"Proceed as if success were inevitable"
Cliff Douglas against the last empire of dogma.
One of the most respected voices in global tobacco control and harm reduction, Cliff Douglas has spent more than three decades battling the smoking epidemic on multiple fronts: as a lawyer, a public policy expert, an advisor to the U.S. government, a leader at organizations such as the American Cancer Society, and, now, as president and CEO of Global Action to End Smoking.
A pioneer of smoke-free environments and an unrelenting advocate for evidence-based policy, Douglas, in a relaxed conversation with the YouTuber GrimmGreen, blends legal rigor, ethical resolve, and a steady conviction: success in saving lives is inevitable—so long as the fight is waged with perseverance and intelligence.
The coffee steams quietly in an old white cup, its surface cracked by time. Across the crazed porcelain, a fading inscription clings stubbornly to life: Proceed as if success is inevitable. Cliff Douglas holds the cup as one might grip a modest shield—a fragile defense against the rough weather of the world.
From his office—perhaps tucked away in a corner of the University of Michigan or his suite at Global Action to End Smoking—Cliff Douglas, surrounded by memorabilia stacked like trenches against forgetting, recounts to GrimmGreen a life spent on the front lines of public health: an existence devoted not only to fighting smoke, but to dismantling a machinery of systematic deception.
He explains that his battle was never merely against tobacco, but against an entire system of institutionalized falsehood, rooted deep in the very entrails of power.
The room where Cliff Douglas reveals himself is not designed to impress, but to endure. The gray of the walls—somewhere precisely between ash and mist—seems to absorb the murmur of the outside world, creating a refuge where words do not ricochet but fall with gravity. Behind him, a dark iron bookshelf holds not just books and papers but a singular kind of order: an order born not of aesthetic impulse, but of urgency, like the provisional camp of someone who, though exhausted, never stops marching.
Objects tell their own story—if one knows how to look. A small plant, straining against the dim light, hints at the stubbornness of life under adverse conditions. A roughly sketched portrait, its expression grave, seems to stand watch over the conversation, a silent reminder of battles already fought. A desk clock, half-buried under papers, measures time not as a threat but as a promise. Even the side table, where rigid wooden figures rest, carries the aesthetic of the trenches: utilitarian, sober, built to endure.
Douglas, his hair slightly tousled and the collar of his gray shirt undone, embodies a paradox: the serenity of a veteran and the urgency of a militant. He speaks in measured phrases, like someone who has learned that every misplaced word can become a weapon in the wrong hands. But he also smiles, at times, like someone who knows that irony is the last trench of optimism.
Light cuts across the room in oblique bands, casting long shadows that slide over family photographs. Outside, though unseen, the world keeps spinning in its usual din. Here, though, time seems to have thickened. There is no visible urgency, yet everything—the papers, the figurines, the way Douglas subtly adjusts his posture before answering—suggests that, for him, every conversation is part of a larger campaign. Not against a tangible enemy, but against something more elusive: forgetting, resignation, the loss of faith in the possibility of bending fate.
One might think of his surroundings as a kind of campaign library: functional, human, marked more by causes than by comforts. As if every object—every photograph, every book, every small plant—participated silently in the same conviction that sustains Douglas: that saving lives is not an occasional act of heroism, but a daily, almost monastic, practice of hope, exercised with stubborn persistence.
In the end, one understands that this is not merely an office. It is a redoubt—a cell of resistance.
From Smoke in the Skies to the Necessary Evolution Toward Harm Reduction
In the late 1980s, Douglas was a young lawyer facing a monumental adversary: Big Tobacco, an industry that seemed invincible, capable of dominating courtrooms, congresses, and entire cultures. He led the national campaign to ban smoking on commercial flights in the United States—a battle waged more with conviction than with resources.
"Our annual budget?" he recalls with an ironic smile. "A hundred and sixty-five thousand dollars. For everything. Including my salary."
The symbolism was powerful: if they could clear the air at thirty thousand feet, perhaps they could also cleanse the lungs of a nation. At a time when smoking was ubiquitous and tobacco executives reigned untouchable, banning cigarettes on airplanes delivered a small but seismic blow. It opened a crack in the illusion of inevitability that the industry had spent decades cultivating.
Douglas’s career was not confined to public campaigns. He ventured into the very entrails of one of the twentieth century’s great monsters, working alongside whistleblowers who exposed decades of fraud: internal documents that revealed just how deeply the tobacco companies understood—and concealed—the lethal effects of their products. “The crime fraud committee was charged with preventing plaintiffs or the government from seeing sensitive documents that Philip Morris wanted to keep secret.”
