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FDA Chief Scott Gottlieb Says He Has to Restrict E-Cigarettes in Order to Save Them

If the FDA does not try to reduce underage vaping, Gottlieb says in a Reason interview, congressional intervention could wreck the industry.

Eduardo Munoz / Reuters / NewscomEduardo Munoz / Reuters / NewscomFDA Commissioner Scott Gottlieb says he still believes that e-cigarettes offer "a tremendous public health opportunity" to reduce the harm caused by smoking but felt compelled to impose restrictions on them because of a surprising surge in underage vaping. Had the FDA not acted, he said in an interview with Reason today, political pressure could have led Congress to intervene, presenting "an existential threat" to the vaping industry.

"We were shocked when we saw the data," Gottlieb said, referring to results from the National Youth Tobacco Survey showing a sharp increase in e-cigarette use by high school and middle school students between 2017 and 2018. "It doesn't matter what you think or what I think. We're going to have congressional legislation that's going to foreclose and supersede anything we can do. We're at 20 percent of high school kids using vaping products, based on the data. You have another year of 50 percent growth on top of that, we'll be at levels that will be intolerable to the general public. The political consensus tilts pretty heavily in favor of restrictions on these things. I worry about the existential threat that comes with continued growth in youth use if we do believe that this is an opportunity to really shift the trajectory of smoking-related disease and get more adults off of combustible tobacco."

Gottlieb acknowledged that the new FDA rules, which ban the sale of most e-cigarette flavors in locations open to minors, will make it harder for adult smokers to get the e-cigarettes they prefer, which might make it less likely that they will switch to vaping or more likely that they will switch back to smoking. "I'm accepting the fact that steps that we take to provide additional restrictions on access to these products [by] kids are going to have an impact on adult access," he said. "We tried to strike a balance. There is no free lunch here. Anything we do to try to foreclose the rampant use by kids is going to also have some impact on adult access." That seems like an overstatement, since better enforcement of the minimum purchase age could reduce access by minors without creating significant barriers for adults.

In addition to his concern about possible congressional action, Gottlieb said he is personally worried by the increase in underage vaping and has a legal mandate as head of the FDA to reduce it. "I'm in a position where we simply have to respond to the youth use," he said.

Gottlieb has repeatedly said he worries that some teenagers who otherwise never would have tried tobacco will start smoking after being introduced to nicotine via e-cigarettes. Today he said proprietary industry survey data he has seen indicate that teenagers who view smoking with disgust do not have the same reaction to vaping. "We've been relatively successful in this country at stigmatizing traditional cigarette smoking among kids," he said. "That stigma doesn't attach to e-cigarettes."

At the same time, Gottlieb acknowledged that some teenagers who vape might otherwise be smoking, a substitution effect that seems plausible given that the surge in e-cigarette use by teenagers has coincided with a continued decline in smoking. "It's probable," he said. "It's implausible for me to say that there aren't kids out there who are using e-cigarettes instead of combustible tobacco and probably, if they never had this opportunity, would have used combustible tobacco." But he added that it's hard for the FDA to consider that as "a public health justification" when "our mandate is that no child should be using a tobacco product." That suggests the FDA's mission to reduce underage vaping may conflict with the public health goal of minimizing morbidity and mortality.

Yesterday Gottlieb said the FDA would consider additional restrictions on e-cigarettes if the upward trend in underage consumption is not reversed. But today he said he is determined to keep e-cigarettes on the market as a harm-reducing alternative for smokers. "I think there's a tremendous public health opportunity," he said. "These things do have risks associated with them...but certainly not any risks on the same level as combustible products....It wouldn't be my intent to ever impose a complete ban on e-cigarettes. I've said repeatedly that we see a public health opportunity here, and I think it would be an unfortunate day if there ever was a ban imposed on e-cigarettes. I wouldn't foreclose the possibility that Congress could contemplate more restrictive measures in a world where youth trends continue at the same rate they are right now, and I do worry about that."

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  • Fist of Etiquette||

    I'm accepting the fact that steps that we take to provide additional restrictions on access to these products [by] kids are going to have an impact on adult access...

    For the children.

  • Longtobefree||

    Why do you make me hit you?

  • MatthewSlyfield||

    We had to destroy the village to save the village.

  • DenverJ||

    "our mandate is that no child should be using a tobacco product."

    e-cigs are not a tobacco product. Also, why is it so god dammed important to keep children from using a harmless product? There are people out there who would ban toothpicks because it reminds them of smoking, which they find offensive. That kind of person needs to be told to fuck off.

