FDA to Ban Juul, Flavored E-Cigarettes If Industry Doesn't Change

I don't know how anyone who works for JUUL Labs can sleep at night.

Why not? This not the first startup who’s profit and success comes at the expense of the well being of children and youth.

Vaping is not the same as smoking.

As I understand it, they are really a nicotine company. There is neither tobacco nor smoke.

> Banning them because “think of the children!” is extraordinarily short sighted.

Alternatively, prioritizing the needs of the already-addicted vs. keeping a new generation off the product entirely is "short sighted". Statistically, let's be honest: you guys are a lost cause.

>Why not ban fruity alcoholic drinks too? Kids prefer those to beer.

Because alcohol use is much more socially accepted than nicotine use.

Then Juul should be put next to the nicotine patches and gum in the pharmacy, and be marketed as a medication. The FDA heavily regulates substances that can be abused when not used as medication (things like meth ingredients).

Frankly, letting a company aggressively market a highly addictive compound to an impressionable segment of society because of a single-use excuse ("it can be used as medication!") is a bit disappointing. It also reads as astroturfing because it's such a limp talking point.

>Why not ban fruity alcoholic drinks too? Kids prefer those to beer.

Sure, why not. Germany for example put a heavy tax on alcopops because they were too popular with teenagers (despite teenagers not being allowed to buy them), which largely drove alcopops from the market [1]

1: https://en.wikipedia.org/wiki/Alcopop#Germany

Because high-status people drink, while smoking is mostly a habit of low-status people.

It would’ve been so easy to make these prescription only. That way people who wanted to use them in place of cigarettes or to help them quit would be able to, but it would be much harder for them to become “cool“ and take off the way e-cigarettes/vaping have.

> Why not ban fruity alcoholic drinks too? Kids prefer those to beer.

No, they don't, and we do ban advertising those drinks directly to children.

> Kids prefer those to beer.

Inexact. A lot of young women prefer those to beer and are getting hooked on alcohol through them. Much to their detriment. (Alcohol consumption causes cancer, especially breast cancer in women.)

>I highly suspect these young vapers would have picked up smoking instead if products like this didn't exist.

personal observation, not data, but I don't think this is so. I work on a university campus, and the proportion of people on campus that smoke has cratered this decade. The only reliable smoking populations are foreign students, and they seem to taper off over their undergrad years, which I can ascribe only to peer pressure against smelling horrible -- and maybe easy access to "study aids" like adderall.

edit: i should add that juul use has jumped just this year alone, and with less focused of a user group.

> I highly suspect these young vapers would have picked up smoking instead if products like this didn't exist.

We've got plenty of data that shows a steady, large decline in number of smokers since the 1970s.

> I don't know what more the industry can realistically do.

Stop selling poison.

> Maybe I'm missing something, but as an outsider, the FDA seems dead set on killing your vaping industry by all means necessary.

Well, yeah. The FDA Mission, which is defined by statute:

"The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation.

FDA also has responsibility for regulating the manufacturing, marketing, and distribution of tobacco products to protect the public health and to reduce tobacco use by minors.

FDA is responsible for advancing the public health by helping to speed innovations that make medical products more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medical products and foods to maintain and improve their health.

FDA also plays a significant role in the Nation's counterterrorism capability. FDA fulfills this responsibility by ensuring the security of the food supply and by fostering development of medical products to respond to deliberate and naturally emerging public health threats."

You know the FDA didn't handle this correctly when shares of Altira and British American rose after the announcements.

"I don't know what more the industry can realistically do"

I wouldn't mind if they just went out of business and did something useful instead.

Its a combination of a few different things. The flavors make it more attractive to kids. The non-combustible method of inhalation means it can be safely/cleanly vaped indoors, say in school bathrooms, and you don't have to waste a whole cigarette just for one puff. They're also ridiculously easy to find online under 18; Juul themselves does digital age verification, but plenty of retailers don't.

