Only two years ago, electronic cigarettes were viewed as a small industry with big potential to improve public health by offering a path to steer millions of smokers away from deadly cigarettes. Today Juul and hundreds of smaller companies are at the center of a political backlash that threatens to
1 / 4Vaping Backlash SmokersFILE - In this Feb. 20, 2014, file photo, a patron exhales vapor from an e-cigarette at a store in New York. Only two years ago e-cigarettes were viewed as holding great potential for public health: offering a way to wean smokers off traditional cigarettes. But now Juul and other vaping companies face an escalating backlash that threatens to sweep their products off the market.
"This could take us from potentially the single biggest improvement in public health in the United States toward a public health disaster in which cigarettes continue to be the dominant nicotine product," said Jonathan Foulds, an addiction researcher and tobacco specialist at Penn State University. On Friday, the Food and Drug Administration specifically warned the public not to vape THC or purchase any vaping products off the street.
E-cigarettes generally heat a flavored nicotine solution into an inhalable aerosol. There is little research on the long-term effects of inhaling the chemicals in vaping, such as vegetable glycerin. Despite those unknowns, most experts agree e-cigarettes pose a much smaller risk than cigarettes, which cause cancer, lung disease and stroke and account for some 480,000 U.S. deaths each year.
The U.S. FDA has been struggling to find the right approach since it gained authority over e-cigarettes in 2016. A smoker since age 16, Adams was rushed to the hospital in April when a coughing fit left her struggling to breathe. Doctors diagnosed her with chronic obstructive pulmonary disorder, or COPD, and told her she needed to quit cigarettes.
But some public health advocates fear less motivated ex-smokers will simply return to cigarettes. Even with the success of Juul, e-cigarettes remain a tiny slice of the U.S. tobacco market, accounting for $8.6 billion in sales compared to $95 billion for cigarettes, according to Euromonitor. As FDA chief, Gottlieb outlined an ambitious anti-smoking plan intended to shift most of the nation's 34 million smokers away from cigarettes and toward less risky products. The unprecedented plan involved a two-step process: cutting nicotine in traditional cigarettes to make them virtually nonaddictive and then promoting FDA-sanctioned, lower-risk alternatives, such as e-cigarettes.
The FDA says it remains committed to Gottlieb's vision of lower-nicotine cigarettes and less-harmful alternative products. The agency's regulatory calendar lists this month as the target date to release its proposal for regulating nicotine. But that effort will take years to implement and will almost certainly face lawsuits from tobacco companies.
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