Nicotine Policy Should Not Be Exempt From Science

Jeff Stier

May 4, 2020

There seems to be an inclination among policy-makers that adherence to evidence-based policy-making is a luxury we can only afford when not in a crisis.

After the U.S. Food and Drug Administration and Centers for Disease Control bungled last year’s “EVALI” outbreak, one might have thought federal officials would have exhibited some humility. Or at least limited their statements to those supported by science.

But when it comes to tobacco and vaping policy, that’s just not the case.

According to a March 27th article in Bloomberg News, titled, Vaping Could Compound Health Risks Tied to Virus, FDA Says,” 

People with underlying health issues, such as heart or lung problems, may have increased risk for serious complications from Covid-19,” Michael Felberbaum, an FDA spokesman, said in an email Friday in response to questions from Bloomberg. This includes people who smoke and/or vape tobacco or nicotine-containing products.” “E-cigarettes can damage lung cells,” Felberbaum said.

The article went on to report that “Some health experts have speculated that vaping is causing younger patients in the U.S. to be hospitalized with Covid-19 at a higher rate than anticipated.”

It’s true. There’s plenty of speculation.  Among those speculating was New York Cirty Mayor Bill DeBlassio. Back on March 8th, the mayor of the city which would go on to have the worst Covid-19 outbreak in the world, stated that If you are a smoker or a vaper that does make you more vulnerable” to coronavirus. Note that this was three days before the mayor advised that New Yorkers who are not sick “should be going about your life,” and frequenting restaurants.

The FDA’s claim that vapers with underlying conditions “may have increased risk for serious complications from Covid-19” is just about as useful as stating that people whose last name begin with the letter “Z” who have underlying conditions “may have increased risk for serious complications from Covid-19.”

Actually, with regard to the allegation against vaping, it’s not only useless, it’s harmful. The FDA’s unsupported allegation is likely to cause vapers to go back to smoking.

In fact, in the same article, Bloomberg reported, “E-cigarettes have been touted by some as less risky than smoking. But any increased harm associated with Covid-19, and the FDAs direct language linking the products to lung damage, could boost detractors who have raised questions about the potential that vaping can lead to health problems.”

And boost detractors it did.

As if on cue, on April 1st, a House oversight committee wrote to the FDA requesting that that the agency immediately remove all e-cigarettes from the market because their presence during this period would “exacerbate the coronavirus crisis.”    

It took more than two weeks, and a scathing letter from scientists, policy experts and Iowa Attorney General Thomas Miller for the FDA to attempt to put the genie back in the bottle. In a statement to Bloomberg, the FDA wrote that whether vaping increases the risk of Covid-19 “is not known.” 

For two critical weeks during the early days of the Covid-19 outbreak in the U.S., the agency tasked with using science to regulate tobacco products and e-cigarettes, issued and allowed stand a false statement about e-cigarettes and Covid-19, even though it knew of no evidence to support the statement.

Since the onset of Covid-19, conventional wisdom has been that smokers are more susceptible to worse outcomes from Covid-19 because of the damage smoking inflicts on the lungs.

So the idea of making baseless statements and potentially removing vaping products from the marketplace in the midst of the crisis seems like an exceptionally reckless idea, as it would send countless former smokers back to cigarette smoking. 

Already, former smokers are struggling to get their preferred alternative to widely-available cigarettes. Some e-cigarettes are available in convenience stores, but federal and state crackdowns and looming regulatory bans have already significantly reduced the range of choices available outside of vape shops— which states generally don’t deem essential businesses. If smoking makes Covid-19 worse, the essential nature of vape shops should be obvious.

While much is unknown about Covid-19, there seems to be one point that most scientist and policy-makers seem to agree upon, at least in principle. Policy should be confined to the evidence. There’s no reason policy related to nicotine products should be any different.