The FDA’s war on Juul is bad health policy

The Food and Drug Administration has once again exposed a deadly threat to the health of Americans: the FDA itself. Smoking rates have plummeted among Americans over the past decade, but now the agency’s empire-building bureaucrats are doing their best to reverse that trend.

The FDA has ordered Juul to stop selling its e-cigarette (popularly known as Juul), the most effective technology ever designed to get smokers to quit. The agency also proposes limiting the amount of nicotine in traditional cigarettes, an approach that has failed in the past to wean smokers from their habit – and would perversely encourage them to obtain their nicotine in more dangerous ways, either by smoking. more cigarettes or buying full-strength products on the black market.

Juul’s ban, temporarily suspended by a federal judge while Juul appeals the FDA order, defies not only public health principles but also political common sense: why upset millions of voters during an election year by taking away their vape sticks? The FDA admitted it could point to no “immediate danger” to the public from Juul. He claimed the company hadn’t provided enough information about Juul’s safety, but that claim is dubious: Juul spent over $100 million on its FDA filing. Either way, it’s silly to quibble about the unknown minor risks of e-cigarettes, which the UK public health agency estimates to be 95% safer than tobacco cigarettes.

The ban only makes sense as a concession to bureaucrats and special interests threatened by e-cigarettes, which provide the many benefits of nicotine – weight control, improved concentration and cognitive performance, reduced anxiety and improved mood – without the thousands of toxins found in tobacco. smoke. Like caffeine, nicotine is addictive and causes mild, temporary increases in blood pressure, but both are “fairly harmless”, as the British Royal Society for Public Health concluded.

Anti-vaping activists and their allies at the FDA have claimed e-cigarettes serve as a “gateway” to smoking for teens, but teen smoking rates have fallen much faster in the age of vaping than they have in the past. previous ones. When e-cigarettes were introduced ten years ago, 13% of high school students smoked; today the figure is less than 2%.

Nobody wants to see teenagers addicted to nicotine, but it’s already illegal for them to buy e-cigarettes. Surveys show that the rate of vaping among high school students has dropped sharply over the past two years, and most teenage vapers only do it occasionally, often without nicotine. (A majority say they use vaping devices for marijuana, but progressive activists don’t use that as a reason to ban the sale of marijuana to adults.)

Smoking rates among adults also declined sharply during the vaping era, especially after the introduction of Juul, and the health benefits were evident. A recent study, which followed more than 30,000 Americans for six years, found that the rate of cardiovascular disease among e-cigarette users was one-third lower than the rate among smokers, and no different from the rate among people who did not smoke or vape.

Other studies have shown that e-cigarettes help smokers quit smoking and are much more effective than other nicotine replacement therapies (like nicotine patches or gum). Even smokers who have no intention of quitting are much more likely to quit if they use an e-cigarette at least once a day. Juul has been particularly successful because it delivers a high dose of nicotine in a form that is absorbed quickly, like in a tobacco cigarette. A study found that 50% of smokers who bought Juuls quit smoking within a year. Another showed that smokers are more likely to quit if they use a full-strength Juul rather than one with less nicotine.

This is great news for public health, but bad news for the companies that market less effective smoking cessation products, as well as the activists, academics and bureaucrats who have built careers fighting cigarettes. Now that so many Americans have used vaping devices to quit smoking on their own, how can anti-tobacco activists justify their work? A lot of money is at stake: more than $800 million a year the FDA collects in tobacco user fees, which are supposed to be spent on improving health by reducing the harms of tobacco products.

To keep the money flowing, bureaucrats misleadingly defined the e-cigarette as a “tobacco product” and set a new goal of eliminating the regular use of nicotine. Since beginning its campaign against e-cigarettes, the FDA’s Center for Tobacco Products has more than doubled the size of its staff, to more than 1,100 people, and it has handed out hundreds of millions of dollars a year in grants external sources, many of them to non-profit organisations. spread anti-vaping messages and to researchers advocating for nicotine bans.

Unfortunately, the FDA’s misinformation campaign was successful, aided by mainstream journalists who created a moral panic by blaming e-cigarettes for deaths that were actually caused by black market THC products. At the start of the vaping era, most Americans realized that e-cigarettes were safer than tobacco cigarettes, but in later surveys a majority said e-cigarettes were just as dangerous, if not more dangerous, a mistaken belief that will shorten the lives of many smokers.

Banning nicotine is an unnecessary and unrealistic goal. Alcohol abuse is a much bigger problem than teenage smoking, but we’ve learned that banning the sale of alcohol to adults will create more problems than it solves. The same is true for electronic cigarettes. If the FDA succeeds in banning Juul and similar products, Americans will simply revert to tobacco cigarettes or turn to modern smugglers for less safe vaping devices.

“There are at least 4 million former adult smokers who have successfully quit using e-cigarettes and who remain dependent on these products to quit smoking,” says Michael Siegel of Tufts University, who studies e-cigarettes. tobacco control for three decades. “If the FDA disapproves of most e-cigarettes, the end result will be a large number of former smokers starting to smoke again, which would be a public health tragedy.”

In the fantasy world of the FDA, smokers will be saved once the level of nicotine in cigarettes is lowered to “non-addictive” levels. The agency last week announced its intention to limit the level of nicotine in all cigarettes, and it even said that very low nicotine cigarettes were “appropriate for the protection of public health”. It’s a bizarre endorsement for a deadly product, especially given the past failure of low-nicotine cigarettes to entice smokers to quit, as University of Louisville professor of medicine Brad rodu.

“If the only cigarettes the FDA has cleared are low-nicotine, that’s a perfect setup for the black market,” says Rodu, who writes the Tobacco Truth blog. “The FDA has banned Juul, a far less dangerous and uniquely successful cigarette substitute for millions of American adult smokers, while approving cigarettes that contain virtually none of the essentially harmless nicotine and all of the toxins found in traditional cigarettes. These illogical actions will have no impact on the annual smoking death toll of half a million Americans – or they could perversely increase it.

For now, the best hope for sound policy remains outside the FDA. Maybe the courts will shield Juul from FDA madness, and maybe politicians facing re-election will defend nicotine-loving voters. But as long as the agency and its $800 million in tobacco royalties remain under the control of nicotine prohibitionists, the FDA will remain dangerous to the health of Americans.

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