Nicotine and Harm Reduction Newsletter – September 2019
ID 157209275 © Roman Stetsyk |

Harm Reduction Newsletter

Nicotine and Harm Reduction Newsletter – September 2019

The FDA is renewing its push to place graphic warnings on cigarette packages, Michigan is the first state to ban the sale of non-tobacco e-cigarette flavors, and more.

Federal Updates

On Aug. 17, the Centers for Disease Control and Prevention (CDC) began investigating an outbreak of severe lung illnesses associated with vaping. In the weeks that followed, more than 200 cases were reported across 25 states. While the CDC, public health groups, and most of the media initially highlighted the association with vaping none of these cases have so far been attributed to any single ingredient in legal e-cigarettes or any particular model or brand of e-cigarette. However, a large number of these cases appear to be linked to the use of illegal and counterfeit products containing unknown chemicals and THC. 

The Washington Post reports that “state and federal health authorities are focusing on the role of contaminants or counterfeit substances as a likely cause of vaping-related lung illnesses.” They “are narrowing the possible culprits to adulterants in vaping products purported to have THC…as well as adulterants in nicotine vaping products.”

Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb took to Twitter to share his views: “These tragedies point to illegal vapes and THC,” he tweeted. Gottlieb later expanded his assessment in an op-ed for the Washington Post. In a joint statement issued Aug. 30, the FDA and the CDC said, “Anyone who does use e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC or other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.”

Reason Magazine’s Jacob Sullum, Michelle Minton of the Competitive Enterprise Institute, and the Heartland Institute’s Lindsey Stroud all provided excellent analysis of recent events.

Elsewhere, the FDA is renewing its push to place graphic warnings on cigarette packages. The new warnings would occupy the top 50 percent of the front and back panels of packages and at least 20 percent of the area at the top area, according to the FDA. The final issue of the rule is due March 2020 and would appear on packages 15 months afterward. Reason Foundation policy analyst Jacob Rich highlighted the failures of these warnings to reduce smoking rates in other countries.

Reason Foundation’s Guy Bentley and Jacob Sullum both covered the latest National Survey on Drug Use and Health (NSDUH) data showing yet another decline in the teen smoking rate. 

State Updates

Michigan Gov. Gretchen Whitmer (D) signed an executive order on Sept. 4 banning the sale of all non-tobacco flavored vapor products and other alternative nicotine delivery systems (ANDS). Michigan is the first state to ban the sale of non-tobacco e-cigarette flavors. Reason’s Jacob Sullum questioned the governor’s authority to unilaterally impose such a sweeping ban and highlighted some of the problems such a prohibition would pose for tobacco harm reduction.

California Assembly Bill 1639 passed on Sept. 5 and will proceed to the State Senate next week. Proposed by Assemblyman Adam Gray (D-Modesto), the bill would impose a raft of draconian and arbitrary marketing restrictions on vaping products. “We are all concerned about AB 1639 as it leaves many small business shops at risk of facing harsh fines and penalties that could potentially cost them their business,” said Jake Butcher, State Affairs Manager for the Vapor Technology Association (VTA), on Aug. 28.

The Los Angeles County Board of Supervisors is pushing to ban the sale of flavored tobacco products. If passed, the ban would be enforced starting in February 2020. 

Science and Harm Reduction

The R Street Institute released an excellent evidence update on tobacco harm reduction encompassing e-cigarettes, heated tobacco products, and the smokeless tobacco snus. Regarding the state of the evidence surrounding these products, authors Carrie Wade and Chelsea Boyd write, “It has been conclusively shown that the profile of dangerous constituents, including particulate matter, lack of carbon monoxide and HPHCs is much more favorable in the ANDS discussed than that of cigarettes.”

Writing on his blog The Counterfactual, tobacco harm reduction advocate Clive Bates provided a systematic takedown of the numerous and unscientific anti-vaping claims made by Professor Stanton Glantz of the University of California, San Francisco.

Additional Resources

Consumer Surplus in the FDA’s Tobacco Regulations

A Question of Taste: The Public Health Case for E-Cigarette Flavors

The World Health Organization’s Opposition to Tobacco Harm Reduction: A Threat to Public Health? 

The Vapor Revolution: How Bottom-Up Innovation Is Saving Lives 

Reason’s Research and Analysis of Nicotine and Vapor Issues