They're being asked to prove that the device helps adult smokers more-so than it hurts new smokers. The keyword is "more-so", because if these statistics suggest that Juul's uptake in adult users is lower than the FDA's statistics on high school usage, or if Juul can't prove that the vast majority of their users were former smokers rather than new users at any age, or if Juul can't present evidence that vape devices (especially their ultra concentrated 5% nic salt formula) are safe, they're finished. And they'll take the rest of the vape industry down with them.

Vaping is a gateway for some who would not have smoked to begin doing so. Some of them would have picked up smoking if the products did not exist. Not all; some who vape would not have smoked. And it's also a release for some who do smoke to quit.

It's very difficult to measure these populations and movements, and also difficult to make statements about the magnitude and worth of their effects.

Regardless, the goal is to reduce the ingress of new smokers, and if possible to increase the success rate of those who wish to quit smoking. The FDA can make progress on this by policies that reduce kids picking up vaping and using proven methods to stop them from picking up smoking.

The amount of misinformation in this thread is worrying. Seems like your American pharmaceutical lobbies, or whoever gains in destroying the vaping industry, have succeeded in spreading the idea that vaping is somehow more damaging than smoking. Now that the science showed pretty clearly it's at least way less dangerous than cigarettes in short-to-mid term, they switched the narrative to "for the kids".

I'm afraid you haven't actually quit, merely swapped one delivery mechanism and associated set of toxic compounds for another.

I, too, am a former smoker and I have questions. Mostly how a device that delivers the addictive substance helps you quit.

Were you taking a "step-down" strategy like with the nicotine gum? Since the gum is carefully regulated and the "juice" isn't, how can you be sure your step-down is actually doing anything? And since the gum is metered out in measured doses, what's to prevent you from just grabbing full-strength juice and falling off the wagon? (Compare with smoking, which means you ostensibly have to go and buy a pack of smokes and a lighter, assuming you followed step 1 in the gum and got rid of your cigarettes and lighter)

> Kids getting hooked on something that's significantly less deadly? It's not ideal, sure, but it's better than a slew of cancer epidemics.

The whole point is that these are kids who wouldn't be using nicotine products at all. Smoking rates have declined in the US over the last 40 years, and yet there's been an uptick in youth nicotine usage since the introduction of e-cigarettes.

So when talking about youth usage, no, this is clearly not an improvement, by any measure.

There is a very long term downward trend with cigarettes from the 70's. https://www.hhs.gov/ash/oah/adolescent-development/substance...

So, no it's not obvious that electronic cigarettes are replacing smoking. The upward trend with electronic cigarettes is a huge public health issue.

It seems like it might not just be a replacement effect, though. Adding those numbers together, and pretending that 2016 == 2017, you get an increase from 17.3% of kids using either in 2011, to 19.3% in 2016/2017.

Perhaps you can make an argument that, lacking tar and being (purportedly?) less addictive, e-cigs are enough less bad that a net increase in the number of kids consuming nicotine is an acceptable price for halving the number of kids who are smoking cigarettes. That's a more arguable argument, though.

A package of Juul pods contains 4 cartridges which each contain approximately 1 pack of cigarettes worth of nicotine. In NYC these sell for ~$20, while 1 pack of cigarettes sells for ~$13.

> The FDA is in an interesting regulatory bind here, too -- I think nicotine is unique in their regulatory scope in that the FDA is concerned with efficacy and safety and tobacco products are known to be unsafe and ineffective therapeutic agents.

Thr tobacco industry tried this approach, claiming tobacco is an "agricultural product". Congress fixed that by passing a law specifically authorizing the FDA to regulate tobacco, which includes smokeless nicotine products.

Not arguing your main point at all, but I wanted to correct your last statement. While not considered safe, cigarettes have proven to be remarkably protective against the development of Parkinson's disease in a slew of studies spanning decades of research. This is relatively little-known outside of the field. I did my PhD in Parkinson's drug discovery, and it was one of those findings that is frustrating due to the lack of other effective therapies for PD prevention and the obvious deleterious effects of smoking on heart disease, lung cancer, etc. Here's a relatively recent review paper on the topic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494127/.

