Lindsey Stroud joins us for the second part of our USA special exploring the FDA's approach to safer products, and whether a change in approach is likely at the agency controlling the addition of new safer products to the market.
Transcription:
00:29 - 00:45
[Joanna Junak]
Lindsay, let's talk about young people and vaping. There are significant difficulties facing regulators in balancing the public health benefits of adult vaping with the risk to young people. What do the data say about this phenomenon?
00:46 - 04:35
[Lindsey Stroud]
Yeah, and this is where it gets really, really You know, there's ethical dilemmas in this kind of part. I mean, you know, you don't want any young people using these products. And that's where, you know, CHR is going to have to face a wrecking because it's like, oh, these products are designed for people who smoke. Well, what happens when we have no smokers left? I mean, so you can't keep using that argument on this one. um and their introduction though it was like i've been looking at the data the burfess data behavioral risk factor surveillance system uh survey data from the cdc for now god going back to like 2020 actually and it's been really fun to watch the young adult smoking rate just go it's been eradicated so oh in the us um yeah in 2023 like 20.9 of 18 to 24 year olds were vaping and they are the highest contingent now I was looking at the numbers earlier. It's like 16% of 25 to 34 year olds that are vaping. So you're just going to see that those numbers increase too. But the one part that you saw is that there's 18 to 24 year olds, only 5.5% of them were smoking. And this is huge because 20 years ago in 2003, 29.1% of them were smoking. And they've always been consistently like the group that smokes the most or have the highest rates of smoking. So, well, I mean, most of them, as I know, I'll be out and hanging out and see some young people and they're under the impression that vaping is just as harmful, if not more harmful than combustible cigarettes, but they are still using these products and they're not smoking. And even though they might not understand that as a harm reduction tool, as far as like the costs associated with cigarettes, this is gonna be a public health win. And so I've always sat here and said, if you're gonna have a young person doing anything, Wouldn't you want them to be doing the least harmful thing? I mean, then just smoking a cigarette. But one of the ways that this could be reformed is if, yeah, you make e-cigarettes more widely available through a regulated FDA marketplace instead of increasingly putting restrictions on this. on these to harm reduction products, because I can understand why somebody who is just, you know, might not know what's going on with the FDA, might not know the science, might not know, you know, that cigarettes contain 600 ingredients. And when lit on fire, you know, that they, you know, we have 7,000 chemicals. They might not understand, again, that the combustion is what causes the harm, not the nicotine. But one of the things that, again, when you have 140 cigarettes approved for every one single e-cigarette, I can understand why most people would stay here and say that cigarettes are safer for you. I mean, the FDA sure... Wants to make sure you have access to those and not to these other products. And I think public awareness campaigns. But, I mean, ideally, too, I mean, I understand... You know, they're trying to sit there and say, oh, significant progress was being made, but not really. I just pulled the numbers for 18 to 24 year olds this morning. So in 2009, it was like, what, 23% that were like smoking. 2013, it's still around 23%. So that's after the federal, that's after banning, you know, flavors and cigarettes. It's after the federal tax. you don't really start seeing, you know, young adult smoking rates start to really just significantly declining as yeah, 2016 and the advent of like the pod device. And, and that's another thing too, with all these devices and how, you know, it's kind of really the U S marketplace has been very resilient for being a lot of uncertainty around But it's been because it's been so easily adaptable. You know, we went from single likes to open systems and the mods and the, you know, kind of clunky things to the pod device, which has really revolutionized it. And unfortunately, due to some reactionary policy at the federal level, you know, that with, you know, restricted flavored pod systems. Yeah. Now we have, you know, this disposable stuff and we'll see what I mean. Something's just going to happen again. I mean, it's just how it seems. That's how the free market works. And I love it. So.
04:37 - 04:50
[Joanna Junak]
You mentioned the FDA, so what do you think about the recent decision by the US President regarding layoffs at the agency? In which direction might the US nicotine industry go now?
