Is there any limit to the Trump administration’s willingness to endanger public health and safety for political purposes?
First, it weakened environmental protection standards, despite clear evidence that the air we breathe is irreparably harming us and our children. Then it formally left the Paris Agreement on climate change, despite its being the only available option to help address our worsening air. Now the president has walked back his promise to regulate the vaping industry and ban most flavored e-cigarettes, even as they render an entire generation more vulnerable to nicotine addiction — not to mention life-altering severe lung injury.
And that’s just in the past month.
You have to mine the deepest depths of shamelessness to understand the prevailing motives for these actions. In the case of the proposed flavored e-cigarette ban, the vaping industry has engaged in a vigorous defense campaign. Its products just help smokers get their nicotine fix more safely, it says. (As it turns out, we have no long-term safety data on the effects of vaping on lung tissue, and what small studies we do have are ominous and suggest vaping might even be more harmful to vital organs than traditional smoking.) Businesses could be hurt by a ban, the industry said; Trump voters might turn on their president.
Attempts by the Trump administration to appease everyone in the room have failed miserably, most likely because they are so intellectually dishonest. The facts remain clear: A vast majority — over 70 percent — of our youth who decide to vape do so because they want to experiment with flavors. Why are we surprised that candy flavors like cherry and bubble gum appeal to youth in ways that tobacco-flavored e-cigarettes do not? As these products have become more accessible, youth vaping rates have risen: Today, one in every four high schoolers report at least occasional use of a vaping device. Between 2017 and 2018, e-cigarette use among high school students increased by nearly 80 percent.
This is a problem. First, just one pod from the e-cigarette brand Juul — a brand especially popular among teenagers — contains as much nicotine as 20 cigarettes, and nicotine has adverse effects on adolescent brain development. Second, e-cigarettes are a known gateway to other harmful substances — most worryingly, conventional tobacco cigarettes.
With nearly 2,000 cases of severe lung illness and 37 deaths across the country attributable to vaping, this crisis has brought new attention to products that have long needed, but never received, federal scrutiny. Vaping devices have been on the market since the late 2000s, and yet the Food and Drug Administration has not examined a large majority of these products for their health or safety impact on humans. This is a failure of leadership on both sides of the political aisle.
High-profile advocates of stronger vaping regulations, like former F.D.A. Commissioner Scott Gottlieb, once had influential platforms in the Trump administration to lead on this issue. Instead, Dr. Gottlieb chose to use his privileged position to grant additional delays to vaping companies before establishing federal oversight of e-cigarette companies. Now that he’s out of office, he has called for a sweeping ban on all pod-based cigarettes. But demonstrating courage on the sidelines after misusing an opportunity to lead is the type of inauthentic leadership we’ve come to expect from our politicians, not our high-level appointed health officials.
As a public health researcher and pulmonologist, I am constantly asked by families how to stay healthy and safe despite a seemingly endless array of health threats all around us. Our lungs, after all, are often our first line of defense against what we are exposed to, both intentionally (vaping) and involuntarily (pollution). I wish I could look to our country’s surgeon general or its F.D.A. commissioner — both physicians — for guidance on how to counsel American families and reassure them that policies will change and help is on the way. But the deafening silence from these members of the Trump administration in the wake of this month’s reversal on flavored e-cigarettes flies in the face of their most sacred commitment: First, do no harm.
Vin Gupta is a health policy researcher and assistant professor of global health and pulmonary/critical care at the University of Washington.