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Director of CTP acknowledges vapes as harm reduction

Director of CTP acknowledges vapes as harm reduction

 

Brian King is the Food and Drug Administration’s (FDA) new head of the Center for Tobacco Products (CTP). Recently, Dr. King gave an interview to the Associated Press that has caught the attention of many vapers. Here’s an excerpt from the interview that highlights the most important parts:

Q: Surveys have shown that many adults think e-cigarettes are as dangerous as traditional cigarettes. Is that a problem?

A: I’m fully aware of the misperceptions that are out there and aren’t consistent with the known science. We do know that e-cigarettes — as a general class — have markedly less risk than a combustible cigarette product. That said, I think it’s very critical that we inform any communication campaigns using science and evidence. It has to be very carefully thought out to ensure that we’re maximizing impact and avoiding unintended consequences.

Q: What’s your view on the potential for vaping to help reduce adult smoking?

A: I think there’s a lot of really important science and innovations that have occurred in the industry in recent years. The most notable I think is nicotine salts (in e-cigarettes).

We know that when you smoke a tobacco product, it’s a very efficient way to deliver nicotine across the blood-brain barrier. So it’s been very difficult to rival that efficiency in another product. But in the case of nicotine salts you have the potential to more efficiently deliver nicotine which could hold some public health promise in terms of giving smokers enough nicotine that they would transition completely. But you also have to consider the opposite side of the coin, which is the inherent risks of initiation among youth. So I do worry about that.

So there’s a lot happening and I think that it could be promise or peril. But I think it’s important that the science drives that.

While a statement from the head of the CTP that acknowledges e-cigarettes as harm reduction may sound like good news to vapers, Dr. King’s past makes it difficult to believe the FDA will behave any differently than it has in the past. One of the studies he co-authored was titled “Reasons for current E-cigarette use among U.S. adults.”

On the other hand, he has generally opposed vaping and has been a source of the misinformation he speaks out about himself. Not only did King push for the term EVALI (E-cigarette or Vaping use-Associated Lung Injury) during a crisis now largely blamed on black-market THC vapes rather than e-cigarettes, he also chose to speak the unused, unrelated flavoring agent diacetyl during the crisis to spread fear. Additionally, he does oppose flavors for youth.

Dr. King is also worryingly inexperienced for the position that was given to him. While he has co-authored papers on electronic cigarettes and tobacco, he has never held a position in charge of regulation. King’s lack of experience is worrying to anti-vaping advocates and pro-vaping advocates alike, as the CTP has many new challenges regarding e-cigarette regulation.

The Pre-Market Tobacco Applications (PMTA) has many large companies stuck in the review process. Both anti and pro vape advocates are upset with the quality, speed, and order of PMTA handling. Not only have companies with larger shares of the market not been prioritized as promised, many small companies were simply rejected in a blanket rejection.

Juul, the company most associated with youth vaping, has challenged the FDA’s PMTA decision in court, along with many smaller companies. Many vaping companies currently have holds on their marketing desist orders - a decision which has angered many anti-vaping advocates. Even the FDA themselves are confused - commissioner Robert Califf has ordered an outside review of the tobacco center because the handling of the PMTA process has been so questionable.

Additionally, PMTA applications for synthetic nicotine products have not been looked at - many major products that are under review were submitted before synthetic nicotine became popular and banned. There is also a menthol ban that is supposed to be going on, but very little news has been released as to how it will be handled.

What does Dr. King’s situation look like to many people? One thing is agreed upon - he is not necessarily a strict follower of science, given how he acted during the EVALI crisis, and he is a questionable decision for the Director of the CTP. 



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