FDA must consider public health to determine the future of e-cigarettes

Marc Hyden is the Director of State Government Affairs at the R Street Institute and has long resided in Georgia. You can follow him on Twitter at marc_hyden.

America may soon see a turning point in the country’s strategy on reducing tobacco-related illnesses. The Food and Drug Administration (FDA) is race to meet a September 9 deadline to determine whether JUUL, an electronic cigarette producer, can continue many of its regular business activities.

“The company is seeking approval for its iconic vaping device, once dubbed the iPhone of electronic cigarettes, with tobacco and menthol flavored pods in two nicotine strengths: 5%, which is equivalent to nicotine in an average pack of cigarettes, and 3 percent, ”The New York Times wrote.

In recent years, electronic cigarettes have come under increasing scrutiny from state legislatures, and even the Trump White House, who sought either to ban products outright or to over-regulate them. Now, the future of much of the industry may lie with the Biden administration. It’s impossible to predict the FDA’s decision, but if it were to reject JUUL’s 125,000-page request, it could portend a bleak future for e-cigarettes in general, a choice that would negatively impact public health and would reverse years of progress.

Although demonized as a danger to public health, electronic cigarettes have proven to be an essential tool in the fight against tobacco-related illnesses. As it stands, more 11,000 Georgians and almost 500,000 Americans die each year from smoking combustible cigarettes, while some 16 million others struggle with chronic illnesses from smoking. Tobacco use has long been a plague in the United States and around the world, but traditional efforts to control smoking have had limited success.

In a costly federally funded anti-tobacco advertising campaign in 2014, 1.8 million Americans have tried to quit smoke — about 34 million smokers in total– but only 104,000 were successful. While the ad campaign was well-intentioned, the results were disappointing. In addition, many cessation products, such as the patch, lozenge and gum, “do not appear to be effective in helping smokers quit smoking in the long term,” according to the. Harvard School of Public Health, and abstinence-only approaches have failed.

Considering the dire consequences of tobacco consumption, electronic cigarettes have shown great promise. They became one of the main tools that smokers use to quit smoking, and the successful quit rate is encouraging. A recent study concluded that they could be more efficient to help people quit smoking for good than nicotine replacement therapy.

This should be good news, but opponents of e-cigarettes have lamented that they are unhealthy and even compared their risks with those of combustible cigarettes. To be clear, the healthiest option is to avoid nicotine, and people shouldn’t be using nicotine products. Period. But the evidence is compelling, showing that e-cigarettes are a much safer alternative to combustible cigarettes. Public Health England said they 95 percent less harmful than fuels, and the reason is the way they are designed and used.

While there are different types of electronic cigarettes, none use the combustion process found in cigarettes, which releases a host of chemicals, some of which are unmistakably fatal in the long run. In electronic cigarettes, the liquid is heated so that people can inhale the vapor. Additionally, manufacturers do not include tobacco in e-cigarette pods. Electronic cigarette liquid typically includes water, a flavoring agent – often mimicking the natural flavor of tobacco or menthol – a base of propylene glycol or vegetable glycerin, and nicotine.

Nicotine is not the main chemical of concern in tobacco, although it is addictive. Indeed, a review of the literature National Center for Biotechnology Informationfound that “studies involving nicotine exposures throughout the body […] have repeatedly failed to show a significant relationship between nicotine and cancer initiation. Several documents published by authoritative bodies also indicate that nicotine is not considered to be carcinogenic.

Considering all the available data, it seems clear that e-cigarettes offer current smokers an alternative method of consuming nicotine without the many harms associated with combustible cigarettes, and it is a viable route to quitting smoking for good. It’s another arrow in the quiver in the fight against the many dangers of smoking.

As FDA officials review e-cigarette claims, it would be wise to remember all of this and prioritize better health outcomes for Americans. Banning proven methods that reduce damage would be a serious mistake with serious consequences.

Marc Hyden is the Director of State Government Affairs at the R Street Institute and has long resided in Georgia. You can follow him on Twitter at marc_hyden.

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