Federal tobacco policy is failing the American public and destroying businesses across the country. Only sweeping reforms can protect public health and save an entire industry from prohibition, according to a new report from the R Street Institute.
Prohibitive regulation of e-cigarettes and reduced-risk tobacco products combined with a public health establishment committed to an ideology of nicotine abstinence is creating an environment where Americans will find it harder to quit smoking and save themselves from an early death, the report argues.
More than 480,000 Americans died from smoking-related diseases in 2015: more than alcohol, car, illicit drug, HIV and gun deaths combined. The cause of these deaths is the deadly smoke inhaled into the lungs, not nicotine.
With the advent of e-cigarettes and the possible introduction of heat-not-burn products onto the market, smokers can mimic the experience of smoking and get the nicotine they desire while significantly reducing their risk for deadly disease.
But thanks to draconian regulation and misleading information from ideologically-driven public health authorities, the opportunity for a revolution in tobacco harm reduction is being lost and the American public will suffer as a result, according to the report’s authors Clive Bates, Professor Davis Sweanor and Eli Lehrer.
To remedy this potentially lethal cocktail of poor policy and misinformation, the authors set out a roadmap for the new administration which, if implemented, would a be sea change in policy with potentially huge dividends for public health changing the lives of countless individuals for the better.
One of the central targets of the report’s recommendations is the FDA’s woefully misconceived Deeming Rule, which took effect on Aug. 8, 2016. One of the most damaging aspects of the rule is the requirement for costly pre-market approval to keep existing vapor products on the market.
The process is so expensive that some experts believe 90-99 percent of vapor products could be yanked off the market. The consequence would be thousands of small businesses closing their doors, a major quit option taken away from smokers, and a boon to big tobacco companies who are the only players with the resources to comply with FDA regulations.
The report urges the administration to scrap the worst parts of the regulation before the entire vapor market is ruined and what’s left is held in the hands of a few tobacco companies.
The authors suggest this could be achieved with a series of reforms, including putting the implementation of the deeming rule on hold and changing the Tobacco Control Act predicate date to Aug. 8, 2016, meaning existing nicotine products that don’t contain tobacco can stay on the market.
More fundamentally, the report recommends a shift from the current regime of product-by-product authorization, which is prohibitively costly for most businesses and stifles innovation, to a standards-based regime.
The benefits of a such a regime would be fair regulation of reduced risk tobacco and nicotine products whereby chemical contents and devices are subject to a level playing field while reducing possible hazards to the consumer.
But it’s not just the heavy hand of FDA regulation which is responsible for the dire situation facing smokers desperately trying to switch to products that will reduce their risk of deadly disease.
Public health bodies from the Surgeon General’s office to the Centers for Disease Control and Prevention have endorsed a government-centered, abstinence-only approach to nicotine, which undermines the public understanding of the risks between different products.
Indeed, both bodies are guilty of gross fear mongering about the risks of e-cigarettes, portraying the rise of reduced risk products in the most negative light possible.
The misinformation surrounding e-cigarettes has become so pervasive that public understanding of vapor products has actually gone into reverse.
In 2012, half of the United States correctly believed that e-cigarettes are less harmful than regular cigarettes. But by 2014, after an explosion of negative and often inaccurate press coverage about the dangers of vaping relative to smoking, that number fell to 43 percent.
To counter the damage caused by this chorus of misinformation, R Street recommends allowing manufacturers to put labels on their products informing consumers about their relative risks. The report gives the example, “This product presents substantially lower risks to health than cigarettes.”
Public health campaigns should be refocused to ensure an accurate understanding of the dangers of various products. The authors recommend a goal that by 2020, at least 75 percent of Americans believe e-cigarettes, smokeless tobacco, and heated tobacco products are “very much less harmful” than regular cigarettes.
More fundamentally, the report says there needs to a change in the very “incentive structures in tobacco-related research, to stress objectivity in the public interest, not to justify expanded bureaucratic intervention.”
Changes would include congressional oversight, contrarian analysis, open data principles, and the establishment of a “Center for Nicotine and Tobacco Science in the Public Interest.”
The report is a siren call for reform and takes the world as it is, not as they the authors wish it to be, making a powerful argument for compassionate harm reduction in place of rigid abstinence. For whoever the new head of the FDA may be, the R Street report should be required reading.
Guy Bentley (@gbentley1) is a contributor to the Washington Examiner’s Beltway Confidential blog. He is a consumer freedom research associate at the Reason Foundation and was previously a reporter for the Daily Caller.