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The Future Of Vaping Is In The FDA's Hands

AILSA CHANG, HOST:

What might the future of vaping hold? Well, we could have an answer to that question tomorrow, September 9. That's when the FDA faces a deadline to decide which e-cigarettes are safe for the public and which might need to be removed. E-cigarettes were created to help cigarette smokers quit, but they have become a gateway to smoking for many consumers, including teenagers. And tomorrow, the industry could face a shake-up. Joining us now to talk about all this is Kathleen Hoke, professor of public health law at the University of Maryland.

Welcome.

KATHLEEN HOKE: Hello. Thank you for having me.

CHANG: So explain exactly what is at stake tomorrow. Like, what are the questions the FDA is wrestling with here?

HOKE: I mean, the primary question that the FDA faces is whether vape products, generally speaking without talking to a specific one, meet the public health standard that should allow them to be on the market. And that is whether they are, quote, "appropriate for the protection of public health" - looking at the risks the products present, the benefits that they offer to the population as a whole.

CHANG: OK. Well, let's talk about youths in particular, youth initiation. This is the idea of youths getting hooked onto e-cigarettes very early on in life. That's been a big deal for years now with kids getting their hands on Juuls and many of them getting really sick. Do you think we're going to see new requirements for marketing, like, to make e-cigarettes less appealing to teenagers?

HOKE: Yes, I do see, whether it's tomorrow - and I think it's optimistic to think we're going to know everything tomorrow. But when the FDA does make final decisions on the Juul application, on the application of the over, you know, 500 other manufacturers, whether they approve, there will - you know, if they approve any of these, they definitely will have restrictions on both marketing and some of the product design that will be, you know, intentional to reduce youth initiation and use.

CHANG: Now, there are people in the public health world who say that, you know, millions of people quit cigarettes by switching to vaping. How do you think the upcoming decision by the FDA might affect those individuals?

HOKE: So I don't anticipate that the FDA is going to be taking all vape products that adults might be using to assist them in - I'm not going to say cessation. I'll say transitioning down the harm spectrum. So they may stop using combustible smoking cigarettes and move down the harm spectrum to vaping. So I think they're going to leave product on the market that allows that dynamic to continue. I will note that none of these product applications are to allow the manufacturers to market the products as cessation products. That is a wholly different type of application. And no vape manufacturer is allowed to market their product right now as cessation, nor will they after tomorrow. That's, again, another process that would have to take place.

CHANG: Let me make sure I understand. So if the FDA ends up cracking down quite hard on certain e-cigarettes, do you think that that could push some people back to smoking tobacco cigarettes?

HOKE: You know, that's possible. That's what the vape industry would have us believe. But again, you know, that is kind of putting the cart before the horse because these have not been demonstrated, at least through the FDA approval process, to be cessation products. So there may be some products that people prefer that will no longer be available. And whether those people choose to go back to a cigarette that tastes like a cigarette or a vape product that tastes like a cigarette, I think, is anyone's guess.

CHANG: How worried do you think the e-cigarette industry even is right now about what the FDA might decide?

HOKE: I suspect the large players, the big market players like Juul are less worried. They have submitted substantial applications with likely a significant amount of science space. But there are, you know, many other manufacturers that probably submitted applications with a less strong science base. And so whether they get to bootstrap on some of the data presented by the other manufacturers or not as a question. So I think we're going to see a winnowing of the market. And so our major players will probably stay in the business, and some of our smaller manufacturers will likely be out.

CHANG: Interesting. Well, personally, from you, I mean, from a public health perspective, I'm curious, what do you hope to come out of the FDA's upcoming decision?

HOKE: I think what would be tremendous is elimination of flavors. I know the FDA has been tenuous about whether they will go that far as far as all flavors, but at the very least, all flavors in the youth attractive devices. And, you know, whether they leave menthol on the table, they've indicated they're going to take action on menthol cigarettes, so hopefully they would really strip away the menthol cigarettes. But I also think some other, you know, marketing restrictions and retail restrictions about where and how the products can be sold would be really helpful. They don't need to be in every mom and pop store, every convenience store where kids are going on a regular basis, and that can have a tremendous impact.

CHANG: That is Kathleen Hoke, professor at the University of Maryland.

Thank you very much for joining us today.

HOKE: Thank you for having me. Transcript provided by NPR, Copyright NPR.