On Tuesday, e-cigarette maker Juul announced it would remove their fruit-flavored products from store shelves, caving into pressure from the U.S. Food and Drug Administration. A week earlier, Florida voted to ban indoor vaping through, of all things, a constitutional amendment that also banned offshore drilling. Needless to say, this November has been a rough month for Juul and other e-cig companies. While this is by no means a death blow, it is a sign that the days of the unregulated e-cig industry are over. Good riddance.
While the Trump administration is widely, and rightfully, seen as dysfunctional, the FDA under Trump-appointed Scott Gottlieb, commissioner of food and drugs, is coming down hard on tobacco and e-cig makers. In addition to giving e-cig manufacturers an ultimatum to pull fruit-flavored products off the market, Gottlieb is moving to ban menthol cigarettes, which were exempted from the immediate ban on flavored cigarettes under the Family Smoking Prevention and Tobacco Control Act. Gottlieb has even proposed using the FDA’s regulatory power to force tobacco companies to reduce nicotine in cigarettes.
All of these regulatory actions are focused on combating one public health problem: adolescent smoking. According to the findings, the number of U.S. high school students who reported being current e-cigarette users increased 78 percent between 2017 and 2018 to 3.05 million (or 20.8 percent). Numbers among middle school students rose 48 percent to 570,000 (or 4.9 percent). I think we call too many things “epidemics” these days, but if youth e-cig use does not cut it as an epidemic, what does?
Many people will take issue with the FDA’s actions against e-cigs, but any action that increases social good is bound to have detractors. Let us inspect the arguments presented by the pro-vape lobby.
Perhaps the biggest pro-vape argument is that e-cigs are safer than traditional cigarettes and we should therefore count our blessings that people prefer a Juul over a Camel. Cigarettes and tobacco kill half the people that use them and its seems e-cigs are indeed a safer option because they don’t involve the combustion of plant matter. This smoke is what creates the cancer-causing chemicals that make smoking so dangerous.
However, e-cigs are not harmless. It is important to note the FDA is not moving against all e-cigs, only flavored ones. Currently, e-cig flavoring ingredients are unregulated. That should concern everyone. A Harvard University study found 39 of 51 e-cig flavors tested contain diacetyl. What is diacetyl? It is an organic compound that when vaporized and inhaled can cause a serious lung disease called bronchiolitis obliterans. The disease is nicknamed “Popcorn Lung” after it was discovered in workers at a microwave popcorn factory who were exposed to—you guessed it—diacetyl. While microwave popcorn manufacturers removed diacetyl from their products in 2007, e-cig users and those who inhale the secondhand smoke are being exposed to this potentially dangerous chemical regularly. E-cig makers are not required to list the ingredients of their flavors, so your favorite vapor flavor may very well contain diacetyl or other potentially hazardous chemicals. Regardless of how you feel about e-cigs, I hope we can all agree that smokers should know exactly what they are inhaling.
Gottlieb and the FDA are not coming for flavored e-cigs and menthol cigarettes because of chemicals, but instead because flavored products are more attractive to young people. Even if there was no malicious intent, e-cig makers who market flavors such as mango and Skittles are basically waving a big flag to young people saying “come and try me, I am fun and flavorful.” Imagine if Skittles-flavored oxycodone hit the market. Would you approve? If you think I am over-exaggerating, just remember nicotine addiction kills 7 million people globally every year. Yes, those deaths are not caused by nicotine directly, but 30.7 percent of teen e-cig users become smokers (includeing the use of cigarettes, cigars and hookahs) compared to only 8.1 percent in teens who do not vape. Because 90 percent of adult smokers start by the age of 18, you can see why that vape-to-tobacco statistic is striking.
E-cig companies love to advertise their products as a way for people to get off of tobacco. If Juul and other companies truly believe their products can help people quit, then they should submit their products to the rigorous FDA approval process that all medical devices go through. But these companies will not do that. Why? Because their objective is to make money, and hooking adolescents, with their developing brains, on either nicotine or marijuana is a great way to make customers keep coming back. Removing flavored e-cigs from the market will make adolescents less likely to start the habit because tobacco flavor (which would not be banned) is not nearly as appealing.
Good riddance to flavored e-cigarettes. Good riddance to the Juul.
Ali Safawi can be reached at firstname.lastname@example.org