While the United States of America is ground zero for the anti-vaping propaganda and misinformation that poisoned worldwide public perception of vaping, it’s also home to a solid and relentless vaping advocacy community pushing back against the anti-vaping hordes. How are they doing? Find out in this episode of GFN Interviews.
Vice President, American Vapor Manufacturers
Marketing & Communications Director, ECIG Charleston
Chapters:0:00 - Intro 1:49 - How Allison got involved in vaping advocacy 3:15 - America's approach to vaping 6:14 - The Tobacco Control attitude towards vaping 8:19 - What is AVM? 9:20 - What is the FDA's Premarket Tobacco Product Application? 12:02 - Impacts of the flavor ban in the US 13:17 - The retail side of vaping 15:01 - Aftermath of the interview with Brian King 20:29 - Does the USA understand Tobacco Harm Reduction? 22:45 - Allison's perspective on COP10
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Brent Stafford: Hi, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.TV. All roads in the war on vaping lead back to the United States. The U.S. is ground zero for spurious research, malevolent messaging, wrong-headed regulation, and the millions of dollars dedicated each year to destroying anything positive about vaping. Even so, the pushback by vaping advocates in the U.S. is strong and resolute. Joining us today to offer an insider's perspective on vaping advocacy in the United States is Allison Boughner, Vice President at the AVM, the American Vapor Manufacturers Association, President of the South Carolina Vapor Association, Fellow of the World Vapors Alliance, and she's Marketing and Communications Director for E-Cig Charleston, a vape shop retail chain with 16 locations in South Carolina. Allie, thanks for coming back on the show.
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Allison Boughner: Thank you so much for having me back, Brent. It's good to see you.
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Brent Stafford: You know, I have to say, Allie, that is quite the list of vaping advocacy groups and activities you're involved with. And still I haven't mentioned that you're also the co-host of a weekly podcast on vaping called the Wednesday Night Live Show. How do you fit all this in?
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Allison Boughner: I really don't know. I'll be honest. I mean, I, I have a really hard time saying no, especially when it comes to vaping advocacy. I try to take every opportunity that comes my way. So, um, I try to just pace myself, take one task at a time and try to focus my attention where it's needed when it's needed.
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Brent Stafford: So how did you get involved with vaping advocacy? I assume, of course you were a smoker.
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Allison Boughner: Yes. So I work for ESIC Charleston I've been there for January, it will be 11 years. I did smoke. When I was 30 I was diagnosed with a blood clot, not something that 30 year olds normally have to deal with, six month round of blood thinners having my blood drawn every week to see my levels tested. On my hematologist suggestion, tried everything that was out there. Patches didn't work for me. Gum gave me an awful sores in my mouth. Chantix made me crazy. So, you know, after getting over that whole six month round of blood thinners and life happens, stress happens, you kind of forget the position that you were in and what puts you there and you go back to smoking, which is exactly what I did. I moved from New York to South Carolina and started working for a company and they were like, hey, you smoke, try this. And that was literally my last cigarette was quitting with just a disposable tank and a 650 battery and pina colada and 18 milligram. And so when you start to see this under attack, especially being with them as long as I have been, and seeing the customers that you've helped. And, you know, you can't really just sit down and not say something. And I started a Twitter and here we are.
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Brent Stafford: Well, it's excellent. So we've all heard, Allie, the expression about America, that it's the home of the brave and land of the free. But when it comes to vaping, how free really is it?
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Allison Boughner: I mean, it's not, especially when public health entities like the FDA, CTP is completely ignoring the American adult users and kind of brushing them off as anecdotes with their true stories about how they quit smoking and still hell bent on banning these products that adults are actually using to continue to be successful. So I know I wouldn't say that's very free at all.
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Brent Stafford: They certainly seem to disregard those personal stories and examples when they always want to have things at population level, but then when there's population level data, they seem to ignore that too.
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Allison Boughner: Yeah, they seem to ignore everything, including the science. So, I mean, what do you do when you're in a predicament like that? You have to raise your voice and you have to speak out and contact your local representatives and try to do as much as you can to stop it, at least at a state level, since the federal level is obviously unwilling to listen to reason and also to science.
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Brent Stafford: Is it fair to say that vaping is under assault in the US?
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Allison Boughner: Oh, absolutely. I think it has been. I mean, when I'm sitting at home at night and I'm watching Hulu and an ad pops up, from the Truth Initiative and it's some insanely ridiculous concept of someone fishing a vape out of the toilet to use it and worms crawling around in your face from vaping. I mean, it makes you realize that these things are funded by these organizations and that they just don't care about the messaging being accurate. It's all for the kids, but nobody's really thinking about the adults at all.
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Video: There's an epidemic spreading.
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Video #1: It can expose your lungs to acrolein, which can cause irreversible damage. It's not a parasite, not a virus. It's vaping.
