FDA’s war on nicotine puts ideology over science

OPINION:

Every year 480,000 Americans die from smoking. Yet rather than working to reduce this number, two FDA proposals will do just the opposite.

First, the FDA’s unscientific bid to reduce nicotine content in combustible cigarettes will cause smokers to smoke more cigarettes and inhale deeper, to get the same nicotine fix. Secondly, the announcement that all JUUL products were to be immediately removed from the market would cut off a proven method of helping millions of smokers quit, causing more people to smoke and more people to die.

Nicotine, while highly addictive, is relatively benign. It is comparable in terms of health effects to the caffeine in a cup of coffee. The deadly nature of cigarettes comes not from the nicotine, but the tar and thousands of toxic chemicals created through the burning of tobacco: “People smoke for the nicotine, but die from the tar” is the mantra of smoking cessation experts. 

For decades doctors have prescribed nicotine patches, nicotine gums, and similar products to help people quit smoking, with few adverse effects. However, the problem with these products is that they weren’t particularly effective. Smokers simply didn’t want to make the switch.

This all changed with the invention of “e-cigarettes.” By delivering nicotine through heated vapor, no smoke is produced, and users avoid all the deadly chemicals caused by combustion. A meta-analysis of all available scientific studies on e-cigarettes commissioned by the UK Government, then replicated by outside medical bodies, found them to be 95% safer than combustible tobacco.

The critical difference between these, and earlier generations of nicotine replacement products, is that smokers like e-cigarettes.

By mimicking the ritual actions of smoking and incorporating flavors to make adults want to switch, reviews have consistently found them between 2-6 times more effective than other smoking cessation devices. In fact, since their invention, over 100 of the world’s leading medical bodies have endorsed them as vital to harm reduction.

Governments in countries like the UK and New Zealand began running large-scale advertising campaigns urging smokers to make the switch (even selling them in hospitals). A Georgetown University Medical Center study also estimated that vapor products could save up to 6.6 million American lives over ten years. 

It must be noted that the hysteria driving the decision does not stand up to simple scrutiny. The claim that vaping is a “gateway’ for teens to start smoking has been proven completely false, as the smoking rate among U.S. youths is now almost non-existent. 

Claims of a “youth vaping epidemic” are debunked by the CDC’s own data, which shows that youth vaping has plummeted by 60% over the past two years, and only 3.1 percent of high-school age and 0.3% of middle-school-age students used e-cigarettes daily.

The inaccurately termed “EVALI”, which dominated headlines in 2020, was shown by the CDC and FDA to have been caused solely by illicit THC products laced with vitamin-e acetate, completely unrelated to nicotine vaping. 

So a decision to ban the sale of one of the most popular of these products, credited with helping millions of Americans quit smoking (At least 28.3% of adult smokers had quit smoking cigarettes completely after using a JUUL vaporizer for three months) defies all science. Good public health policy would make it easier for people to quit smoking, not harder. 

FDA’s war on nicotine isn’t just targeted at Juul. FDA announced a rule to lower nicotine content in combustible cigarettes, even though nicotine is the one product in a cigarette that isn’t directly responsible for killing its user. Predictably, evidence shows this would force smokers to smoke more cigarettes and inhale deadly tar even deeper into their lungs to get the same amount of nicotine.

It would also be a boon to tobacco smuggling criminal syndicates, often linked to sex trafficking and terrorism. The U.S. State Department has explicitly called these syndicates a “threat to national security.”

The decisions by FDA are motivated not by science but by the radical ideologies of those in Congress. They are the exact opposite of what we need. Rather than forcing smokers to smoke more low-nicotine cigarettes, FDA should be encouraging them to quit through reduced-harm alternatives that are proven to actually work. 

• Tim Andrews is Director of Consumer Issues at Americans for Tax Reform.