the fall of 2020, Moderna chief medical officer Tal Zaks told the BMJ, “Our trial will not demonstrate prevention of transmission…because in order to do that, you have to swab people twice a week for very long periods, and that becomes operationally untenable.”
Despite these facts, public health officials botched the public health messaging surrounding the Covid vaccines. Based on an illusion of scientific consensus, public health authorities, politicians, and the media pushed vaccine mandates, vaccine passports, and vaccine discrimination.
Prominent officials, including Anthony Fauci and CDC Director Rochelle Walensky, told the public that science had established that covid vaccines stop transmission. CNN anchor Don Lemon advocated for “shaming” and “leaving behind” unvaccinated citizens from society. Countries such as Italy, Greece, and Austria sought to punish their unvaccinated citizens with heavy financial penalties of up to $4,108. In Canada, the government stripped unvaccinated citizens of their rights to travel anywhere via plane or train and their ability to work at banks, law firms, hospitals, and all federally regulated industries.
The premise was that only the unvaccinated are at risk of spreading covid. An illusion of consensus emerged that getting the shots was a required civic duty. Phrases such as “It’s not about you, it’s to protect my grandparents” became widely popularized. Ultimately, as people observed many vaccinated people around them contract and spread Covid, the public trust in these authorities collapsed.
Early last month, the Biden administration extended its foreign traveler mRNA vaccine requirement to May 11th (which is now coming to an end) after the restriction was set to expire on April 11th. None of these policies ever had any scientific or public health rationale or epidemiological “consensus” to support them— and they certainly do not in 2023.
Related errors are overstating the necessity of the Covid vaccine for the young and healthy and downplaying the possibility of severe side effects, such as myocarditis which has been found mainly in young men taking the vaccine. The primary benefit of the Covid vaccine is to reduce the risk of hospitalization or death upon covid infection. There is more than a thousand-fold difference in the mortality risk from covid infection, with children and young and healthy people facing an extremely low risk relative to other risks in their lives.
On the other hand, the mortality risk for older people from infection is considerably higher. So the maximum theoretical benefit of the vaccine is meager for young, healthy people and children, while it is potentially higher for elderly people with multiple comorbid conditions.
Institutional public health and medicine ignored these facts in the push to vaccinate the entire population, regardless of the balance of benefits and harms from the vaccine. Public health should have cautioned young and/or healthy people regarding the uncertainty regarding vaccine safety for a novel vaccine.
For the young and healthy, the small potential benefit does not outweigh the risk, which – with the early myocarditis signals – turned out not to be theoretical in nature. A rigorous independent analysis of Pfizer and Moderna’s safety data shows that mRNA covid vaccines are associated with a 1 in 800 adverse event rate — substantially higher than other vaccines on the market (typically in the ballpark of 1 in a million adverse event rates).
To maintain an illusion of consensus, public health authorities and media thought it necessary to suppress these facts. In June 2021, for instance, Joe Rogan stated healthy 21-year-olds do not need the vaccine. Despite his correct medical judgment which has indisputably stood the test of time, all sectors of the corporate media and social media platforms unanimously pilloried him for spreading “dangerous misinformation.”
Worse, many people who suffered from legitimate vaccine injuries were gaslighted by the media and medical personnel about the cause of their condition. One of us has devoted the past several months interviewing victims of the illusory scientific consensus that covid vaccines are on net beneficial for every group. For example, there is a 38-year-old law enforcement officer in British Columbia who was coerced into vaccination against his conscience to keep his job.
Nearly two years later, he remains disabled from vaccine-induced myocarditis and has been unable to serve his community. National data from countries in France, Sweden, Germany, Israel, and the United States shows a substantial rise in cardiac conditions among younger populations after the distribution of the Covid vaccine.
The illusion of consensus surrounding Covid vaccination — wrongly viewed in the same light as hand-washing, driving within speed limits, or staying hydrated — has led to greater political divisions and discriminatory rhetoric. The failure of the traditionally well-regarded public health agencies like the FDA and CDC – with perverse influences from pharmaceutical companies in tandem with the powerful forces of censorship on social media — has destroyed trust in public health institutions. Disillusioned with the “illusion” of consensus, a growing number of Americans and Canadians are distrustful of scientific consensus and are beginning to question all things.
The project of science calls for rigor, humility, and open discussion. The pandemic has revealed the stunning magnitude of the political and institutional capture of science. For this reason, both of us — Rav and Jay — are launching a podcast devoted to investigating the concoction of pseudo-consensus in science and its ramifications for our society.
You can subscribe to the authors’ new Substack and Podcast
Authors
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.
Author
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.
Author
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