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Video #2: "inaudible conversation"
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Brent Stafford: What's the biggest source of animus towards vaping?
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Allison Boughner: I think it's, I would say anything Bloomberg bucks touch, right, is, you know, is the main source. But it's a combination, it's a combination of the Truth Initiative, of the truth campaign, of the Bloomberg money, of PAVE, of the CTP and the CDC themselves.
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Brent Stafford: Is tobacco controls hostility towards vaping irrational?
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Allison Boughner: Absolutely, I think that the way that they are treating vaping is the way that they should have been treating cigarette smoking all along. And I mean to say, that should be in a prohibition stance, because I think that's absolutely ridiculous. Anything that is prohibited typically goes to an unregulated, dangerous, illicit market. But, you know, I just don't understand why It's all about nicotine now and potentially a nicotine free society when you have approvals for low nicotine cigarettes, but not one single approval for an open system e-liquid.
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Brent Stafford: It almost seemed like a light switch was thrown with regard to nicotine all of a sudden becoming the big enemy as opposed to, say, combustible smoking.
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Allison Boughner: Right. All the other chemicals that are in a cigarette. Yeah, those are fine. But just lower the nicotine and you can get a PMTA approval, which I think is ridiculous. And I think everyone else that actually is paying attention is also saying, how is this getting a PMTA approval and nothing else is.
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Brent Stafford: Yeah, let me ask you. You know, in our interviews that we do out there with people who are not from the US and they're vaping advocates, there is a certain amount of like everything comes from the US. It's kind of born in the US. You ever feel that sense?
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Allison Boughner: Yeah, I mean, I think that that has a lot. I constantly apologize to, you know, my friends out in other parts of the world. And I'm like, I'm really sorry that we started this. I wish that there was something we could do to fix it. FDA, CTP has this history of saying that they're going to do something and that they're going to fix the situation and fix the perception of nicotine because adults have the right to know the truth. But nothing's actually happened to to do that. And I don't see it happening anytime soon.
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Brent Stafford: Ali, you're the vice president at the American Vapor Manufacturers Association. What's the story behind the AVM and what does it do?
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Allison Boughner: I mean, formally speaking, AVM is the leading trade association for independent vape manufacturers and businesses. Our mission is to help members navigate the horrendous gauntlet of FDA, news media, Puritan activist groups, but we also have a calling to be a voice for the customers as well and to stand up against the forces of prohibition and moral panic. Our members are helping save lives and they're constantly vilified and trampled and our customers are taking charge of their health destinies and yet they're marginalized, ridiculed and deprived of their fundamental right to switch. And it's unjust and scientifically deprived and it's dishonest. And so everyone at AVM feels like we have a vocation to take a role and fight back.
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Brent Stafford: Let's talk a bit more about the US Food and Drug Administration, because what they're doing is a bit different than most other jurisdictions around the world, where instead of regulating a market, they're actually overseeing what products can be on the market in the first place, though. They've kind of missed the boat a little bit on that one, but it's a different kind of an approach. And so what is the pre-market tobacco application or PMTA?
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Allison Boughner: So the PMTA applications are supposed to prove that your products are appropriate for public health and that they are safer than smoking cigarettes. And in the beginning, I think we all had a lot of faith that we could get it done. I worked with a small group that Char, who is the president of AVM, had started. We all kind of worked together. We had constant contact with the FDA. They assured us that they were going to work with us, that we should just file something and that this would be acceptable to file as we continue to try to work on completing the PMTA, which is insanely hard task to begin with. For my company, I filed our PMTA application. They went into the acceptance stage and went into the filing stage. And I think within two weeks of getting the letter that it was in the filing stage, we got an MDO. And so it was very confusing. And then even the representative that I had been dealing with the whole time to call me to let me know, hey, we have a letter, is it okay to email it to you, about an acceptance that changed as well. It wasn't the same person that I was dealing with anymore. So, and then all of a sudden it just seemed like it was a very hostile approach, yet you see issues with a PMTA submission going out to the larger companies like JUUL and them having the opportunity to fix it and resubmit the information. And we weren't given, we were just given a blanket MDO. And as we all started to compare notes on our MDOs, we realized that they were all for the same denial reason. It's crazy because, like, we obviously didn't have complete PMTAs, we didn't have all the testing done yet, but that's what we were working towards, to get an acceptance to say everything you have filed so far is sufficient, go ahead and move into the next part of what this is. Also with COVID, FDA approved labs were not open or had major delays. So there's no way that we could have completed the testing, even if we could have afforded to do it. So we were trying to work with them to see if we could use other labs, if we could do bridging for our testing with nicotine levels, and all of that kind of went out the window and everybody just got an MDO.
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Brent Stafford: What about flavor bans, Ali? I mean, I know the California Institute of Flavor Ban about a year ago or so. What's been the impact of flavor bans in the US?
