FDA Commissioner Scott Gottlieb’s Resignation Leaves the Future of Vaping Regulation Hazy
Gottlieb’s exit comes at a time when he and the FDA seemed poised to take serious action against e-cigarettes
Tuesday’s abrupt resignation announcement from U.S. Food and Drug Administration Commissioner Scott Gottlieb caught the political world by surprise. It also raised concerns over an increasingly pressing subject: the future of vaping regulations in the U.S.
Gottlieb, whose tenure as commissioner will end next month, cited a long commute from his house in Connecticut and a desire to spend more time with his family as the reasons for his resignation, according to the Washington Post. His exit comes at a time when he and the FDA appeared poised to begin taking serious action against vaping. In September 2018, Gottlieb released a statement calling vaping “an epidemic” and threatened to pull the devices from the market unless manufacturers made greater efforts to combat vaping among minors.
That charged rhetoric marked a departure from earlier in his tenure, when Gottlieb was criticized by anti-smoking interests for delaying e-cigarette regulations. His change of heart appeared to have been spurred by the explosive popularity of JUUL (a company now valued at $38 billion) vaporizers among teens. While Gottlieb plans to pursue his anti-vaping agenda during his final month at the FDA, the agency’s future course on e-cigarettes—and countless other issues—will largely be determined by his (yet-to-be-named) successor.
Although e-cigarettes do not contain tobacco, the nicotine they deliver is derived from the plant. E-cigarettes like JUUL deliver especially high doses of nicotine, which is is, of course, highly addictive. Gottlieb cited specific concerns about the popularity of e-cigarettes among young people. A recent study revealed a 78-percent rise in e-cigarette use among high school students in the United States from the previous year. Another 2019 survey of 6,000 American youths reported that young people who start vaping are four times more likely to also start smoking cigarettes. Studies have shown that e-cigarette refill fluid, regardless of nicotine content, is toxic to human cells. “I will not allow a generation of children to become addicted to nicotine through e-cigarettes,” Gottlieb said in November.
“It seemed like he was getting very close to taking some tough action.”
Proponents of e-cigarettes as smoking cessation devices argue that the damage caused by vaping pales in comparison to smoking traditional cigarettes. While the American Heart Association and the Center for Disease Control and Prevention both agree that e-cigarettes may be safer when used as a complete replacement for traditional smoking, research has found that e-cigarettes are not particularly effective tools for helping people quit and that cigarette users often combine smoking cigarettes with vaping instead of using the latter to completely replace the former, thus mitigating the health benefits.
“I’ve been very critical of [Gottlieb] for talking more than he’s doing,” says Stanton Glantz, a professor of medicine at University of California San Francisco Center for Tobacco Control Research and Education. “But if you look at where he and the agency were a year ago and compare it to today, it seemed like he was getting very close to taking some tough action.” While there was no definite timeline for implementing new regulations, Gottlieb had proposed limiting sales of flavored vaporizers and menthol cigarettes, cracking down on online retailers, and eventually reducing nicotine content in traditional cigarettes to minimally or nonaddictive levels.
Such steps would pose a significant blow to the American tobacco industry, which has surged on the back of the growing e-cigarette market. The CDC reports that e-cigarette sales grew 14.4 percent in 2014–2015, and a September 2018 report by Research and Markets estimated that the global e-cigarette market would reach $44.6 billion by 2023. With a White House philosophically opposed to regulation of nearly any sort, the FDA’s move toward imposing regulations on electronic cigarettes appeared to be at odds with the larger Trump administration. While Trump did offer praise for Gottlieb in the wake of his resignation, the president’s plaudits centered on Gottlieb’s efforts to reduce drug prices—not his proposed vaping regulations.
Whether the FDA commissioner’s resignation is a signal that the Trump administration is moving away from any effort to reign in the tobacco and e-cigarette industries remains to be seen. Following the announcement, however, Altria, the corporate parent to tobacco giants Phillip Morris and Nat Sherman (and a major investor in JUUL), saw its stock price rise 0.8 percent yesterday, and 0.8 percent as of press time today. British American Tobacco has also seen a roughly three-percent increase in stock price since the announcement yesterday. The implication seems clear: The markets are cautiously optimistic that Gottlieb’s exit could indicate that any regulations may be further delayed or scrapped entirely.
Gottlieb’s characterization of vaping as a teen “epidemic” is supported by data. A 2016 report by the surgeon general concluded, “In 2014, current use of e-cigarettes by young adults 18-24 years of age surpassed that of adults 25 years of age and older,” and, “E-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, including combustible tobacco products.”
In his September 2018 announcement, Gottlieb issued a stern warning to Big Tobacco: “The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products,” he said. But that warning—and that regulatory agenda—is now in danger.
“I think [Gottlieb] was genuinely concerned about the problem of e-cigarettes in kids,” Glantz says. “Especially compared to everybody else in the Trump administration, he certainly was paying more attention to the science. Why he left so suddenly, I have no idea.”