  • lafe.long||

    The FDA has the power to deem anything a tobacco product regardless of the facts. They did the same thing to pipes.

    Even though you can vape 100% nicotine-free, this is NEVER mentioned.

  • NoVaNick||

    Even though you can vape 100% nicotine-free, this is NEVER mentioned

    Next up-FDA will ban nicotine-free liquid because they can't regulate it. That's government logic for you.

  • Vladilyich||

    Not only can't regulate it, can't TAX it!

  • Jerryskids||

    "We've been relatively successful in this country at stigmatizing traditional cigarette smoking among kids," he said. "That stigma doesn't attach to e-cigarettes."

    Studies have shown that 87.3% of all alcoholics started down the road of alcohol addiction by imbibing water and milk and later fruit juice and soft drinks. There's no stigma attached to drinking water and milk* the way there is sugary drinks and alcohol and I for one think it's about high time we start stigmatizing the shit out of drinking water.

    *Well, as long as you don't refer to it as "white" milk, you racist bastard.

  • Fuck you, Shikha (Nunya)||

    That is what most poised me off. "I can't prove this thing is horrible, but the damn kids can't either. So I need to make sure we get rid of this thing that is doing no appreciable harm!"

    Fuck him with a broom while the broom is being put in a chipper.

  • Flinch||

    Deja vu: republicans come up with their own version of "we have to vote on the bill to find out what's in it". Sounds more to me that tobacco lobbyists have bought somebody a nice car and a bottle of good champagne.

  • NoVaNick||

    Its curious that they only allow tobacco and menthol flavors to be sold at convenience stores-almost seems like the cigarette companies started to freak out about losing market share, esp. since Juul isn't owned by them.

  • spork||

    It seems that just being near government turns you into a moron. His argument is plainly self-contradictory.
    .
    Given: some teens smoke cigarettes and that is bad.
    .
    Given: vaping is less harmful that smoking cigarettes.
    .
    Given: restricting access to vaping products makes it more likely that consumers will smoke cigarettes, causing harm.
    .
    Conclusion: restricting access by teens to vaping products will REDUCE harmful smoking of cigarettes by teens.
    .
    Idiotic! They should place Juul vending machines at all high schools outside the gym doors. There should be a jar of free Juuls on the guidance counselors' desks, right next to the jars of free condoms. The innovation of vaping is the greatest public health innovation since Salk.
    .
    The rationale that "if we don't restrict freedom then somebody else will restrict freedom" is plain stupid and immoral. The idea that a single murder is better than a dozen murders does not make the single murder somehow legitimate. Stand up for what is right!
    .
    F--k these people in the neck. I don't want my daughter spreading her legs or consuming nicotine (or THC), but there is not really much I can do about that now is there? At least condoms and Juul and THC vapes make it far less likely that there will be some major problem as a result.
    .
    Gottlieb you dolt, why don't you just come out in FAVOR of teen smoking as a method for reducing teen vaping! Ban condoms to prevent teen pregnancy! Ban seatbelts to prevent deaths from car accidents!

  • Marc St. Stephen||

    "The political consensus tilts pretty heavily in favor of restrictions on these things."

    shouldn't this be where his boss, the President, Mr. Less Regulations, tells the 'political consensus' and the anti vaping lobby to GO FUCK THEMSELVES - publicly, loudly, and with fucking common sense on his side? Or is it too much to ask a President, who has no qualms about picking petty fights, to actually challenge the anti-vaping arm of the nanny state?

  • damikesc||

    I'll never get the anti-vaping message. It is safer than smoking.

    Is it safe? As compared to not smoking at all, no.
    Just as condoms are not safe when compared to not fucking at all.

    Sometimes, it's not a bad idea to mitigate risk to the best of your capacity.

  • AD-RtR/OS!||

    The very essence of "Regulatory Capture".
    Gottlieb, it is not your job to "save" the industry, it is your job to protect the health of American citizens.
    If e-cigs are not a health threat directly, go find something that is.

  • Enemy of the State||

    "There is no free lunch here. "

    No freedom of choice either. The nanny state will decide what's OK and what isn't for everyone...

  • Uncle Jay||

    "Restricting Ecigs in order to save them?
    What next?
    Restricting food in order to save food?
    Oh, wait.
    I didn't mean to give our oppressors any ideas.

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