Quit For Good, a non-profit organization promoting harm reduction in the Philippines, recognized the United States’ intensified campaign on preventing the youth from consuming nicotine products, but said it should also focus on helping millions of adult American smokers who deserve better alternatives to cigarettes.
“The Food and Drug Administration’s Center for Tobacco Products [CTP] should strike a balance between protecting the youth while giving adult smokers access to far less harmful, smoke-free alternatives to cigarettes such as vapes, heated tobacco, and nicotine pouches,” said Dr. Lorenzo Mata Jr., president of Quit for Good.
Mata, a Filipino physician, issued the statement in response to the speech of CTP Director Dr. Brian King at the recent Global Tobacco and Nicotine Forum (GTNF) in Seoul, South Korea that despite US considerable progress in reducing smoking, about 11.5 percent of US adults continues to use combustible cigarettes.
“We’re now down to 11.5 percent among US adults, which is remarkable, and I hope that we continue to see those declines, given that we do know that combustible smoking is responsible for the overwhelming burden of death and disease from tobacco,” said King.
King confirmed, however, the US government continues to spend a considerable amount of money to the tune of $600 billion a year to address the direct healthcare costs and lost productivity because of smoking.
“There is also a financial benefit for us to continue to focus on reducing combustible use in the United States, which is why we are currently pushing forward hard on various product standards and other efforts to ensure that we are able to do that in a meaningful way,” he said.
Mata said that despite the CTP’s acknowledgment that combustible cigarettes are to blame for many of the preventable diseases in the US, it continues to impose strict regulations on smoke-free alternatives that will significantly reduce the positive impact on health and lower healthcare expenses by the Federal government.
“Science supports tobacco harm reduction, which can save smokers’ lives. While the FDA has taken an independent policy from the World Health Organization which continues to demonize these innovative products, it is time for the US to make a significant stride against smoking by promoting, instead of restricting, these products as alternatives to cigarettes. This is what the UK does,” said Mata.
Mata said while US regulators have legitimate concerns over youth vaping, proper regulation and enforcement, instead of restriction, would address the situation. “A balanced policy will protect the youth and help adult smokers at the same time,” he said.
The CTP, a young office under the FDA, is working on foundational rules at present. “We’re focusing on combustibles because again we know those are responsible for the overwhelming burden of death and disease,” King said.
“As we’ve announced, the intent is to focus on cigarettes and certain other combustibles, given the known risks related to those products, and we anticipate that that will follow in the coming months once the other product standards are finalized,” he said.
The CTP agreed that the tobacco landscape is diversifying, as the US now also regulates e-cigarettes as tobacco products. The initial Tobacco Control Act in 2009 gave CTP authority over products containing nicotine.
“Right now, we have the ability to regulate all products containing nicotine regardless of the source, and that is thanks to a new law that Congress passed in 2022. We have been working feverishly over the past year to ensure that we are able to fold in those synthetic nicotine products into our portfolio of regulation,” he said.
King, an epidemiologist, agreed that science should support CTP’s decisions. “As I noted earlier, we also continue to fold in the non-tobacco nicotine work into our broader portfolio around regulation,” he said.
King noted that the number of children using e-cigarettes in the US has decreased by half since 2019. “We’re now seeing about half the number of kids currently using e-cigarettes as we did at that peak in 2019, which is a good thing. And I hope to continue to see that proceed forward. But on balance, we also have over 2 million kids using these products, and there’s still room to go in terms of reducing that use,” he said.
The CTP is in charge of approving premarket tobacco product applications (PMTAs) from the different companies manufacturing tobacco products, vapes and other electronic nicotine delivery systems. It also oversees the public health communication of the relative risks of e-cigarettes and safer nicotine alternatives.