The name Scott Gottlieb may not mean much to most smokers, but he is the man behind a major push to wean people off cigarettes. Gottlieb is the new head of the US Food and Drug Administration (FDA), and earlier this year he outlined plans for non traditional cigarettes, with manufacturers of electronic cigarettes being granted four additional years to provide information on current and future products to gain FDA approval.
Rather than having to provide the relevant information in 2018, they now have until 2022. It is being widely hailed as a pro-active, ambitious and forward-thinking strategy which aggressively seeks to reduce the 480,000 deaths caused every year in the US from tobacco, while also embracing the popularity of electronic cigarettes as a far less harmful alternative and a viable quitting tool.
The irony, of course, is that nicotine represents both the problem and the solution for Gottlieb, given that it is prevalent in both traditional and electronic cigarettes. Yet with electronic cigarettes being hailed as some 95 per cent less harmful than traditional cigarettes, the consequences of using them for a nicotine hit pales in comparison to conventional smoking.
“Our approach to nicotine must be accompanied by a firm foundation of rules and standards for newly-regulated products,” Gottlieb said. “To be successful all of these steps must be done in concert and not in isolation.” In another step forward, the FDA also created the Nicotine Steering Committee at the end of November, charged with modernizing their approach to nicotine replacement therapy products.
But this part of the plan does have its critics. Many fear that smokers could simply end up smoking more to satiate their nicotine craving. “The idea of gradually reducing the addictive ingredient of cigarettes, nicotine, looks attractive on the surface,” said Robert West, professor of health psychology at University College London. “But unless nicotine is pretty much eliminated quickly and comprehensively in all available tobacco products – which seems unlikely – it runs a serious risk of making things worse as smokers smoke cigarettes harder in order to get the nicotine they need, leading to more exposure to the harmful tar.”
The one area which does appear to be drawing near-universal praise is the alteration of the deadline for electronic cigarettes.
One study, published in the journal Tobacco Control, suggested that electronic cigarettes could prevent as many as 6.6m premature deaths in the US. World-wide, vaping is now being seen as a key ingredient in reducing smoking numbers – particularly with the concept of harm reduction providing the backbone of a number of countries’ smoking reduction policies. And recently, UK experts of the Committee on Toxicity published a study showing that heat-not-burn products were also less harmful than combustible cigarettes.
For that reason, anti-smoking bodies see the relaxation in deadlines for electronic cigarette manufactures as a positive step. “That is really good,” said the UK Centre for Tobacco and Alcohol Studies’ deputy director Linda Bauld. “The previous deadline meant a lot of e-cigarettes in the market were going to disappear.” Deborah Arnott, chief executive of public health charity ASH, was also positive. “We have long recognized in this country that it’s not the nicotine but the smoke in cigarettes which makes them so deadly,” she said.