Author Background: Dr. Matthew Holman is the Vice President in charge of regulatory strategy for PMI in the United States. Prior to joining Philip Morris in September, Holman served as the Director of the Office of Science at the FDA's Center for Tobacco Products.
Source: Duluth News Tribune, image provided by Matthew Holman.
The latest data from the National Youth Tobacco Survey tells a story that you may not have heard before. The U.S. Food and Drug Administration and Centers for Disease Control and Prevention recently released the results of the 2022 survey, which showed a decrease in underage e-cigarette use to levels below the "epidemic" announced by the FDA in 2018. The data shows a continued reversal of the trend.
According to the same data, the percentage of teenagers smoking combustible cigarettes is at its lowest historical level of 1.6%. In fact, over the past few years, there has been a significant decrease in the use of all tobacco products among adolescents. Many stakeholders, including myself, have tirelessly worked towards reducing underage usage and have achieved success.
However, according to data from the American Cancer Society, the decrease in the number of adult smokers has not matched this progress, with 34 million smokers currently in the United States.
The FDA could do more to help Americans quit smoking and should engage in conversations with smokers again, just like it did before releasing the 2018 Tobacco Survey results.
Smoking among adults has also decreased, although not significantly, much like among teenagers. According to public health data, smoking remains the largest single preventable cause of death in the United States. Therefore, while acknowledging the significant progress made in recent years in reducing tobacco use among youths is important, it is equally important to recognize that too many Americans still smoke.
As a senior professional at the FDA for 20 years and recently appointed as the top scientist for the agency's Center for Tobacco Products, I am aware that it is home to talented scientists who want to do more to help smokers make better choices than continuing to smoke - while also preventing underage nicotine use.
So, what can be done to speed up the reduction of adult smoking in the United States? The US public health agencies need to adopt a more balanced approach in promoting tobacco and nicotine products, which is an urgently needed and important strategic move.
The FDA has invested a significant amount of funds in launching multiple multimedia campaigns aimed at reducing underage electronic cigarette use among adolescents and parents. These efforts should continue. However, what is completely missing is similar investment in communicating with adult smokers. The FDA must engage smokers in a consistent, transparent, and meaningful way to help them quit smoking altogether or encourage those who don't quit to switch to innovative smoke-free products. The FDA acknowledges that such products are a better alternative to continuing smoking. Let's make sure adult smokers know this.
The message that all Americans need to hear from health experts is simple: if you don't currently use tobacco products, don't start. If you smoke, quitting is the best option. If you don't quit, switch to smoke-free alternatives. This message is scientifically supported, and the FDA's authorization of nicotine products confirms this. For adult smokers who completely switch to nicotine products, the chance of exposure to harmful chemicals in smoke is significantly reduced, and for certain products, the risk of lung cancer and other smoking-related diseases may be decreased.
Today, smokers are not receiving this crucial message, and that needs to change. Otherwise, nearly 500,000 Americans will continue to die unnecessarily every year. Health experts have a responsibility to proactively share information about better choices with adult smokers, while also continuing to prevent underage tobacco use.
When I was working at the FDA, Commissioner Scott Gottlieb announced a comprehensive plan aimed at getting smokers to switch from traditional combustible cigarettes to less harmful tobacco products or to quit tobacco altogether. The plan was unveiled over five years ago, but until now, the FDA's efforts have primarily focused on preventing underage use. It is now time to take action to assist adult smokers in making better choices.
I hope that my former colleagues at the FDA, who are all exceptional public health scientists, will take necessary action to accelerate the transition towards a healthier America by keeping smokers away from cigarettes.
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