It was recently announced that Dr. Brian King would lead the Food and Drug Administration’s Center for Tobacco Products. The center’s previous director retired in April, and an acting director is in place until King takes over in July.
King is the wrong choice and the FDA needs reforms, especially concerning its funding and regulation of tobacco products. While other centers at the FDA receive taxpayer funding through the congressional budget process, the CTP is solely funded by user fees paid by tobacco product manufacturers based upon a percentage of their sales. Only six classes of tobacco products are subject to user fees, and FDA has acknowledged that e-cigarettes are not subject to user fees.
This is not only lousy budgeting, but it forces the FDA to rely on cigarettes (arguably the most harmful form of tobacco) to fund research on less dangerous tobacco products before allowing consumers to use those products. As it is now, tobacco manufacturers are paying for the regulation of other tobacco products — which aren’t paying for any of their rules.
King may not be the best suited for the role. A look at what King did at his previous place of employment, the Centers for Disease Control and Prevention, shows a pattern of complete distrust of less harmful tobacco products, instances of confusing the public, and a conflict of interest in published studies. Congress should be wary of this unaccountable bureaucrat as this change in leadership comes when hundreds of thousands of novel tobacco harm-reduction products are awaiting FDA authorization.
While King may be experienced in leading CTP, given his extensive background on smoking issues at CDC, King is very distrustful of e-cigarettes and is likely to deny authorization for hundreds of thousands of pending products.
King has repeated numerous times that the e-cigarette “advertising is bringing the horse to water. The flavors are getting them to drink and the nicotine is keeping them coming back for more.” He made this analogy in 2017 and 2019.
Moreover, King has helped drive the misinformed narrative that e-cigarettes are harmful and has overemphasized the idea of “ultrafine particulate matter, volatile organic compounds and other potentially dangerous ingredients.” King has also co-authored vaping studies paid for by Michael R. Bloomberg, who donated hundreds of millions of dollars to ban flavored tobacco harm-reduction products, including e-cigarettes and smokeless tobacco.
But perhaps even more alarming (and quite scary) is that while at the CDC, King helped confuse the public to what was causing the spate of lung injuries. He did this despite knowing that a significant number of youths were already vaping tetrahydrocannabinol (THC) before the outbreak.
In February 2019, King reported that according to the then-latest survey on youth e-cigarette use “among those who currently use e-cigarettes in the past 30 days, one-third of those reported that they’ve used marijuana in an e-cigarette.”
But, in August 2019 (amid the lung injuries), King reported that “there’s a variety of harmful ingredients identified … like ultrafine particulates … (and) that a variety of individuals use a number of substances, including THC, particularly young adults, so we continue to investigate that as well.”
As of February 2020, the CDC has identified 2,688 reports of lung injury, with 82 percent reporting using THC-containing vapor products.
Congress should give King the tools needed to promote tobacco harm reduction for adults who smoke and cannot quit. King does understand that adults use e-cigarettes to help them quit smoking. They enjoy flavors, as he co-authored a 2016 study that found that 92.6 percent of then-current adult e-cigarette users were current smokers and that 84.5 percent reported using the products for “cessation/health.” Moreover, the 2016 study found that respondents aged 25 to 34 years and 35 to 54 years were more likely to cite flavoring as a reason for use than respondents 55 years or older.
Tobacco harm-reduction proponents have a reason for concern about this appointment. Congress has the more important job of getting to work to ensure adults who smoke have access to more effective products than nicotine replacement in helping them quit. And to indeed guarantee access, the FDA must be allowed to recognize and promote tobacco harm reduction.