For decades, Washington has mostly banned the use of federal funds for needle-exchange programs for drug addicts. The originator of the ban was uber-conservative North Carolina Sen. Jesse Helms. Although the Institute of Medicine found that providing junkies with clean needles reduced the spread of disease without increasing the level of drug use, the ban has been supported by hard-core drug warriors who prefer moral purity over public health: Better to take a firmly disapproving stand, they believe, than to get desirable results.
Last week the FDA adopted the Helms approach when it handed down nearly 500 pages of regulations tightly controlling the growing market in electronic cigarettes.
Compared to tobacco cigarettes, e-cigarettes are vastly better for you; typically they contain only nicotine and water or glycerine, and use a small battery to create nicotine vapor. Hundreds of thousands of smokers have switched from lung-wrecking coffin nails to vaping. For nicotine addicts, they could be a life-saver. That’s why Britain’s Royal College of Physicians recently declared that e-cigs could be a net public good: They can “prevent almost all the harm from smoking,” the group says.
But the FDA doesn’t care about that. The new rules contain many provisions, the most burdensome of which is the requirement that all e-cigarette products, including the vast majority already on the market, undergo an extensive approval process that will cost, at minimum, several hundred thousand dollars. That will probably drive out of business all producers except a handful of major ones, such as Altria and R.J. Reynolds — further evidence that regulation often serves powerful corporate interests as much as it constrains them.
Amazingly, however, to some people the FDA’s new rules do not go far enough. For instance, anti-smoking advocates wish the agency had prohibited the use of flavorings in vaping products. It might yet do so: “We’re looking at the flavor issue,” says Mitch Zeller, head of the FDA’s Tobacco Center.
The rationale, of course, is that flavorings make vaping products more appealing to teenagers. But they also make them more appealing to adults. If it makes sense to slash the choices available to adults to reduce the appeal of adult products to children, then the country will need to ban whole shelves full of flavored liqueurs — not to mention hard ciders and lemonades, dessert wines, and similar beverages. Can’t be too careful, can you?
Nicotine is a powerful substance — and fatal in large doses. It needs regulating. But the FDA’s punitive, puritanical approach goes well beyond what is necessary to protect public health. Indeed, it goes so far that it is likely to undermine public health by making a safer alternative to smoking more expensive and harder to get. Still, it sends a very clear message of stern disapproval. Jesse Helms would be proud.