Health officials in England, like their counterparts in the United States, recognize that smoking cigarettes is the largest avoidable cause of death and disability. But, when it comes to reducing cigarette smoking and encouraging people to use something less harmful, such as electronic cigarettes, England is leading the way.
E-cigarettes are battery-operated devices that vaporize a flavored liquid, usually propylene glycol, which is found in inhalers, and enables the user to mimic smoking, but without the harmful combustion. Although the liquid usually contains varying amounts of nicotine, it can be sold without it.
In July 2017, England’s Department of Health announced its tobacco-control plan, “Towards a Smokefree Generation.” The report recognized that while England has made great strides in reducing smoking, more needed to be done. Part of DOH’s strategy to achieve a smoke-free generation is to permit innovative technologies that minimize harm and maximize “safer alternatives to smoking.” England’s health officials recognize quitting smoking is the best alternative, but evidence is becoming increasingly clear that e-cigarettes are significantly less harmful to health.
As a result, the “government will seek to support consumers in stopping smoking and adopting the use of less harmful nicotine products.” Public Health England has produced guidance for employers and organizations that want to implement policies around e-cigarettes and vaping, recommending that e-cigarettes should not be covered by smoke-free legislation or be part of a smoke-free policy.
The 2017 plan followed up on the Royal College of Physicians’ April 2016 report, which found that e-cigarettes appear to be both an effective aid to quitting smoking and a safer alternative to smoking and are much more popular than nicotine replacement therapy.
This kind of progress is lacking in the United States. Although vaping products began to appear on the U.S. market in 2007, instead of grandfathering them under the authority provided in the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration chose to deem them a new tobacco product. As a result, e-cigarette manufacturers must submit complicated and expensive pre-marketing review applications, which would eventually force most of them out of business.
In July 2017, under FDA Commissioner Scott Gottlieb, the agency started to take a different path, announcing a comprehensive plan to shift the trajectory downward of tobacco-related disease and death and to better protect kids. Included in the plan was a part ensuring a balance between regulation and encouraging the development of innovative tobacco products that are less dangerous than cigarettes. The FDA modified the time frame for submitting review applications for electronic nicotine delivery systems, such as vaping products, from August 2018 to August 2022.
This delay postpones the problem instead of solving it. Unless Congress acts to change the Family Smoking Prevention and Tobacco Control Act and regulatory requirements for e-cigarettes, most of these products will not be on the market in four years.
There has been a great deal of focus on the use of e-cigarettes by young people and whether they are a gateway to smoking. This has been part of the argument for strict regulation of these products. Under federal law, it is illegal for children 18 years and younger to purchase them.
The good news is the Centers for Disease Control and Prevention reported on June 8 that the use of any tobacco product is down among all youth. While the use of e-cigarettes remains the most commonly used tobacco product for high schoolers, the rate was 11.7 percent in 2017, below the 2015 high of 16 percent, and less than half of the 2011 level of 24.2 percent of high schoolers using any kind of tobacco product.
These figures belie the notion there is a youth vaping epidemic and reiterate the need for balanced FDA regulation and congressional action to help smokers move to less risky tobacco products, just as it is occurring in England. Switching from combustible cigarettes to e-cigarettes is not a simple transition. Ease of use, size, attractiveness of the product, and yes, flavors play a large role in getting adult smokers to change over.
Smokers should have access to harm-reduction products such as e-cigarettes. The government should not be making it harder for them to do so.
Elizabeth Wright is director of health and science policy at Citizens Against Government Waste.
Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.