The Healthcare Policy Podcast ® Produced by David Introcaso Are Federal Regulators Panicked Over the Increased Use of E-Cigarettes Among Adolescents: A Conversation With Prof. David Abrams (April 23rd)
The e-cigarette market, or what the FDA formally terms Electronic Nicotine Delivery Systems or ENDS, has grown since 2004 to approximately 11 million American consumers. Recent survey data published in February in JAMA has shown use of e-cigarettes (or vaping) among underage youths or middle and high school students has increased significantly since 2011. Beyond potentially serving as a gateway to the use of combustible or tobacco cigarettes, there is research to suggest nicotine can harm developing adolescent brains and the exhaled aerosol can also pose a public health threat. Beyond the significant increase in under age use there is also concern recent investments in the e-cigarette industry by tobacco manufacturers, specifically Altria's December investment in e-cigarette manufacturer, JUUL, will result in e-cigarette users transitioning to tobacco cigarettes. Recently resigned FDA Commissioner, Scott Gotlieb, made e-cigarette regulation a priority throughout his two-year tenure. The question begged is will FDA's e-cigarette regulatory actions prove productive, will they prevent or inhibit current and future consumers of nicotine from taking up of combustible/tobacco cigarettes and/or allow or encourage current tobacco cigarette consumers to transition to e-cigarettes a far safer product.
During this 30 minute conversation Professor Abrams critiques the evidence to date that rising use of e-cigarettes among middle and high school students is necessarily a cause for concern, i.e., that e-cigarettes or vaping is a gateway to use of combustible or tobacco cigarettes. We briefly discuss how underage youths are able to acquire e-cigarettes. Moreover our discussion focuses on related regulatory actions under the FDA, i.e., is limiting access and use of e-cigarettes or youth addition to nicotine commensurate with the potential massive public health gain. Are these actions commensurate with the potential to reduce adult combustible cigarette use that remains the leading cause of preventable death in the US at nearly half a million deaths per year (and estimated to kill 1 billion throughout the world this century). We also discuss Altria (manufacturer of Marlboros) recent $13 billion investment in JUUL, the leading e-cigarette manufacturer or what it may mean, reducing nicotine content in cigarettes, raising the minimum age requirement from 18 to 21 to buy tobacco cigarettes and related issues.
Dr. Abrams is currently Profess of Social and Behavioral Sciences at New York University. Dr. Abrams was a professor and founding director of the Centers for Behavioral and Preventive Medicine at Brown University Medical School. He then directed the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). Until 2017, he was Professor of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health and the founding Executive Director of the Schroeder National Institute of Tobacco Research and Policy Studies at Truth Initiative (formerly the American Legacy Foundation). Dr. Abrams has published over 250 peer reviewed scholarly articles and been a Principal Investigator on numerous NIH grants. He is lead author of The Tobacco Dependence Treatment Handbook: A Guide to Best Practices. He has served on expert panels at NIH and National Academies of Sciences, Engineering and Medicine on Obesity, Alcohol Misuse and Ending the Tobacco Problem: A Blueprint for the Nation. He has also served on the Board of Scientific Advisers of the National Cancer Institute (NIH-NCI) and was President of the Society of Behavioral Medicine.
For information concerning the FDA's regulation of tobacco products go to: https://www.fda.gov/TobaccoProducts/default.htm
The JAMA studied discussed during this interview, "The Association of Electronic Cigarettes Use with Subsequent Initiation of Tobacco Cigarettes in US Youths," is at:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723425
Concerning Prof Abrams recent related research see: https://www.clivebates.com/documents/AbramsFeb2019.pdf and https://www.sciencedirect.com/science/article/pii/S0091743518301981?via%3Dihub
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com