While he’s sure to acknowledge a potential risk to teens, he advocates that “combustible cigarettes are the problem,” not vaping
The FDA Commissioner, Dr. Scott Gottlieb has had an interesting relationship with vaping since taking office last year. He’s already become the most vaping friendly commissioner the FDA has ever had, especially after he decided to delay the deeming rules until 2022. But he has also taken care not to go too far in his endorsement of vaping, choosing instead to focus on what he believes are more impactful issues. It was during an interview on MSNBC’s Squawk Box about one of these alternate strategies, reducing the level of nicotine in combustible cigarettes, that the commissioner made his latest positive statement about the place of e-cigarettes on the continuum of risk.
Some have focused on what they believe are thinly veiled warnings to the vaping industry, ultimately fearing that action taken by the FDA that could make vaping less viable in the US. While his latest interview has been interpreted both ways depending on what side of the debate you’re on, One thing is very clear. The current FDA commissioner firmly believes that while they do present some level of risk to teens, vaping is a preferable alternative to traditional cigarettes, and ought to be supported as such.
In his second formal interview on Squawk Box as the FDA commissioner, Dr. Gottlieb was taking aim at Big Tobacco while discussing the FDA’s plan to reduce the amount of nicotine found in traditional cigarettes as a means of helping smokers quit. Part of his reason for going on the talk show was to ask for direction from tobacco control experts, including what they believe the new nicotine limits should be and if they ought to be implemented all at once or slowly over time. According to Gottlieb, this is the very first step in the rulemaking process, finding adequate guidance in how to efficiently reduce the nicotine level in cigarettes.
After talking at length about how they plan on reducing the nicotine level in combustible cigarettes, Dr. Gottlieb had some contradictory comments about vaping. First, he applauded the devices, saying “We’re looking to try to transition smokers to modified risk products, less harmful products. We see a lot of potential from new product innovation that’s coming on the market including electronic cigarettes and electronic nicotine delivery systems. It might be modified risk ways to receive nicotine if you’re an adult who still wants to get access to satisfying levels of nicotine. And so by regulating the nicotine content in combustible cigarettes, we think we can more quickly migrate smokers off of combustible tobacco onto modified risk products, or preferable to encourage them to quit altogether.”
But he then he was quick to acknowledge the common concern among public health officials, that vaping is leading to an increased acceptance of smoking among the youth. He mentioned how over 2 million teens admit to having used e-cigarettes in the past, but the statistics on full-time usage, as well as never smoking vapers are desperately lacking. But one thing is apparent to the Commissioner; We must ensure that vaping isn’t leading more teens to smoke or “we will have done a bad service to this country.”
Debunking Teen Risk
It’s true that if vaping is indeed causing smoking cessation rates to slow or even reverse, then it represents a significant concern for the medical community as a whole. Luckily, the evidence we have on the subject suggests that these concerns are unfounded. While rates of teenage vaping have been steadily increasing over the last five years, they remain similar to the smoking rate. However, most of the scientific information on this subject doesn’t take into account whether or not the teen had already been a smoker before picking up vaping. When studies have looked into this niche, they’ve found that the overwhelming majority of teenage vapers had already been smokers. In fact, one study concluded that only between 0.1% and 0.5% of never smoking teens vape on a daily basis. So it seems that vaping is serving the same purpose for teens that it serves for many adult smokers, helping them get off of cigarettes for good.
When vaping is used as a substitute for traditional smoking, the harm reduction is staggering. A now famous 2015 report by Public Health England found that vaping is at least 95% safer than smoking, and just last fall a study found the excess lifetime cancer risk of a vaper is over 57,000 times lower than a smoker. Not only that, but it also appears that e-cigarettes are the best smoking cessation tools we have at our disposal after a study out of Louisville University found that they outperformed all other tested smoking cessation aids, including prescription drugs.
We’re still a long way from a total endorsement by the FDA, but compared with the level of skepticism in the past, were clearly on the right track. Dr. Scott Gottlieb has been willing to acknowledge that vaping, while not harmless, represents an excellent opportunity for us to win the battle against smoking once and for all. This marks several occasions where given the easy opportunity to condemn vaping outright, Dr. Gottlieb has opted for the more diplomatic and reasonable route of acknowledging the positive and potentially negative aspects of e-cigarettes. It may only be a moral victory, but it’s still a victory for vaping. Having the support of major health organizations such as the FDA and CDC is vital if we’re ever going to improve the public perception of vaping in the general public.
Do you think it’s reasonable to wonder if vaping leads to teenage smoking? Are you happy with the commissioner’s stance on vaping? What do you think would improve the public perception of vaping more effectively, a grassroots movement, or explicit institutional support? Let us know in the comments below, or get in touch with our communities on Facebook and Twitter.