FDA has authorised 22nd Century to claim a reduced nicotine cigarette is a reduced risk product. This will spread confusion and divert smokers from better choices.
In one of its most ill-judged moves to date, the US Food and Drug Administration has today granted 22nd Century Group the right to market its VLN King and VLN Menthol King combusted, filtered cigarettes as modified risk tobacco products.
It has done this because these products are reduced in nicotine and, FDA concludes, anyone who is willing to smoke them will experience lower exposures to nicotine. But we have known for a long time that “people smoke for the nicotine but die from the tar” (Mike Russell). This is a product that reduces the nicotine but keeps the tar. What could possibly go wrong?
At the start of COP-9, the head of the FCTC convention secretariat proudly drew a comparison with the other COP, the one going on in Glasgow dealing with the UN Framework Convention on Climate Change (UNFCC). Perhaps she hoping some of the interest in UNFCCC COP-26 would rub off on the altogether more tawdry FCTC COP-9. But the tobacco COP takes an aggressive exclusionary and insular approach to stakeholders that would never be tolerated in the climate COP. This post compares the two COPs.
This post examines how WHO and related institutions aggressively promote the prohibition of much safer alternatives to cigarettes, such as vaping and heated tobacco products. The effect, if not the intent, is to protect the cigarette trade from competition, to promote black markets, to stimulate harmful workarounds, to nurture criminal networks, to harm young people, and to prolong the epidemic of avoidable smoking-related disease. It’s a reckless policy, built on misplaced righteousness, defended by bureaucratic inertia, sustained by group-think, and cultivated by elitist billionaire foundation money. It’s a curse and a blight on public health, and government representatives should apply real-world policy disciplines and reject it.
I had an excellent conversation with Ethan Nadelmann, the founder of the New York-based Drug Policy Alliance for his outstanding Psychoactive podcast series about all aspects of drugs and drugs policy, which I highly recommend.
In this episode, “The E-cigarette revolution”, we covered vaping, nicotine, harm reduction – science, policy, politics and controversy – with Ethan as host putting the challenging questions. Listen via your usual podcast provider (search on Psychoactive)… or via these links.
The September 2021 edition of CHEST, the respiratory journal, features a point/counterpoint debate on the value of e-cigarettes for tobacco harm reduction. I am making the case in favour (the Point) and Dr Hasmeena Kathuria (Boston University) and Dr Frank T. Leone (University of Pennsylvania) are making the case against (the Counterpoint). We each provide a shorter rebuttal to the arguments made by the other. We also recorded a 30-minute podcast to air these arguments face-to-face. Recognising the broader interest in the subject, CHEST has kindly made this content open access so far.
Whatever you think of the respective arguments, it was refreshing to find a forum willing to air them in a respectful and measured way, I am grateful to Drs Kathuria and Leone for engaging and making their case and to CHEST for providing the platform. I wish we could have much more debate like this.
For ease of access, I have added the relevant links below.
This blog gives my take on how to think about the FDA’s decisions (some taken, some forthcoming) on approving or denying thousands of “pre-market tobacco applications” (PMTAs) to allow vaping products to remain on the US market. FDA must make decisions no later than 9th September 2021, following legal action brought against the agency. FDA’s Director of the Center for Tobacco Products, Mitchel Zeller, provides the background in a February 2021 blog.
There’s a lot to be written on this, but I will settle for 16 observations and questions that will shape my take on FDA’s announcements.
Health Canada is trying to ban almost all vaping liquid flavours. This is on top of measures to limit nicotine strengths and marketing. It is the nearest they can get to a prohibition without actually having to prohibit the most promising low-risk rival to cigarettes. The likely effects are obvious: more smoking. But in a bizarre twisting of reality and evidence, Health Canada finds that making vaping less attractive relative to smoking will… um … reduce smoking. And that’s how it justifies the measure. We respond with a counter-analysis.