June16 - Research Message

Food and Drug Administration Announces Regulation of E-Cigarettes
Kim Horn Responds

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The new FDA regulations for e-cigarettes and other Electronic Nicotine Delivery Systems (ENDS) permit regulation of manufacturing, packaging, labeling, advertising and distribution, which beforehand occurred without oversight. Without regulation, consumers cannot be certain what they are smoking or the potential harm. With regulation, products will be reviewed before they hit the market, misleading claims can be minimized, the ingredients will be known and the facts about risks (or benefits) can be communicated to the public. But debate over these regulations persists among public health experts. While most public health experts (and some e-cigarette companies) support regulation, there is concern among others that the heavy burden and cost of regulatory compliance will put most e-cigarette companies out of business (perhaps all except those that are owned by the tobacco industry). One might ask, why is this a problem?

A majority of cigarette smokers try e-cigarettes as a step toward quitting or switching from cigarettes; some succeed. In the absence of complete cessation, which is not achieved by most cigarette smokers who try to quit, e-cigarettes are a less harmful choice.  Studies show, for example, that e-cigarettes deliver nicotine without the harmful tar and chemicals in combustible cigarettes that cause cancer.

Proponents of e-cigarettes argue the FDA must assure that regulations do not diminish innovation in cessation by putting product makers out of business, especially those smaller companies not owned by the tobacco industry. The UK, in fact, as endorsed by Royal College of Physicians, has embraced e-cigarettes as a cessation tool emphasizing that getting just a small percentage of cigarette smokers to switch to e-cigarettes could change the health of generations. Few dispute that preventing the use of tobacco or ENDS among youth in any form is the best first course of action. We continue to struggle, however, with effective tools to help those were not aided by our prevention efforts and those, who despite their best efforts, repeatedly fail to quit smoking cigarettes.

The science on e-cigarettes is young and we clearly don't know all the answers. As the science unfolds, regulation is a necessary step to better understand the possible benefits of e-cigarettes while minimizing the harm.

Here at Milken Institute SPH, we’re participating in the discussion. In March 2016, Brian King, PhD, MPH, deputy director for research translation with the Centers for Disease Control and Prevention’s Office on Smoking and Health, gave the keynote address for the school’s Research Days. His talk, “Public Health Promise or Peril? The Rise of E-Cigarettes,” focused on e-cigarette’s implications for tobacco control policy, planning and practice.

The school is also leading the way with cutting-edge tobacco research by faculty and students to understand tobacco use and develop prevention and cessation strategies that work. This can be seen in the recently launched DC Metro Tobacco Research and Instruction Consortium (MeTRIC), a partnership of DC-based experts in tobacco control, housed at the school. Additionally, at the 21st annual meeting of the Society for Research and Nicotine and Tobacco, nine students and two faculty members presented a total of 15 abstracts – a school record. The research, some conducted through MeTRIC, addressed a number of problems related to nicotine addiction and factors that may help more people, especially teenagers, to quit using tobacco. 

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