The U.S. Surgeon General is due to release a report on e-cigarette use today. Jeff Stier, director of the Risk Analysis Division at the National Center for Public Policy Research, a nationally-recognized authority on e-cigarette policy, says the topic should be of particular interest as the Trump transition team considers key appointments at the U.S. Food and Drug Administration (FDA), as well as when the time comes to appoint a new Surgeon General.
Dr. Vivek H. Murthy’s report concurs with the research consensus that e-cigarettes are less harmful than cigarettes because they don’t combust. But he said there isn’t enough evidence supporting the effectiveness of e-cigarettes as an aid for quitting conventional cigarettes. His report concludes that e-cigarette use among young people is strongly associated with the use of other tobacco products, including traditional cigarettes.
In anticipation of the release, Stier says, “If Surgeon General Murthy only addresses the serious risks of e-cigarette use by minors, something we all agree on, but fails to provide much-needed education about their benefits to adult smokers who would like to quit, he’ll have missed an important opportunity.”
Murthy writes in his report that e-cigs “are now the most commonly used form of tobacco among youth in the United States, surpassing conventional tobacco products, including cigarettes, cigars, chewing tobacco and hookahs.” The report claims that the use of e-cigarettes among high school students increased by 900 percent from 2011 to 2015.
Further, says Stier, “If the Surgeon General goes on to make policy recommendations based only on the risk part of the equation, without considering the benefits, he will have failed his fundamental obligation of improving public health. Without a deep and thorough analysis of the issue, the Surgeon General’s approach becomes little more than platitudes.”
In the report, the Surgeon General called for federal, state and local action immediately, such as including e-cigarettes in smoking bans as well as significant increases in taxes and the price of e-cigarette products.
While Murthy raised concerns about flavors that appeal to young users—such as gummy bear, cotton candy and chocolate—he stopped short of recommending restrictions on flavoring. The FDA has said it is looking at flavors that might appeal to youth.
The Surgeon General would have been wise to adopt the clear approach used by the Royal College of Physicians in its landmark report last year, by saying, “It’s very simple: adult cigarette smokers who switch to e-cigarettes dramatically reduce their risk, by using nicotine without smoke,” according to Stier.
That report avoids mentioning the role e-cigarettes most likely played in reducing combustible cigarette smoking by youth and young adults. Vaping among young adults between 18 and 24 years old more than doubled from 2013 to 2014, according to the report, while cigarette use has plummeted. However, it does note older adults are more likely to report using e-cigarettes to wean themselves off conventional cigarettes.
Murthy also writes that nicotine can damage the developing teen brain while leading to addiction. “Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure.”
“This is just another politically motivated attack on an industry that is helping people to quit,” said Gregory Conley, president of the American Vaping Association, an vapor advocacy group.