In 2018, the U.S. Food and Drug Administration (FDA) declared a teen vaping epidemic, sought public comments on e-cigarette regulation, and proposed restricting access to tobacco harm reduction (THR) products, notably flavored electronic cigarettes and vaping devices. States and localities have also introduced and passed similar measures. For instance, in July, San Francisco banned the sale of flavored tobacco products, including e-cigarettes and menthol cigarettes.
These actions from policymakers are in response to what they call an alarming increase in youth vaping. However, the only epidemic taking place is policymakers’ distortion of youth tobacco and vaping usage and their inability to separate Big Tobacco from THR. Unfortunately, this has vastly increased unfounded fears at a cost to public health.
Despite the cavalcade of fearmongering, youth combustible smoking rates peaked for high school students in 1997, with 36.4 percent reporting smoking cigarettes on “1 or more of the 30 days preceding the survey.” In 1996, more than 10 percent of eighth graders reported daily cigarette smoking.
FDA’s November announcement relied heavily on the 2018 National Youth Tobacco Survey, which found a 78 percent increase in high school students using e-cigarettes. This “alarming increase” is based off the use of an e-cigarette more than one time in the past month prior to the survey and does not distinguish casual curiosity from actual addiction and daily use.
Even more noteworthy, only 20.8 percent of high school students identified as current e-cigarette users, nearly 16 percent less than the peak rate of 36 percent in 1997. FDA did not seek to restrict access to combustible cigarettes by permitting their sale only in age-restricted stores in 1997, and should not issue unnecessary regulations on e-cigarettes in the future.
The recently released Monitoring the Future Survey found that any “use of vaping nicotine specifically in the 30 days prior to the survey nearly doubled for high school seniors from11 percent in 2017 to 20.9 percent in 2018.” Once again, this statistic is misleading because it does not differentiate between experimental use and daily use.
Fortunately, the survey did reveal that daily cigarette smoking has fallen precipitously. According to the report, “only 3.6 percent of high school seniors smoking daily, compared to 22.4 percent two decades ago,” which is obviously a huge public health victory.
This type of rhetoric only increases the smokescreen of misinformation that clouds the fact that THR products work as cessation tools. Even worse, FDA and public health groups are also promoting a false narrative that electronic cigarettes and vaping devices are Big Tobacco’s latest efforts to get kids addicted.
Big Tobacco entered the electronic cigarette market several years after the introduction of e-cigarettes to the U.S. market and only after electronic cigarette companies had won their case against FDA banning the importation of e-cigarettes in 2010. Blu’s product first came to market in 2012, RJ Reynolds and Altria’s products in 2013. In fact, in 2010, FDA issued warning letters against five electronic cigarette companies that most Americans would not recognize their names, including Johnson Creek Enterprises, LLC and Ruyan America Inc.
Although FDA’s initial actions to e-cigarettes may have been justified in the late 2000s when the products first entered the market and their dangers were relatively unknown, their alarmism campaign is unjust to the millions of adult smokers addicted to harmful, combustible cigarettes. These agencies are ignoring findings from public health organizations they once relied on for the harms associated with combustible cigarettes. The Royal College of Physicians (RCP) first reported the ill effects of smoking in 1962, leading to the 1964 U.S. Surgeon General’s Report on Smoking. Unfortunately for American smokers, public health agencies ignore RCP’s 2016 report finding electronic cigarette use “unlikely to exceed 5% of the harm [caused by] smoking tobacco.”
Perhaps the most distressing element of FDA’s propaganda war against THR products is that FDA’s Center for Tobacco Products is “funded solely from user fees.” In short, as more Americans ditch combustible cigarettes for vaping, the Center’s funding drops accordingly — creating a blatant conflict of interest. As one epidemiologist noted about FDA’s scare tactics on e-cigarette use, “[t]he agency was implicitly saying, Stay away from these newfangled untested cigarette substitutes — better to stick with the real ones,” or the real ones that fund CTP.
Combustible cigarette smoking is at an all-time low, thanks in part to THR products. However, so-called public health agencies continue to shamefully misrepresent youth tobacco usage numbers and throw in Big Tobacco to strike public fear against THR products. Unfortunately, these agencies are doing a major disserve to the American people by undermining the positive outcomes that THR products can bring to public health.