Feds Owe the Public 'Corrective Statements' on Vaping
Major tobacco companies, such as Altria and R.J. Reynolds Tobacco, have unveiled primetime television commercials and full-page ads in over 40 newspapers telling Americans something they already know: Smoking kills.
One ad says, “Altria, R.J. Reynolds Tobacco, Lorillard, and Philip Morris USA intentionally designed cigarettes to make them more addictive.” Another reads: “More people die every year from smoking than from murder, AIDS, suicide, drugs, car crashes, and alcohol, combined.” The companies were ordered to make these “corrective statements” as the result of a 1999 lawsuit the Justice Department filed over the industry’s decades-long misleading statements about the effects of smoking.
They are a long-overdue correction by an industry that long tried to suppress the truth about the lethal effects of smoking.
Now would be a good time for the Centers for Disease Control and Prevention (CDC) and the Surgeon General – two entities entrusted to give the public credible health information – to make their own corrective statements. Both agencies have committed public health malpractice by trying to scare people who can’t or won’t give up smoking while withholding or distorting data about viable alternatives.
Take the CDC. Throughout Dr. Tom Frieden’s tenure at the CDC, he maintained a drumbeat of negativity toward vaping, harping on unknowns while ignoring palpable benefits. “There are things we don’t know about [e-cigarette] toxicity,” he warned.
On the contrary, there is a lot we do know. Most important, e-cigarettes do not burn tobacco, which is the process that produces the vast majority of carcinogens at unsafe levels. And in a recent development, the CDC has now acknowledged that “e-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.”
But this statement can only be found if you know for what you are looking on their website—and thus it is a far cry from Public Health England (the English CDC equivalent) using television commercials to promote e-cigarettes as part of its Stoptober campaign.
In the U.K., Public Health England has announced that vaping is 95 percent less risky than conventional cigarettes. Nearly all of the nation’s public health community has promoted vaping as a smoking cessation tool. The Royal College of General Practitioner’s Clinical Priority program, created in partnership with Cancer Research UK, recommends e-cigarettes as a valid cessation tool for patients who have not succeeded with other options.
In the U.S., by contrast, former Surgeon General Vivek Murthy's 2016 report on youth vaping raised a range of concerns, including the risk of a “gateway” effect whereby teen vapers allegedly progressed to smoking. That would be a grave concern if it were happening – but it’s not.
For one thing, the majority of e-cigarette use by youth who do not already smoke is infrequent, experimental and negligible. In 2014, only 0.7 percent of youth who’ve never smoked reported using e-cigarettes on 20 of the last 30 days, according to the Monitoring the Future Survey. The same government survey showed that approximately 65 percent of all youth who had ever vaped claimed to use nicotine-free e-liquids. Youth smoking has fallen to historic lows, despite—or perhaps because of—greater numbers of teenagers experimenting with e-cigarettes. Nowhere in Murthy’s report, however, does the heartening news about diminished teen smoking appear.
Murthy never cited two studies suggesting that state-based age-restrictions of e-cigarette purchasing might increase youth smoking. The current Surgeon General should tell the truth about youth vaping, and correct the Murthy report’s unfounded statement that “e-cigarette use among U.S. youth and young adults is now a major public health concern.”
If the government demands that tobacco companies make corrective statements about the dangers of cigarettes, it should allow those same companies to provide accurate information about alternatives that may save lives. Unfortunately, tobacco companies seeking to communicate the benefits of switching from cigarettes to reduced-risk products confront a regulatory nightmare.
In June 2014, Swedish Match applied for modified risk tobacco product (MRTP) status for its line of snus smokeless tobacco products, a status that would allow the company to state – in accord with decades of epidemiological evidence – that snus poses less harm than cigarettes. Although the FDA had previously granted a new product marketing order on the basis that the products were appropriate for the protection of public health, the agency concluded (after a delay of over a year) that there was insufficient evidence for the company to claim that snus presents “substantially lower risks to health than cigarettes.” The FDA also rejected the company's request to remove warning labels that its products can cause gum disease and mouth cancer and it asked Swedish Match to amend its application.
If the FDA really wants to give smokers the best possible chance of quitting smoking, it cannot continue to leave them in the dark about the benefits of switching to reduced-risk products. It should grant MRTP status to products like snus and heat-not-burn tobacco and ease the process by which e-cigarettes come to and stay on the market. Big Tobacco’s well-documented sins do not excuse public authorities from their duty to tell the public the truth.
Sally Satel MD is a resident scholar at the American Enterprise Institute. Guy Bentley is a research associate a Reason Foundation.