FDA Chief Scott Gottlieb Strikes Right Tone on E-Cigarettes

There's no doubt about it. E-cigarettes have the potential to save millions of lives.

What makes smoking so dangerous isn't the nicotine, per se. Nicotine is an addictive alkaloid, just like caffeine. (Believe it or not, plants produce both compounds because they are insecticides.) The addiction makes people want more tobacco, but the molecule itself isn't all that harmful.

Tobacco is lethal because of the smoke. A lit cigarette releases known chemical carcinogens and tiny bits of particulate matter, which are incredibly damaging to the lungs. Setting anything on fire, not just tobacco, and inhaling the fumes is a bad idea. That's why innovative ways to get smokers to stop their habit is a top public health priority.

One such innovation is the e-cigarette. These devices deliver inhalable nicotine without all the noxious carcinogens associated with tobacco. But they aren't perfect, and it would be incorrect to call them "safe" without long-term data. They are unquestionably far safer than cigarettes, but as we wrote in Little Black Book of Junk Science, non-smokers shouldn't begin using e-cigarettes for the fun of it. And few do.

Yet enough young people say they have done just that, trying one at least once in the previous year, that FDA Commissioner Scott Gottlieb reaffirms it is a bad idea. In an interview with CNBC, he said, "If all we end up doing is addicting a whole new generation on nicotine through e-cigarettes, then we will have done a bad service to this country."

Without exception, Gottlieb believes that the FDA should be in the business of getting smokers to transition away from cigarettes to something less harmful, such as e-cigarettes or other products. That is similar to the policy taken by the UK's NHS, and it is precisely in line with ACSH's policy stance of harm reduction.

Abstinence-Only Nicotine Education

Unfortunately, other more ideologically driven public health groups are resistant to this scientific, common sense policy.

Take the King County Health Department, for example, which serves the Seattle area. It is running a public health campaign that is meant to scare people about e-cigarettes, labeling them toxic, addictive, and not safe. It ominously warns, "Don't be fooled." If smokers follow that advice, they will die. Plain and simple.

Nobody at the King County Health Department would support an "abstinence-only" approach to sex education or drug abuse. So, why would they endorse the same for nicotine education?

For far too long, ideology has trumped science in the tobacco debate. Let's hope the vision for harm reduction shared by the FDA, UK NHS, and ACSH wins the day.