Is the Food and Drug Administration (FDA) changing its tune on electronic cigarettes?
In May, Brian King was appointed head of the FDA's Center for Tobacco Products. King is not known for championing e-cigarettes or reduced-risk alternatives to cigarettes. But after a few months on the job, he's out on the media and conference circuit giving a clearer idea of how he envisions the future of nicotine regulation.
In an interview with the Associated Press on Monday, King was asked about surveys showing most people think e-cigarettes are just as dangerous as traditional cigarettes and whether that was a problem. "I'm fully aware of the misperceptions that are out there and aren't consistent with the known science," King replied. "We do know that e-cigarettes — as a general class — have markedly less risk than a combustible cigarette product." King went on to say that communication campaigns must use science and evidence and be careful to avoid unintended consequences.
Earlier this year, Clive Bates, a tobacco harm reduction advocate and former chief of the anti-smoking charity Action on Smoking and Health, called the public misperceptions of vaping an "American crime scene." Bates was referencing the 2020 Health Information National Trends Survey showing just 2.6 percent of Americans accurately believed e-cigarettes were "much less harmful than combustible cigarettes."
Harm reduction advocates such as Bates believe these misperceptions about the risks of vaping are holding back many smokers from switching to a safer product and causing a rash of bad public policy decisions. These include bans on nontobacco flavors in e-cigarettes, capping nicotine levels, and taxes that make vapes just as expensive as cigarettes.
King's acknowledgment that much of the public is wrong on the "known science" and that we "know that e-cigarettes — as a general class — have markedly less risk than a combustible cigarette product" is more straightforward than anything you'll find on the FDA's website.
"Many studies suggest e-cigarettes and noncombustible tobacco products may be less harmful than combustible cigarettes," reads the FDA's main page on e-cigarettes. "However, there is not yet enough evidence to support claims that e-cigarettes and other ENDS [Electronic Nicotine Delivery Systems] are effective tools for quitting smoking."
After King's statement Monday, many were hoping to elicit further detail in a speech he gave two days later at the Global Tobacco & Nicotine Forum (GTNF), an annual conference that bills itself as a "global exchange for views and ideas between public health experts, government representatives, the industry, and investors." The conference's sponsors and most attendees are drawn from the tobacco and e-cigarette industries.
Those looking for an expansion on King's remarks to the A.P. were left disappointed. King told attendees that he believes in the "continuum of risk" regarding nicotine products. The idea is that combustible cigarettes are the most dangerous form of nicotine consumption and nicotine replacement therapies are the safest. Toward the safer end of the spectrum are products like e-cigarettes that offer smokers a satisfying nicotine product but without the smoke that may kill them.
But King didn't mention the public's misperceptions about the relative risks of e-cigarettes. Instead, King highlighted that the FDA had denied more than 99 percent of e-cigarette applications to stay on the market, and e-cigarettes still present a danger for youth.
When asked by Reason whether the FDA is going to commit any resources to correct misperceptions about e-cigarettes, King simply responded with "I can't commit to any specific actions."
When asked for further comment, an FDA spokesperson responded saying the "FDA continues to explore how best to communicate with the public about the continuum of risk related to tobacco products. We cannot comment on or commit to any specific actions at this time. However, we do note that it is critical that the development and implementation of public health education campaigns are evidence based to best achieve intended effects on the target population while minimizing adverse consequences for the population as a whole."
In other words, the FDA has no plan to correct any of the widespread misinformation about e-cigarettes anytime soon. If you want to know the real risks of e-cigarettes vs. combustible cigarettes, you'll have to look to the U.K. government for that.