Douglas argues that Big Tobacco has been—and remains—an emblem of conspiracy and contempt for human life. In his view, the industry’s historical actions not only revealed a profound disregard for collective well-being but also continue to fuel social distrust and complicate the present-day dynamics. Far more complex dynamics.
That experience forged his professional ethic: an absolute devotion to scientific truth, a radical skepticism toward official narratives, and an unwavering defense of the public’s right to honest information.
Douglas also recalls his role in the historic lawsuits of the 1990s, when the major tobacco companies were finally exposed to the world. In his view, it was not merely a business, but an institution deliberately designed to cause harm.
Douglas’s journey led him, decades later, to a heretical conclusion within the traditional public health movement: absolute abstinence was not the only path—nor necessarily the most effective one.
During his tenure as vice president for Tobacco Control at the American Cancer Society, Douglas pushed for a bold strategic shift: recognizing that the enemy was not nicotine itself, but combustion. He makes it clear that nicotine, while addictive, is not what kills smokers. The real enemy, he insists, is the smoke—the combustion that releases the poisons.
Under his leadership, the American Cancer Society published a groundbreaking manifesto in 2018 calling for the elimination of combustible tobacco use in the United States. It was, at once, a declaration of war and an act of compassion.
Douglas emphasizes that it was, above all, about honoring lived experience—meeting people where they are, not where we wish they were. This strategic shift was influenced by thinkers such as Dr. Alex Wodak, who coined a phrase Douglas now repeats like a silent mantra: harm reduction strategies always succeed; it’s only a matter of time.
The Swedish Mirror: An Uncomfortable Model and a Narrative of Hope
Douglas sees in Sweden an illustrative paradox. He points out that the country managed to reduce smoking to minimal levels thanks to snus—smokeless oral tobacco—while its use remains banned across much of Europe. A painful irony: the country with the fewest smokers is precisely the one that permits combustion-free alternatives, while those that ban them suffer far higher smoking rates.
Douglas is careful to note that harm reduction does not mean eliminating all risks, but somewhat diminishing suffering and saving lives. The Swedish case, he concludes, shows that public health does not always move hand in hand with moralist orthodoxy.
Yet this debate is far from calm. Douglas denounces the rise of a “neo-puritanism” in public health policy—a dogma that rejects any form of nicotine consumption, without nuance or context. He criticizes this new movement for lumping everything together—cigarettes, vapes, snus—as if they were the same, failing to distinguish between a burning cigarette and an alternative a hundred times safer.
He points especially to the influence of philanthropists like Mike Bloomberg, whose funding has fueled prohibitionist policies worldwide. At times, he quips, it seems more important to destroy the industry than to save the smokers. A strategy, he warns, that could condemn millions to continue consuming the deadliest products simply because there are no recognized, accessible alternatives.
Despite everything, Douglas holds fast to an unshakable conviction, anchored in the facts. He notes that youth smoking in the United States has dropped by more than 70 percent over the past five years, and that youth vaping has also plummeted—achievements that, paradoxically, have been minimized rather than celebrated. In his view, the battle against youth smoking has mainly been won, yet instead of recognizing the victory, society seems determined to find the next moral panic. Douglas is not naïve: he knows that victories in public health are rarely final. But he insists that the progress is real—and enduring.
Today, through Global Action to End Smoking, Douglas advances a strategy that is simple but powerful: to offer clear, scientific, and accessible information, free of alarmism and moralism. He stresses that they are not there to promote products, but to promote the truth. His organization recently achieved a notable milestone: it was cited in a U.S. Supreme Court decision involving tobacco regulation—a recognition that honors its independence, its rigor, and its commitment to public well-being, beyond economic or ideological interests.
Douglas knows that change will not come all at once. There will be no final judgment, no triumphant proclamation. Transformation, as always in public health, will be a long, patient, persistent, and inevitable march. He believes that every smoker who switches to a safer alternative represents a life extended, and that there are no small victories. He is convinced that if harm reduction strategies are embraced wisely, smoking could be virtually eradicated in the United States within a few years. Even now, in a largely unregulated market, some twenty million Americans have left cigarettes behind in favor of less lethal alternatives.
Douglas holds his old cup, gazes at the nearly faded inscription, and smiles—a blend of tenderness and determination. For him, success remains inevitable, but only if the fight endures.
It’s worth watching the whole interview—not only to grasp the complexity of the challenge facing public health today, but also to hear, in Douglas’s measured voice, a lesson in patience, courage, and active hope.