Dispatch: FDA in NEJM

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Three top FDA administrators have a column published in the New England Journal of Medicine this week about how they will use their authority under the 2009 Family Smoking Prevention and Tobacco Control Act.

“We’ve established that we don’t like this law,” says Stier. “But it is the law now and we have to live with it, so the issue now is implementation. They talk about all sorts of things like candy-flavored cigarettes and restrictions on advertising, but what I don’t see them talking about is one of the most important issues when it comes to tobacco: helping addicted smokers quit.

“This article is not only self-serving, it’s troubling because of how it neglects to mention how to help smokers quit. They only mention smokeless tobacco and other forms of harm reduction in the context of how they are dangerous because they can lead young kids to cigarettes. They went so far as to compare these scientifically validated tools to tobacco industry chicanery, such as their earlier claims that low-tar cigarettes are safer cigarettes.”

“That’s preposterous,” says Dr. Ross. “It is well-established that smokeless tobacco is not a gateway to cigarettes. If anything, the flow of users is largely from cigarettes to smokeless tobacco, not the other way around. That’s a straw man argument, as is their initiative to list ingredients in cigarettes. There are 4,000-plus ingredients in cigarette smoke, and 200-plus have been found to be carcinogenic in animal studies. No one knows which exact chemicals in cigarettes cause the manifold deadly health conditions associated with smoking, so listing ingredients has nothing to do with health.”