In the United States, there is a vaping inquisition. Welcome to the U.S. where a powerful smoking cessation tool is viewed as a public health hazard by almost every public health authority at the local, state, and federal level.
They’re following their emotions but, when it comes to vaping, shouldn’t we be following the science?
When President Biden was elected, he and his administration proclaimed that science is back, and we all applauded it – especially during Covid. What we later found out is what he really meant is that science is back – only when it is politically convenient.
When it comes to the science, we should be basing our decisions on the solid, significant, and abundant data on the value, safety, and effectiveness of nicotine vaping for, among other things, helping people to stop smoking combustible (aka: “traditional”) cigarettes. But, unlike some outspoken public health officials who don’t think vaccines work and climate deniers sharing their fake news, we should be making clear to Americans the relative risks and benefits of vaping nicotine compared to deadly cigarettes.
The unfortunate skew of the problem wasn’t caused by the U.S. Food and Drug Administration. The problem was caused by the inappropriate efforts of some vaping companies to market their flavored vapes to underage audiences. Marketing strategies that placed profits over the public health.
But regardless of where it started or why, that doesn’t excuse the hysterics, hyperbole, or selective sharing of relevant science. Unfortunately, politicians and the media love all three, especially when it comes to grabbing their share of the headlines.
The prevailing narrative against vaping nicotine, from politicians and the media, completely ignores (and often downright denies) the sound science that supports vaping nicotine as a smoking alternative. Their emotional arguments are incomplete at best, methodologically flawed in general, and downright misleading at worst. Alas, the FDA’s under-funded and under-staffed Center for Tobacco Products (CTP) is having a hard time keeping up, and the agency’s low post-pandemic trust ratings aren’t helping.
Apart from perception and politics, the most frustrating part about the FDA’s current posture on nicotine and harm reduction is that the regulatory process is so vague and expensive that only the big boys (aka: Big Tobacco) have the wherewithal and resources to shepherd their products through the CTP’s byzantine approval process.
The FDA’s most important policy should be advancing the regulatory science of smoking cessation. And, given that e-cigarettes are one of the most effective tools to do so – according to science –– the drive to remove as many products from the market as possible makes little public health sense.
The problem is that there’s a culture war about vaping in the U.S, so how do we solve it?
Step one must be a thoughtful, collegial conversations about vaping chaired by the FDA and including stakeholders across the policy spectrum, where the agency actually follows the science. The FDA should, and everyone must demand, that they hold themselves to the highest scientific standard. Shouting alarmist and emotional views on vaping and nicotine shouldn’t be allowed to preclude or drown out a robust scientific debate.
When it comes to vaping and e-cigarettes, we mustn’t ignore the body of science proving their harm reduction and smoking cessation benefits. The vaping inquisition must end.
Peter J. Pitts, a former FDA Associate Commissioner and member of the United States Senior Executive Service, is President of the Center for Medicine in the Public Interest and a Visiting Professor at the University of Paris School of Medicine.
