FDA’a Regulatory Dilemma on e-Cigarettes
September 18th, 2018 // 2:13 pm @ jmpickett
Many experts in the FDA regulatory industry say that FDA has a serious regulatory issue on its hands with e-cigarettes. In a sense, the US government may want to encourage people to use e-cigarettes; if e-cigs were to replace cigarettes entirely, it is certain that this would save lives and billions of dollars in medical bills. But claims are rising that e-cigarettes appeal to young people. Some argue that e-cigs could serve as a gateway to smoking cigarettes. If that is true, then e-cigs could actually be detrimental to public health.
FDA thinks that e-cigarette companies are advertising their wares to teens, especially flavored products. FDA also argues that teens could progress to smoking regular cigarettes. But FDA also has said that it recognizes the important role that e-cigs can play in helping people to quit smoking. It has mentioned the tradeoff between stopping youth from smoking and hindering grown ups from quitting if FDA lowers the boom on e-cigarettes. FDA recognizes the regulatory decision that they need to make boils down to economics and math.
The Math on E-Cigarettes and Cigarettes
It is estimated that 15% of adults in the US smoke cigarettes. Each year, about 50% of smokers try to quit. With the help of e-cigs, 20% of people who try to quit do so. Without e-cigs, 12.5% succeed. The higher level of success in quitting smoking with the use of e-cigs means that e-cigs increase the number of smokers who quit every year by 4%. That means there are 1.5 million more smoking quitters every year because of e-cigs.
Only 8% of children in high school smoke, and 14% use e-cigs. Non-smoking teenagers have about an 8% chance of turning to cigarettes in six months. But if they use e-cgs, the chance of starting to smoke rises to 30%. This means that 3% more teenagers will try regular smoking because of e-cigs. Based upon 16 million youth in high school, this means about 500,000 more teenaged smokers every year.
Following this math, the balance on e-cigs is 1.5 million smoking adults became ex-smokers, compared to 500k teens who are trying smoking because of e-cigs. If you value all smokers the same regardless of age, the e-cigarettes are a positive for public health. But if you value stopping teens from smoking at a value of three times or more that you value getting an adult to stop smoking, e-cigs have a negative effect on public health.
But is is more complex than that. About 32% of children in high school have tried a regular cigarette at least once. Compare this fact to the 8% of teenagers that smoke makes it clear that teenagers are more likely to stop smoking than adults, and could start smoking but stop quickly.
All of this suggests to many experts that FDA should use care in regulating e-cigs too strictly. Unless the agency can justify weighting new young smokers more heavily than adults who quit, cracking down on e-cigs and vaping could have a serious negative effect on public health. It appears right now that FDA is learning towards shielding teenagers from the dangers of smoking, at the expense of assisting adults to quit. We will see in the coming years how wise this calculation is.