04:51 - 07:35
[Lindsey Stroud]
Well, unfortunately, I mean, I know it's really big for us, but you, again, like we've had probably about in the States, it's like 11% of adults who smoke. We're some of the lowest rates ever. We definitely are a minority group and even less, they're actually vaping. And so as far as I guess, you know, the immediate stuff that they're going to do with reforming, you know, CTP center for tobacco products is going to be, I don't know. I'm not very hopeful on it. I mean, it is part of a larger overhaul. We do have Robert Kennedy, Robert, f kennedy jr you know that's been you know promising a dramatic shift um and i actually think that you might see a lot more reforms just through the the whole entire structure of the fda um i mean it's unfortunately it's it's just i don't think it's i know a lot of people were celebrating you know brian king is uh and everything i mean and i you know as part of it's like yeah you didn't really do a lot for us you But I mean, this agency was already bogged down to begin with. And then now you just lost a bunch of, you lost even more employees. The only good thing is it's like, who's going to do the enforcement actions? I guess, I guess they're not going to be banning, you know, like, you know, banning imports of e-cigarettes because there's nobody working there. But it does also mean that, you know, the 180 days that they could never make with the statutory requirement to approve an application is definitely not going to be met at this point anymore. And it could be, I mean, I know I always joke about reforming the TCA. I joke about just dismantling the TCA, just ripping it up, starting all over again. You always have to face that thing that it could be way worse. And, you know, you could get so many incentive for tobacco products that, you know, is just as bad as Brian King or maybe not even worse. I mean, never smoke, never hung out with people who smoke, doesn't under, you know, looks at big tobacco, just trying to hook another generation of kids. hopefully you know nobody that is really tied to bloomberg would want to even work for that for the administration but um it's going to be interesting and unfortunately too because what we're seeing at the state level with these like vape directory bills that um pretty much you know knock out anything that doesn't have an fda approval or whatnot so it's like oh the 34 products and then the ones that are in regulatory limbo um because the federal government is not going to be doing a lot of enforcement the states are now going to be in power to do their own policies to address so-called illicit Chinese vapes or whatever, or even, you know, probably flavor bans. I imagine to see them happening too. So it's going to be, I would sit there and say, you know, everybody around the world, like, you know, keep your eyes on us. Okay. I will be telling you like, you know, do not follow what the U S does, you know, as far as regulatory things do. But I understand that everyone's kind of watching us right now. And it's going to be interesting to see. I mean, I'm hoping for, a revolutionized marketplace. But I understand it's kind of a pipe dream.
07:37 - 07:47
[Joanna Junak]
And now I've got one question regarding nicotine powders. Since they are currently a big issue in Europe, can you tell us how nicotine powders are regulated in the US?
07:48 - 10:06
[Lindsey Stroud]
So they're going to have to go through the pre-market tobacco application process. So because that's anything that the predicate date. So any product you had to have like a product that was substantially similar by Excuse me, February 18, 2007. Yeah, I think it's the 18th. It might be the 16th. February 2007. So, yeah, they have to do the pre-market tobacco application process. So, yeah, I mean, lots of science, lots of data. I don't know exactly how long it took. I think it took about two to three, four, maybe even four years for the ZIN authorization. I know there's a lot of pending. Again, there's a lot of pending applications that are probably not going to be worked on right now and everything. And I mean, that's going to be the one to watch, actually, especially when you're looking at the public health stuff, because the risk profile of the pouch is no different than a risk profile with Nicorette gum. And that's going to especially when you're looking at that's where you're going to, I think, see the pharma guys really come out against those ones, especially because there's going to be more variety of flavors that are easily accessible. You know, you're going to see them. I mean, I'm seeing. I'm even now seeing like caffeine pouches now at gas stations and everything. So there's like this whole new like snooze pouch thing that's like happening. It's going to be interesting. And thankfully, at least in the States, we have not seen like a dramatic increase in youth use despite like. you know you always go back to jewel you have to wonder who actually did who did the most advertising was it jewel or was it how public health and everything you know in the news media and stuff and it only yeah there was a dramatic increase and you're like comparing the two numbers but it's like 2.8 2.9 percent of youth that were using pouches last year and that's despite all of this you know media attention i mean i always sat here and said it's like well they can't share them i mean unless you're swapping spit they're not gonna just be like oh you're trying it So it's going to be interesting to watch it and and watch that, you know, the that industry come out. And I mean, again, this is the tobacco harm reductions, this consumer driven revolution that, you know, for, you know, again, 1976, people smoke for the nicotine or smoke for the nicotine, but they die from the tar. And now we're going to have this wide variety of products out there that can satisfy people's nicotine cravings without the harms associated with combustible smoking. And that's pretty awesome. And no, it's not big tobacco. Who did it?
