With the way the news moves these days, it’s easy to miss the drama unfolding in the world of tobacco. During this year, the Food and Drug Administration announced a plan to reduce nicotine in all cigarettes, frankly to forbid all menthol cigarettes, and refused a request from JUUL to sell its products, only to turn around and suspend this ban that the company appealed the decision. All of this, however, is overshadowed by the fact that US health agencies finance research trials for two very low nicotine (VLN) cigarette products – one of which is a menthol – which later received FDA approval as reduced-risk products.
It is amazing that the FDA and other agencies spent 100 million dollars from the American taxpayers for develop evidence on the safety and efficacy of combustible cigarettes. Worse, these agencies then used this insufficient evidence to justify their approval as low risk, mandate labels with the marketing claim “Helps you smoke less” on cigarette packages.
This is the wrong way to achieve a smoke-free USA.
But the FDA doesn’t seem concerned. Instead, it seems to be shrouded in wishful thinking that individuals will quit smoking after using VLN cigarettes because the reduced nicotine will lessen their addiction. In reality, VLNs will likely be exacerbate risk of misperceptions among consumers. Nicotine isn’t the biggest problem; it is the burning of tobacco that is most harmful to health. In other words, the FDA approves the combustible cigarettes it helped develop while rejecting over 99 percent of vape products on the market have not.
Coupled with the efforts of reduce nicotine in all cigarettes, this amounts to a total ban as most brands would be taken off the market for non-compliance. But the FDA-approved VLN brands would remain. The type of political maneuvers and transactions indicate anti-competitive behavior, the government trying to pick winners and losers.
History has shown us time and time again that prohibition never works – whether for alcohol, opioids Where flavored vapes. Additionally, FDA-funded research to understand acceptance of VLNs show that immediate reductions in nicotine resulted in greater withdrawal symptoms and an increased likelihood that smokers would seek out alternative sources.
Since the first commercially successful e-cigarettes were published, they have evolved and grown dramatically. In 2014, the British Medical Journal documented approximately 460 different brands of electronic cigarettes that deliver nicotine without the harmful effects of smoking. Researchers have confirmed that e-cigarettes exist on a risk continuum, comparing them to nicotine patches used to quit smoking. Because e-cigarettes mimic the rituals of smoking, they have proven to be handy quit smoking tools for adult smokers. Even the Centers for Disease Control states that “more frequent use of e-cigarettes is associated with greater smoking cessation than less frequent use”. A reasonable approach to reducing adult smoking would be to increase the availability of these products.
The FDA would do well to recognize this evidence to achieve a smoke-free United States. It could start by updating the national tobacco control plan strategy –– one that was published over a decade ago that doesn’t even mention vaping. It is also expected to update the FDA’s comprehensive tobacco and nicotine regulatory plan. Created in 2017, it includes a hodgepodge of strategies to reduce youth use, address racial justice and eliminate smoking. Yet, like the National Tobacco Control Strategy, it does not consider e-cigarettes as a tool to quit smoking. The FDA could also learn a bit from the comprehensive, evidence-based tobacco control strategies of other countries like the UK Where New Zealandwho have codified what a smoke-free society means for their people.
It is important to remember that no tobacco product is safe. Those who smoke cigarettes are encouraged to use alternatives such as reduced-risk nicotine products (like e-cigarettes) as they have become essential in helping adult smokers move away from deadly fuels. Banning vapes while increasing the number of reduced-fuel nicotine cigarettes is as counterproductive as it is political. It’s not necessary.