E-Cigarettes: Opinion Poll + US Summit Report
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Recently, leaders in the tobacco control community gathered in Washington DC for the 2nd “US E-Cigarette Summit”. The one-day meeting attracted more than 200 participants from the US and beyond, including the tobacco industry as well as scientific and policy leaders. Twenty expert speakers shared brief summaries of data and perspective on this complex topic, followed by panel discussions and audience Q&A. Presentations and videos are available here.
Mitch Zeller, Director of the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products, opened the meeting with a comprehensive overview of FDA’s plans to regulate nicotine and tobacco products, and the complexities involved. The FDA’s plan is built upon a “continuum of risk” in which nicotine-only products, including some e-cigarettes, occupy the least risky position compared to combustibles and other products with harmful or unknown constituents.
In another pivotal session, Nancy Rigotti, Professor of Medicine at Harvard Medical School, summarized the conclusions of the recently-issued National Academies (NASEM) Report which was commissioned to provide data to help the FDA develop its regulatory plan. The NASEM conclusions, Dr. Rigotti pointed out, are also useful in guiding clinicians when their tobacco-using patients wish to use e-cigarettes as cessation aids, a use which is not yet sanctioned by the FDA.
U.S. and International Public Health Responses
Dr. Rigotti also praised the American Cancer Society for being the first U.S. public health organizations to issue a public statement on the use of e-cigarettes for cessation, in February 2018.
Other speakers shared international experience and data on the use and regulation of e-cigarettes in other countries, which varies widely; regulatory and/or scientific bodies in the United Kingdom and New Zealand have openly endorsed the use of e-cigarettes among adults who are attempting to stop or even reduce their consumption of combustible tobacco while others countries, such as Australia, have banned their sale. A casual observer might well take away the general impression that tobacco control’s scientific and policy leaders are growing more comfortable with the use of at least certain e-cigarette products, in certain situations.
However, there is still no shortage of controversy over the use and regulation, and particularly the unintended consequences, of e-cigarettes. Matt Myers, President of the Campaign for Tobacco-Free Kids, and others pointed out that allowing novel and unstudied products to lure youth to a priori use would not constitute a public health victory, and in fact could erode decades of hard-won progress.
While e-cigarettes were first developed by small entrepreneurial concerns, some of which at least claimed to have a public health goal, the large tobacco companies, which now through acquisition control a significant portion of e-cigarette sales, cannot be trusted. The case of Juul, which is independently owned and has recently become popular among both teens and adults in the US, was repeatedly cited as both a potential hazard (for increasing use of nicotine by youth) and a potential benefit (for its role in reducing combusted cigarette use among adults).
The sixth UK E-Cigarette Summit will take place on Thursday 15th November, at The Royal Society in London.