10:08 - 10:21
[Joanna Junak]
Okay, and finally, what's your personal take? What do you think there's so much misinformation about vaping in the US? And how does it impact tobacco harm reduction efforts across the country?
10:22 - 14:40
[Lindsey Stroud]
So I've been sitting here thinking about this for a while, for the past year, because it's like, you know, I've been, what, doing this since 2016 and seeing the same arguments. And again, what's the definition of insanity? Doing the same thing over and over again and expecting a different result, which is to be a THR advocacy. But I've come to realize that, you know, tobacco control is two, there's two sides of the same coin and it's big health and big tobacco. And both of them need each other to really much survive. you have do you have these products that are not only you know satisfying consumer demand they're getting their you they're responsible for like a whole generation that's never going to smoke cigarettes but there's a lot of money to be made in treating the cost of smoking um i remember trying to look at the numbers one time for like i want to say it was michigan it was years ago but i was trying to again they're not 100 numbers but like i figured it out it's like you know for one every one dollar that big tobacco got in profits big health was getting three dollars whether it was from you know, pharmaceutical companies to hospitals to, you know, all these specialties. My dad last year had a lung biopsy and I walked in. I was like, yeah, here's the here's the wing that, you know, lung cancer and smoking bill. And I even asked his doctor, you know, what's the percentage of your patients that are smokers? And Yeah. Overwhelmingly. So when you have something that's literally going to eradicate this and it wasn't slow, I mean, vaping is not, this is a 20 year thing at boom. Like it is kind of like the industrial revolution for tobacco and everything. And I think that's where you're getting a lot of, you know, pushback. And then especially, I mean, I get, I understand tobacco manufacturers who spend billions of dollars to get their products authorized. Then they're not only losing money through their combustible cigarettes, but they're also like, people are making hand over fist on these products that they didn't even notify the FDA, let alone get approvals is catch 22 on it. So I understand their problem with, and all of that. And I understand too, they were kind of stunted. I mean, okay, China and India probably have the largest tobacco markets. Unfortunately, when you're looking at e-cigarettes, we don't have data on that because their government's just, you know, they're banned in India and China. I don't even, that's such a confusing situation over there. So when you're looking at the U.S. e-cigarette market, it is one of the largest markets in the world. And unfortunately, due to our federal regulations, all the innovation's been stifled. I mean, even... I know the TPD in Europe's pretty, you know, you guys think it's really restrictive and everything, but our FDA regulations are a heck of a lot worse actually. And very, I mean, as far as like, what's legal and what's not legal. But that being said, like, yeah, the majority of our products here in the States are completely illegal or illicit or whatever. I like to call them non-FDA regulated to get rid of that negative connotation on it. But they've always been that way. Again, consumer-driven revolution. When you're looking at the vape shop and these are people who quit smoking themselves and then started tinkering around and making their own devices. And it's truly what I love about it. Okay. I mean that you've actually forced, you know, large tobacco companies to change their product portfolio. And it wasn't because of government regulations, you know, with like when you're looking at EVs or, you know, electric vehicles or whatnot. No, this was like, Oh God, we're losing market share. They're not smoking anymore. We got to get a product out there. We're not going to have any customers. And again, again the tobacco companies should be allowed to exist i'm not going to be on this whole like oh they you know they get you know they hook people and everything there's so many industries out there that we could talk about that you know get paid there's people on everything some of them that are subsidized um as well uh so they're allowed to exist i mean we should be empowering them to actually bring a safer product to market if not mandating it so it's going to be interesting to see this pushback because i think yeah you're and i just for the record yeah um I was looking at the numbers between 2022 and 2023 states among like the state cigarette excise taxes, $1 billion in lost cigarette tax revenue. And that's awesome. Not for state coffers, but, you know, I just show you the power that people are, you have some of the lowest rates of smoking and there's going to be a lot of like, I always think if you got rid of cigarettes tomorrow, there'd be like so many things missing because cigarettes have built a lot, whether, you know, I mean, just a lot of hospitals and everything. So, It's just a battle. It's just, again, two sides of the same coin, you know, big health and big tobacco.
14:42 - 15:01
[Joanna Junak]
Thank you, Lindsay. That's all for today. Tune in next time here on GFN TV or on our podcast. And make sure to check out our social media pages for the latest updates on this year's Global Forum on Nicotine Conference. Thanks for watching or listening. See you next time.