Senate Minority Leader Chuck Schumer, D-N.Y., is taking aim at the Food and Drug Administration’s recent announcement that it would delay enforcement of new regulations on e-cigarettes until August 2022.
Ignoring academic laboratory and public health reports, Schumer has taken to asserting publicly that e-cigarettes contain so-called “mystery” chemicals that, when burned at high voltage, release toxic chemicals even more dangerous than combustible cigarettes. And citing “alarming” data that high school kids are sneaking e-cigarettes into school, Schumer has raised particular alarm about the Juul brand of e-cigarettes, which he says easily could fool teachers with their small size and apparent likeness to USB ports.
Hyperbolic is nothing new for Schumer. He’s the same senator who spread the paranoia that a trend of snorting chocolate would lead to a new epidemic of adolescents dying from heart attacks – never mind that they have all the energy drinks they could ever want at hand.
Also not new is the fact that kids sometimes sneak cigarettes into schools. “Smokin’ in the Boys Room” was far from science fiction. Whether it’s a Juul e-cigs or others from the first generation of so-called “cig-a-like” products or even later versions of vaporizers, it’s not especially difficult to put one in your backpack or pocket. Most public health agencies would concede that, given a choice, it would be preferable that kids sneak in noncombustibles, rather than traditional cigarettes.
Unlike many vaporizers, Juul devices “use smart temperature-regulation technology to heat the material to an optimal level for vaporization, without ever reaching a state of combustion.” The devices are hard-wired to produce vapor at low power, negating any concern that formaldehyde or the other “mystery” chemicals that can be produced at higher voltages.
Of course, even personal vaporizers that give users much more control over the temperature are rarely set at voltages that produce those toxic chemicals, because doing so renders the vapor bitter and dry, characteristics that are clearly unappealing, if not unbearable, to e-cigarette and vapor users.
Schumer has taken specific issue with the fact Juul sells liquid pods that contain nicotine concentrations equivalent to one pack of cigarettes. But it’s not clear why this should be a cause for concern. One of the appealing aspects of these devices is that one doesn’t have to carry around odds and ends. Humans, just like rats and mice in laboratory studies, are exceptionally adept at self-titrating the amount of nicotine they consume. It’s really not much different from coffee and espresso enthusiasts consuming as much or as little as they want until they get the desired effect, and stopping until they have a caffeine craving. The effect that nicotine and caffeine have on the body is the primary determinant of use, not the volume consumed.
Perhaps the most inaccurate and disparaging aspect of Schumer’s recent comments is their lack of awareness and understanding about the crucial role that e-cigarettes and vapor products are playing in tobacco harm reduction, a new approach to public health. THR seeks to reduce the incidence of cigarette use and smoking-related diseases by encouraging smokers to use less-harmful alternatives to cigarettes.
A holistic approach to harm reduction demands that, in addition to discouraging adolescents from using nicotine and cigarettes, tobacco regulations should encourage adult smokers to switch to safer alternatives. Greater product options provide smokers with more paths away from the most harmful and widely used tobacco products: cigarettes. Taking steps to make e-cigarettes less accessible to current and future smokers will ensure that future rates of smoking-related diseases, which collectively kill 480,000 people in the United States each year, remain steady.
By focusing solely on minors, many tobacco regulations disregard and discount cigarette use among adults. The measure of a successful public health policy should be the impact that it has on the whole population, not just certain segments. With cigarette use in the United States at an all-time low, the significant drop-off in smoking rates is due in part to the emergence and popularity of these safer alternatives.
While no nicotine product can ever be considered “healthy,” e-cigarettes and vapor products continue to be far-safer alternatives. The FDA should commended for taking the time to get the rules right.
Image by Glynnis Jones