The Food and Drug Administration has once again exposed a deadly menace to Americans’ health: the FDA itself. The rate of smoking has plummeted among Americans in 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 electronic cigarette (popularly known as the Juul), the most effective technology ever devised for inducing smokers to quit. The agency is also proposing to limit the amount of nicotine in traditional cigarettes, an approach that has failed in the past to wean smokers off their habit—and would perversely induce them to get their nicotine in more dangerous ways, either by smoking more cigarettes or by buying full-strength ones on the black market.
The Juul ban, temporarily suspended by a federal judge as Juul appeals the FDA’s order, defies not only the principles of public health but also political common sense: Why antagonize millions of voters in an election year by taking away their vaping sticks? The FDA conceded that it could point to no “immediate hazard” to the public from the Juul. It claimed that the company didn’t provide enough information on the Juul’s safety, but that claim is dubious—Juul spent more than $100 million on its application to the FDA. In any case, it’s silly to quibble about minor unknown risks in electronic cigarettes, which the U.K.’s public-health agency estimated to be 95 percent safer than tobacco cigarettes.
The ban makes sense only as a sop to the 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 better mood—without the thousands of toxins in tobacco smoke. Like caffeine, nicotine creates dependence and causes slight temporary rises 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 that e-cigarettes serve as a “gateway” to smoking for teenagers, but the rate of teenage smoking has fallen much faster during the vaping era than in previous years. When e-cigarettes were introduced a decade ago, 13 percent of high school students smoked; today the figure is less than 2 percent.
No one wants to see teenagers addicted to nicotine, but it is already illegal for them to buy e-cigarettes. Surveys show that the rate of vaping among high school students has declined sharply in the past two years, and that most teenage vapers do so only occasionally, often without nicotine. (A majority of them report using vaping devices for marijuana, yet progressive activists aren’t using that as reason to ban marijuana sales to adults.)
The rate of smoking among adults has also declined sharply during the vaping era, especially after the introduction of the Juul, and the health benefits have been obvious. A recent study, which tracked more than 30,000 Americans for six years, found that the rate of cardiovascular disease among e-cigarette users was a third lower than the rate among smokers, and no different from the rate among people who neither smoked nor vaped.
Other studies have shown that e-cigarettes help smokers quit and are far more effective than other nicotine-replacement therapies (like nicotine patches or gum). Even smokers with no intention to quit are much likelier to do so if they use an e-cigarette at least once a day. Juul has been particularly successful because it provides a high dose of nicotine in a form that is absorbed quickly, as in a tobacco cigarette. One study found that 50 percent of smokers who bought Juuls went on to 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 all wonderful news for public health, but bad news for companies that market less effective smoking-cessation products, as well as for 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 the anti-smoking activists justify their jobs? A lot of money is at stake: more than $800 million a year that the FDA collects from tobacco user fees, which are supposed to be dedicated to improving health by reducing the harm from 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 over 1,100 people, and it has been dispensing hundreds of millions of dollars annually in outside grants, much of it to nonprofits spreading anti-vaping messages and to researchers who advocate for nicotine prohibition.
Unfortunately, the FDA’s misinformation campaign has been a success, aided by mainstream journalists who created a moral panic by blaming e-cigarettes for deaths that were actually caused by black-market THC products. Early in the vaping era, most Americans realized that e-cigarettes are safer than tobacco cigarettes, but in subsequent surveys a majority say that e-cigarettes are as dangerous or even more dangerous—a mistaken belief that will shorten many smokers’ lives.
Nicotine prohibition is a pointless and unrealistic goal. Alcohol abuse is a much bigger problem than smoking among teenagers, but we’ve learned that banning alcohol sales to adults would create far more problems than it would solve. The same is true for e-cigarettes. If the FDA succeeds in banning Juul and similar products, Americans will simply revert to tobacco cigarettes or turn to modern bootleggers for less safe vaping devices.
“There are at least 4 million adult ex-smokers who quit smoking successfully using e-cigarettes and remain dependent on these products to stay off of cigarettes,” says Michael Siegel of Tufts University, who has been studying tobacco control for three decades. “If the FDA disapproves most electronic cigarettes, the end result will be huge numbers of ex-smokers returning to smoking, which would be a public health tragedy.”
In the FDA’s fantasy world, smokers will be saved once the level of nicotine in cigarettes is lowered to “non-addictive” levels. The agency last week announced plans to limit the level of nicotine in all cigarettes, and it has even declared very low-nicotine cigarettes to be “appropriate for the protection of public health.” It’s a bizarre endorsement for a deadly product, especially considering the past failure of low-nicotine cigarettes to get smokers to quit, as University of Louisville professor of medicine Brad Rodu has pointed out.
“If the only cigarettes the FDA allows are low-nicotine, this is a perfect setup for the black market,” says Rodu, who writes the Tobacco Truth blog. “The FDA has banned Juul, a far less hazardous and uniquely successful cigarette substitute for millions of American adult smokers, while endorsing cigarettes that contain virtually none of the essentially harmless nicotine and all of the toxins of traditional cigarettes. These illogical actions will have no impact on the yearly smoking death toll of a half-million Americans—or they may perversely raise it.”
For now, the best hope for sane policy remains outside the FDA. Perhaps the courts will protect Juul against the FDA’s folly, and perhaps politicians facing reelection will stand up for voters who enjoy nicotine. But as long as the agency—and its $800 million in tobacco fees—remain under the control of nicotine prohibitionists, the FDA will remain hazardous to Americans’ health.
