In the past, the FDA has been very negative towards the electronic cigarette industry, labeling e-cigs as dangerous and harmful. However, the e-cig debate has now taken an unexpected turn as one of the FDA’s former advisors recently spoke out in favor of electronic cigarettes.
Dr. Neal Benowitz is a respected professor of medicine and medical researcher. With expertise on how nicotine and tobacco impact the human body, he previously served on the FDA’s Tobacco Products Scientific Advisory Committee. In a move that shocked many, Dr. Benowitz co-authored a surprising report about electronic cigarettes that was published on the Journal of the American Medical Association’s website on July 15.
In the report, Benowitz said that electronic cigarettes “likely pose less direct hazard to the individual smoker than tobacco cigarettes and might help smokers quit smoking or reduce harm by smoking fewer cigarettes.” This was a monumental moment for many e-cig fans, to actually have a prestigious member of the medical community linked to the FDA speak out in favor of e-cig use for smoking cessation.
While Benowitz did not completely endorse e-cigs, it is a big step that he acknowledged the possibility that they could be effective for smoking cessation. Of course, he balanced this statement by pointing out that e-cigs do also have potential risks. He speculated that they could promote continued smoking behaviors or reduce the current social stigma related to smoking.
In some cases, smokers might choose to use e-cigarettes as a permanent alternative to e-cigs, but in a lot of instances, they are simply a gateway to stop smoking completely. Even when people have continued use of e-cigs, Benowitz still felt confident enough to say that e-cigs probably were less hazardous than tobacco cigarettes would be.
Benowitz is currently a member of the Pfizer Smoking Cessation Medication Advisory Board. He has also served as a consultant for two pharmaceutical companies in the past. His stance in the recent report was surprising and courageous, considering that e-cigarettes could actually be a competing product for pharmaceutical nicotine replacement if the FDA were to ever approve them for use as smoking cessation products.
Still, the recent report by Benowitz acknowledged that current nicotine replacement products just were not working. Smokers do not find them satisfying because they don’t offer the opportunity for inhaled nicotine. That is why he believes e-cigarettes could be a plausible option.
“The possibility of an inhaled clean-nicotine device has been discussed by health researchers for many years as a potentially more effective way to promote smoking cessation.” He went on to say that even though e-cigs have not been approved for use as a smoking cessation product, they are often perceived as such and in turn, they have worked to help some smokers quit in the same way medical researchers hoped an inhaled nicotine delivery system would.
Of course, every e-cigarette is different. Benowitz reports that with more than 250 e-cig brands available today, it’s hard to really generalize the benefits or consequences of e-cigarettes as singular device. “Different e-cigarette brands are engineered differently, affecting the character and potential toxicity of the vapor,” he said.
Benowitz went on to call for future regulations of all nicotine containing products. In the UK, new legislation recently passed allowing e-cigarettes to be regulated as medication starting in 2016. The regulations will allow e-cig companies to market their products for smoking cessation, however they will have to meet strict criteria. The US could potentially follow suit if the FDA would ever determine e-cigs are an effective option for smokers who want to quit.
In the aftermath of the report, reactions have been mixed. Carl Phillips works as the scientific director of the Consumer Advocates for Smoke-Free Alternatives Association. He remarked that he was happy that Benowitz took a positive approach towards e-cigarettes, but he also fears that regulating e-cigarettes as medical devices would hinder innovation.
John Spangler is a professor of family and community medicine at Wake Forest School of Medicine in North Carolina. After reading the report, he had mixed feelings. On one hand, he said if e-cigs were scientifically proven to decrease tobacco exposure, he would support their development and marketing. But he’s not so sure that e-cig ads are making a positive impact on society as a whole. He said, “E-cigs might normalize or glamorize smoking because e-cigs look like regular cigarettes, and people will see others/celebrities smoking them.”
Another medical professor argued that claiming e-cigs could be a gateway to cigarette smoking is really just speculation. Brad Rodu works as a smokeless tobacco advocate and he is also a professor of medicine at the University of Louisville. He believes that all the hype about e-cigarettes acting as a gateway to tobacco use is “unsubstantiated and hypothetical.”
Scott Ballin put it all in perspective. As the past chairman of the Coalition on Smoking or Health, he believes e-cigs need to be regulated quickly to insure that they are safe and effective. He urged the FDA, manufacturers, and researchers to all work together to get e-cigs regulated and approved.
“Meanwhile, cigarettes are killing 1,205 Americans every single day… We should be encouraging innovation and the development of new low-risk products, not suppressing them.” Ballin continued by saying, “The public needs and deserves access to these products. Not making these products available under a regulated system could be a public health disservice.”
Ultimately, the new report by Benowitz is a positive step for electronic cigarettes. It’s a huge moment when someone so highly respected in the medical community publicly acknowledges the potential benefits of e-cigarettes for smokers. In a small way, Benowitz is backing what many former smokers have been saying for years. E-cigs are a better choice than tobacco cigarettes and they could help you quit smoking.
Do you agree with Benowitz that e-cigarettes need to be regulated? How will the report impact future FDA interactions with American e-cig companies?