HEALTH

Vaping is risky. Why is the FDA authorizing e-cigarettes?

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Vaping is risky. Why is the FDA authorizing e-cigarettes?

when they first Appeared in the United States in the mid-2000s, “electronic nicotine delivery systems”—e-cigarettes, vapes, e-liquids, and other goods containing the stimulants found in tobacco—were subject to little federal oversight. Their creators could have included countless other ingredients and flavors. Like the cigarettes before them, the devices proved extremely attractive to young people; In 2018, the Surgeon General declared youth an “epidemic” and noted that one in five high schoolers and one in 20 middle schoolers used e-cigarettes. Nicotine can harm the developing brain, and e-cigarettes contain potentially harmful toxins such as heavy metals; The long-term effects of the vapor – heating of nicotine to form an inhaled aerosol – are uncertain.

Despite these concerns, public-health officials in the US expect that, given an alternative in the open market, people already addicted to nicotine will choose e-cigarettes instead of cigarettes – a deadly consumer product that attracts users. is so successful in doing and maintaining that it has killed 24 million Americans over the past six decades. Since e-cigarettes generally contain fewer toxic chemicals than tobacco smoke, they are believed to be less harmful than cigarettes. If a whopping one in seven adults who smoke in America switched to e-cigarettes, the theory goes, significantly fewer could suffer from cancer and heart and respiratory diseases.

In 2016, in an effort to reduce the potential harm of e-cigarettes, the Food and Drug Administration began regulating them as “new tobacco products.” It became illegal to sell e-cigarettes to anyone under the age of 18 (a cutoff that rose to 21 nationally at the end of 2019), and the agency was empowered to require a warning label. The FDA also obtained the right to take products off the market unless it can be demonstrated that their public-health benefits outweigh their risks. (As a result of legislation passed in 2009, this condition applies to new tobacco products in general; the cigarettes themselves, and other tobacco products on the market before February 15, 2007 are not required to meet the same standard.) Last month , the agency had rejected nearly one million applications. But a vaporizer and two liquids, in regular tobacco and menthol flavors, were authorized when the FDA announced that data submitted by their manufacturer showed they were actually less toxic than cigarettes, according to the agency’s news release. In words, the “benefit” of the addicted adult smokers who switch to these products would be “out of the risk to the youth” and would lead to the “protection of public health” overall.

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The decision was controversial. In part, this is because research into whether e-products can help adult smokers stay away from cigarettes has yielded mixed results. For example, in October, the same month as the FDA’s decision, JAMA Network Open published a study that “found no evidence that switching to e-cigarettes can prevent cigarette smoking,” lead author John P. Pierce, an emeritus professor at the Herbert Wertheim School of Public Health and Human Longevity Science at the University of California, San Diego. He and his colleagues analyzed data from the Population Assessment of Tobacco and Health Study, a longitudinal study of tobacco use in the U.S. commissioned in 2013 by the National Institutes of Health and the FDA, based on responses through 2017, researchers identified 13,604 participants who were cigarette smokers. When the same participants were surveyed a year later, 9.4 percent of them reported that they had quit.

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