The reaction to the U.S. surgeon general’s first-ever report on e-cigarettes has been swift and severe.
“It is truly terrible,” writes Counterfactual’s Clive Bates, a former executive director of Action on Smoking and Health.
“It’s so bizarrely bad,” said Jeff Stier, risk analyst with the National Center for Public Policy Research.
“The Surgeon General has failed the American people,” Gregory Conley, president of the American Vaping Association, said in a statement.
“Full of false, misleading, deceptive statements re #ecigs. Needs a health warning: do not read!” tweeted Derek Yach, a former executive with the World Health Organization.
The primary problem with the 298-page report — E-Cigarette Use Among Youth and Young Adults — according to critics, is that Surgeon General Vivek Murthy ignored science and addressed only risks of e-cigarette use by youth, while neglecting to include the real benefits to adult smokers.
In his scathing review, Bates called the report a “heady mix of emotive propaganda and a completely warped and one-sided account of the science.” He said the findings reveal “a lack of insight into youth behaviors,” as well as ignorance about the tobacco and nicotine market and its consumers.
Murthy acknowledged in the report’s preface that the science is indeed incomplete.
“Gaps in scientific evidence do exists,” he wrote. “[A]nd this report is being issued while these products and their patterns of use continue to change quickly.”
Neither the rapidly changing e-cigarette culture nor the dearth of sound science stopped Murthy from issuing broad policy recommendations to deal with the 900 percent growth in usage among high school students from 2011 to 2015 — “a public health concern,” according to the report.
Among other strategies, Murthy suggests incorporating e-cigarettes into smokefree policies, preventing youth access to e-cigarettes, imposing high taxes and targeting youth with educational programs.
The recommendations stem from what the report considers potential adverse health effects of direct and secondhand exposure to nicotine, chemicals, aerosol and “other particulates.”
While no one thinks young people should use nicotine products, critics say the report fails to show actual harm. “Is this a big deal or not? We have no way to know,” Bates wrote.
He notes that mere exposure to chemicals isn’t enough to show harm, and added that the report “ducks the issue” of whether actual e-cigarette use has negative health effects.
Stier echoed those concerns: “If the surgeon general goes on to make policy recommendations based only on the risk part of the equation, without considering the benefits, he will have failed his fundamental obligation of improving public health.”
Dr. Edward Anselm, senior fellow a the R Street Institute, says use of cigarettes and e-cigarettes is at an all-time low. He also highlighted a link between the two: “Young people who try e-cigarettes are more likely to experiment with other adult behaviors, including smoking. If there were no e-cigarettes, they would go straight to smoking.”
University of Michigan researcher Dr. Ken Warner says the surgeon general ignored a landmark study from England which could be a game-changer for the United States.
“The Royal College of Physicians issued a report in which they concluded that e-cigarettes were likely 95 percent less dangerous than smoking, and should be used by smokers to try to get off of cigarettes, if they have been unable to do so otherwise,” Warner told Watchdog.org.
“The difference in conclusions between these two reports is amazing,” he said.
Warner says the United Kingdom takes a completely different approach to e-cigarettes, viewing vaping as an aid to quit smoking.
“In the U.S., e-cig companies are not even permitted to advertise that their products are less dangerous than smoking because they haven’t gone through the FDA approval process to do so,” he said. “Most of the companies don’t have the resources necessary to get that approval, which requires a long, laborious, and very expensive effort, with no assurance of approval.”
The timing of this report could be fortuitous, as President-elect Donald Trump’s transition team is considering candidates for the next commissioner of the Food and Drug Administration. The next FDA chief could radically overhaul the agency and upend the huge regulatory regime that includes the recent rules on the e-cigarette industry.
Top names under consideration are Jim O’Neill, a former Health and Human Services advisor, and Dr. Scott Gottlieb, a former FDA deputy commissioner and current resident fellow with the American Enterprise Institute.
Murthy is halfway through his four-year post as surgeon general. But in the wake of today’s report, some groups, including Americans for Tax Reform, are calling for Trump to dismiss Murthy. The group’s online petition urges Trump to “fire the Surgeon General and replace him with someone who actually cares about tobacco harm reduction and saving lives.”