FDA change tactics in the war on tobacco

It’s a bit of this and a bit of that.

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Last Friday the FDA gave us this Official Press Announcement It came a bit of a surprise not just because it came without warning or leak but because of its contents. As you know the FDA now has deemed authority over e-cigs and has insisted on authorization for any product not on the market before 2008. Fridays announcement has been greeted with applause by e-cig proponents as the cut off date for authorisation has been moved to 2022.  It also contained the announcement that a conversation around reducing and removing nicotine from cigarettes will be started. Also some stuff about the role for harm reduction in the fight against tobacco.

 

While the movement of the deadline is welcome, I don’t think it’s because of any change of heart. I suspect it’s more to do with the FDA realizing it’s won’t be able to achieve even a fraction of the process in the current time limit. They had no option but to extend the deadline or risk looking incompetent. The talk of harm reduction may just be a cover story.

The stuff about reducing nicotine in cigarettes is another McGuffin. It’s a wet dream of the anti nicotine zealots and probably just thrown in to shut them up. Only a fool would think it would achieve anything other than a black market in nicotine containing cigarettes or people lacing their zero nic cigs with e juice.

Oh, I get the argument, nicotine addicts people to tobacco which is mostly consumed by smoking which is the major cause of the harm. Therefore remove the nic and no one will get addicted and so no one will smoke.  It sounds logical enough but the flaw is those already addicted will either switch to another consumption method, bypass the low nic cigs and buy from the black market or smoke more. Then again I’m not sure tobacco control care about current smokers, I’m pretty sure the focus is on preventing future smokers and letting current smokers quit or die.

It’s not all bad.

Yet, this announcement had some positive stuff about harm reduction and encouraging people to move to lower risk products but I’m not persuaded this is anything more than a justification for moving the deadline. I don’t see any commitment to doing anything required to encourage switching. It will take a huge public information campaign to encourage this and undo the years of misinformation already planted in the public mind. Apart from the stick of no nic cigarettes, their’s nothing else. No allowance for new products or innovation, only current products may be sold without authorization. In other words, the market has been mothballed. Getting authorization is a nightmare, if SNUS can’t get a reduced risk status, what chance have e-cigs got?

OK, I’m being overly pessimistic, this is a move in the right direction. Once we see the promised list of product standards we will know how much of a move. Remember, nothing has changed but the date, All that’s changed is when not what or how.

Good stuff that gives hope.

“Envisioning a world where cigarettes would no longer create or sustain addiction, and where adults who still need or want nicotine could get it from alternative and less harmful sources, needs to be the cornerstone of our efforts – and we believe it’s vital that we pursue this common ground.”

This, of course, is an approximation of the perfect scenario. Personally, I would have worded it as ” Envisioning a world where cigarettes are no longer the principal choice for adults who want or need nicotine and are replaced by safer reduced risk products which are the consumers preferred choice.” I think the idea of forcing people by removing product is doomed to failure. It creates the illusion that nicotine is the problem so switching to smokeless but nicotine containing products is at best still a huge risk and at worst pointless. It risks creating the impression that low nic cigarettes are safer than normal cigs and could lead to more people smoking. They are not addictive so what’s the problem? Right?

 “the agency also will seek input from the public on a variety of significant topics, including approaches to regulating kid-appealing flavors in e-cigarettes and cigars.”

This is something we expected, an attack on flavors, I’m not sure what ‘kid appealing flavors’ are. It’s the language of moral panic more than anything else. But they do have to acknowledge the ‘concerns’ of the alphabet groups who have been using this argument forever. The following line gives some hope.

“seek public comment on the role that flavors (including menthol) in tobacco products play in attracting youth and may play in helping some smokers switch to potentially less harmful forms of nicotine delivery”

At least they recognize the argument that flavors have a role in attracting adult smokers away from lit tobacco products.

I think as minimal as this announcement is IMNSHO it’s still a seismic shift in emphasis. It shows that at least in the FDA there is recognition of the current evidence based position and they are willing to go in this direction. Wheather they can bring the rest of public health with them remains to be seen.

For now, the pressure on e-cigs at the federal level has dropped, it will only increase at state and local level but the direction the FDA has indicated is a huge help in fighting that pressure.

 

 

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