America may soon witness a watershed moment with regard to the country’s strategy on reducing tobacco-related illnesses. The Food and Drug Administration (FDA) is racing to meet a September 9 deadline to determine whether JUUL—an e-cigarette producer—can continue many of its regular business operations.
“The company is seeking approval for its iconic vaping device, once dubbed the iPhone of e-cigarettes, with tobacco- and menthol-flavored pods in two nicotine strengths: 5 percent, which is equivalent to the nicotine in an average pack of cigarettes, and 3 percent,” the New York Times wrote.
Over the past several years, e-cigarettes have come under increasing scrutiny from state legislatures, and even the Trump White House, which have sought to either ban the products outright or overly regulate them. Now, the future of much of the industry could lay with the Biden administration. It is impossible to predict the FDA’s decision, but if it were to reject JUUL’s 125,000-page application, it could portend a dim future for e-cigarettes in general, a choice which would adversely impact public health and reverse years of progress.
Despite being demonized as a public health hazard, e-cigarettes have proven to be a vital tool in the fight against tobacco-related illnesses. As it stands, over 11,000 Georgians and nearly 500,000 Americans die each year from smoking combustible cigarettes, while some 16 million others grapple with chronic smoking illnesses. Tobacco usage has long been a scourge in the United States and across the globe, but traditional efforts to combat smoking have enjoyed only limited success.
During an expensive 2014 federally-funded anti-smoking ad campaign, 1.8 million Americans attempted to quit smoking—out of around 34 million total smokers—but only 104,000 were successful. While the ad campaign was well-intentioned, the results were underwhelming. What’s more, many cessation products, like the patch, lozenge and gum, “do not appear to be effective in helping smokers quit long-term,” according to the Harvard School of Public Health, and abstinence-only approaches have been beset with failures.
Considering the dire consequences of tobacco use, e-cigarettes have shown great promise. They have become one of the main tools that smokers use to kick the habit, and the successful quit rate is encouraging. A recent study concluded that they may be more effective at helping people ditch cigarettes for good than nicotine replacement therapies.
This should be welcome news, but opponents of e-cigarettes have bemoaned that they are unhealthy and even compared their risks with those of combustible cigarettes. To be clear, the healthiest option is to avoid nicotine, and people should not use nicotine products. Period. But the evidence is compelling, demonstrating that e-cigarettes are a far less dangerous alternative to combustible cigarettes. Public Health England stated that they are 95 percent less harmful than combustibles, and the reason for this is how they are designed and used.
While there are various types of e-cigarettes, none employ the combustion process found in cigarettes, which releases a host of chemicals—some of which are unquestionably deadly in the long-term. In e-cigarettes, liquid is heated so that individuals can inhale vapor. Moreover, manufacturers don’t include tobacco in e-cigarette pods. The e-cigarette liquid generally includes water, a flavor agent—often mimicking the natural tobacco or menthol flavor—propylene glycol or vegetable glycerin base, and nicotine.
While addictive, nicotine isn’t the primary chemical of concern in tobacco. In fact, a literature review from the National Center for Biotechnology Informationfound that “studies involving nicotine exposures in the whole organism […] have repeatedly failed to show a significant relationship between nicotine and cancer initiation. Several documents issued by authoritative bodies also state that nicotine is not considered a carcinogen.”
Considering all of the available data, it seems evident that e-cigarettes provide current smokers with an alternative method of consuming nicotine without many of the harms associated with combustible cigarettes, and it is a viable path to permanently giving up cigarettes. It is another arrow in the quiver in the fight against cigarettes’ many dangers.
As the FDA officials review applications related to e-cigarettes, they would be wise to remember all of this, and they should prioritize better health outcomes for Americans. Banning proven methods that reduce harm would be a grave mistake with serious consequences.
Marc Hyden is the director of state government affairs at the R Street Institute, and he is a long-time Georgia resident. You can follow him on Twitter at marc_hyden.