In releasing its latest strategy to address the non-existent epidemic of youth e-cigarette use, the Food and Drug Administration has once again ensured that cigarettes — the leading cause of preventable death in the United States — are here to stay. The two main approaches in the FDA’s plan are misguided enough to make conspiracy theorist out of even the most level-headed person.
The agency’s first approach restricts the sales of flavored e-cigarettes to stores, or sections of stores, that are only accessible to adults of legal age. The second approach involves moving the application deadline for FDA approval of flavored e-cigarettes up by one year. Under the original deadline, all e-cigarettes that were on the shelf before August 2016 and properly registered with the FDA are legal until 2022, the deadline by which companies must submit their final applications. If a manufacturer misses this final deadline, its products will be illegal. In its new proposal, the FDA has changed that date to August 2021 — but only for flavored e-cigarettes.
The fact that these new approaches exclusively target flavored e-cigarettes not only threatens to harm adult smokers, it places the future of nicotine back in the hands of Big Tobacco.
For the good of public health, our regulatory agencies should be doing everything they can to help smokers quit combustible cigarettes. E-cigarettes, which are estimated to carry no more than 5 percent of the risk of combustible cigarettes, help this cause.
E-cigarettes have proven their worth to thousands who have successfully quit smoking thanks to these innovative products. Sure, there is lots of evidence behind our currently approved smoking cessation treatments — lots of evidence that they aren’t very effective. In fact, quit-attempts using currently approved methods like nicotine patches and gum have a success rate below 10 percent. Yet people who attempt to quit smoking by switching to e-cigarettes have double the chance of successfully kicking their combustibles habit.
The role that flavors play in the success of quit attempts using e-cigarettes cannot be overstated. While the FDA may point to figures indicating that adults prefer menthol and tobacco flavors to fruit flavors, further examination of the data will tell officials that adults who have completely quit smoking — the ultimate goal — by switching to vaping tend to gravitate toward flavors that don’t remind them of cigarettes. Banning these flavors will only make it more difficult for these people to quit their deadly habit.
Do FDA officials willingly ignore evidence of e-cigarettes’ relative safety and the role that flavors play in helping adults quit when making their case? It’s hard to imagine they aren’t at least aware of the data. But either way, in their attempts at keeping e-cigarettes out of the hands of teens, they have failed to address the valid concern that targeting flavors will harm adult tobacco users.
To a parent who worries about his or her child experimenting with tutti-frutti or mango-tango vaping products, the demise of flavor country might sound like great news. But what always seems to be lost in the conversation is that these flavors played a key role in forcing Big Tobacco to notice the potential of e-cigarettes — a safer product relative to the combustibles that these companies traditionally sell. Indeed, the popularity of e-cigarettes — which are available in flavors that the government prohibits tobacco companies from using in combustible products — was rightly viewed as a threat to these companies, who had no choice but to invest in the future of safer nicotine products.
The effects that these regulations will have on not only smaller tobacco product manufacturers and retailers, but on the entire future of the tobacco industry, should give pause to anyone concerned with public health. Most of the so-called “kid-friendly” flavored products are produced by smaller companies; e-cigarettes produced by the largest companies generally only come in three or four flavors, including mint and tobacco. Restricting non-menthol mint and tobacco flavors to the point of extinction — which seems to be the FDA’s ultimate goal — will deprive these smaller firms of a major revenue source, likely forcing them out of business.
If this happens, not only will smokers and non-smokers alike continue to have unfettered access to combustible cigarettes, but access to safer alternatives will be at the mercy of our country’s largest retailers and producers of combustibles. And with competition out of the way, major companies that primarily make money off time-tested “traditional” products like combustible cigarettes might not see the need to invest in better, safer products like e-cigarettes. Decreasing competition has never been good for innovation; in this case, it may be bad for public health.
The approach that the FDA has proposed might seem fair to some and unfair to others, but it should be considered irresponsible by all. We live in a decade where there is a real chance that combustible cigarettes will become obsolete in our lifetime. Yet thanks to theFDA, this promise is quickly fading.
Image credit: REDPIXEL.PL