Relevant excerpt: "Population-based studies have shown that smoking was associated with approximately 40–50% reduced risk of developing PD. [10, 11] This inverse relationship between smoking and PD was dose-dependent: age-adjusted relative risks (RRs) of PD were 0.8, 0.6, 0.5, and 0.4, for 1-9, 10-24, 25-44, and 45+ pack-years, relative to never-smokers, as shown in a large prospective cohort study [9]. There is also a temporal relationship between cigarette smoking and PD risk [9, 17]. Individuals with more years of smoking, older age at quitting smoking, and fewer years since quitting smoking had lower PD risk. Researchers prospectively observed a significantly lower risk of PD for smoking as early as 15 to 24 years before symptom onset, but not for smoking 25+ years before onset (n = 143,325) [17]."

Not all tobacco/nicotine products are taxed equally. In my state a pack of cigarettes is $10, but you can buy cigarette sized cigars for $2.50 for a 20pk, a 170pk of nicotine gum for $35 (1 gum = 1 cigarette). In defense, chewing nicotine gum is a lot less harmful than smoking a cigarette.

I used to think there is another government agency in charge of alcohol and nicotine - ATF yet FDA makes sense as it is about safety of a thing people consume internally.

Sounds like a lot of nice fines or jail terms to be handed out to whoever sold/gave them to the kids. What kind of investigation is being conducted to find out who's responsible?

Give me a break. Things sucked without the FDA.

Because companies lie, beg, borrow, and steal in favor of profit, at the expense of the public. It is the duty of the public to restrain such abuse.

Yeah: leave

> What happened to being a free people who could make their own decisions?

I'm glad you have the time, knowledge, expertise, and experience to thoroughly investigate the safety and long term affects of every product you use on yourself, second hand effects on others, and the environment. Not everyone is so lucky to be blessed with so much time, energy, and knowledge that they themselves can do what thousands of people so full time.

Hell yeah. Who wants their "food" and "drugs" regulated? Free pain killers for all! Toxic additives are great!

Your complaint is a classic libertarian whine: you want the stuff you think is important regulated (though in practice you don't recognize how much of it already is), but the stuff on the margin is clearly an infringement on the fundamental rights of "free people".

As long as Congress refuses to write laws with more specificity than 'Foo shall write regulations to prevent all bad things', then no - we're stuck with this.

I think this will change if we can elect more repreesentatives that are more intrested in serving 1-2 terms and writing good law than getting re-elected.

Yes. Go vote for candidates that want to deregulate stuff you want deregulated.

That said, the FDA is really, really far down most people's list of agencies that shouldn't exist. ATF and TSA are generally the agencies that most people would prefer to get rid of.

It's not moral panic. Vaping is just as harmful as smoking. Combustion is still the main chemical reaction, and the resultant compounds are just as toxic. They only smell nicer.

It's not a moral panic, in the sense that people don't like kids smoking. It's a public health issue. Juul is bad for kids' health, it causes similar problems as cigarettes, even though it's relatively safe. [1] You can't sell cigarette replacements in 2018, half the price, in a nice package, deceiving kids who have absolutely no idea what the heck they're doing, and expect to profit legally and morally from this.

[1]: https://news.psu.edu/story/527326/2018/07/03/impact/medical-...

That isn’t even slightly true and it’s nonsense like this that is going to kill people when they switch back to smoking cigarettes.

What do you consider the strongest sources for those claims, especially the second hand smoke claim?

The Royal College of Physicians strongly disagrees with you. This is the same group that sounded the alarm on cigarettes in 1962 with their groundbreaking report "Smoking and health" [1]. Their 2016 report, "Nicotine without smoke: Tobacco harm reduction" [2] stands in staunch disagreement with your statement.

[1] https://www.rcplondon.ac.uk/projects/outputs/smoking-and-hea...

[2] https://www.rcplondon.ac.uk/projects/outputs/nicotine-withou...

What if they choose to act collectively using a system established for that purpose?

It's funny how the only regulation that gets treated as a sensible status quo is the limited liability extended to investors in corporations.

We live in a civil society which means we figure out together what our mutual obligations are. Did you not get the memo?