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Allison Boughner: A huge illicit market. So I'm from New York. Most of my friends and family still live in New York and I get messages all the time from my friends like, I'm tired of buying my disposables from my Uber driver. This is a problem because they're still getting what they want, but they're more cautious of where they're getting it from. But at the end of the day, if that's the only place they can get it, they're going to get it. Oh, yeah. So, I'm like, wait, what, your Uber driver selling you disposables? As soon as I get in, do you guys need disposables? And I'm like, really? And I've heard from people that live in Australia, similar stories to this. So anytime you prohibit things that adults want, I think we learned this with cannabis, Adults are going to get that and it's much easier now to create an illicit market than it's ever been because you have things like Uber and you have the Internet and Snapchat and you can get on there and find anybody selling anything and order it. If it's legitimate or not, that's another story.
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Brent Stafford: Allie, you have a ton of experience with the retail side of vaping. Are things different today at retail, post, all of this stuff that's going on, the flavor bans, the denials from FDA?
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Allison Boughner: Absolutely, these Truth Initiative campaigns that are only for the kids, well, unfortunately, there's no disclaimer that comes across your TV that says, hey, adults, close your eyes, cover your ears, this information is not for you And so it is getting to them, obviously, I see it all the time, and I'm not watching shows that are, targeted for youth, just watching normal Hulu, and I'm seeing them as well. So what I do, part of my job is when we release a new product into our locations, We have an informational website where we put a product right up. So I'll put the product right up there. They put it into their binder, their Bible, as we call it, and that way they can learn about the products and then educate the consumers trying to buy those products. Great. I love doing that. I'm interested in that as well. But what I find now is the more information that I'm sending to the stores rather than information on the new products is science debunking fears because we're still talking about popcorn lung. Customers will come in all the time. Is this worse for me than smoking? I hear that it's worse for me than smoking. Is this going to put me in the hospital with a lung injury? So I have to constantly update them with easy to read, easy to use and share information debunking these issues because they're so even afraid to even walk through the door. And they hit these employees with a million questions as soon as they get up to the counter. And this is what they're asking.
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Brent Stafford: Ali, we last had you on the show in spring of this year to talk about the interview you and your AVM colleague Greg Conley did with Dr. Brian King, the director of the US Food and Drug Administration's Center for Tobacco Products. It was an amazing interview, as you know. Let's have a quick listen here to a soundbite.
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Allison Boughner: CTP has been describing teen vaping as an epidemic since 2018, a word that was chosen using focus groups to heighten the emotional reaction. But since then, teen vaping has plummeted and today fewer than 3% of teens vape daily. That's not what the word epidemic means, not clinically, not scientifically, and not in common sense. So how do you expect to be taken seriously by the public as a scientific agency when you continue to use a flatly erroneous term like that?
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Brian King: Yeah, so I believe you're speaking about the CDC, and FDA has not used that terminology to use the most recent estimates of youth use. I will say that I'm an epidemiologist by training, so I'm fully cognizant of the definition of an epidemic, which is unprecedented increases over what you'd expect at baseline. That said, I think and know that the science has shown a decline in the number of youth users, and that's a good thing. Over the past couple years, we have seen decline since the peak in 2019 it's still too high, we've got two and a half million kids that are still using these products and based on what we're seeing with other products among kids including cigarettes and smokeless and others. We can achieve those low levels as well - below 2%, 1% to 2%. I do disagree with the notion that we should only be concerned with daily use among kids. We do have research that demonstrate even infrequent use, illicit signs and symptoms of dependency. And so from my perspective, any youth use of these products is problematic. And that, you know, that's how you become a frequent user is there's a pathway from intermediary to you know, regardless, the good news it's coming down. I hope that continues, we certainly have the pandemic effect which has affected everything we see a variety of health indicators. So it's interesting to see next year once kids are back in school more frequently and there is potential social sources, whether we see a change in that use. But I hope it continues to decline. And as I've noted previously, I see where we can go based on the use of other products. And I'm hopeful that we can continue these types of interventions to continue to reduce use, but it's not mutually exclusive from actions to help continue to address the issue of heart reduction among adult smokers and getting them to quit completely.
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Gregory Conley: So on your watch, the FDA has decided to no longer use the term epidemic?
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Brian King: Since I've started, I haven't uttered it. I'm not aware of any of my staff, but as far as I'm aware, we have not used the term.
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Brent Stafford: Ali, it's such a huge get to get an interview like this. How did it come about and what did you think after it was done?
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Allison Boughner: Well, I can say the ball was rolling before I came into AVM. So they were already in talks with them constantly hounding them basically to try to put something on the books. When something finally did get put on the books, then it was, well, what if we change the time? What if we have this much time for Brian to speak and then this much time for questions? And we were like, absolutely not. This is what you agreed to. This is what we're doing or we're doing nothing at all. We haven't had a voice. And then we found out that he was the one who initiated the interviews with PAVE and Truth Initiative and all of those. And so it's like, you're going to talk to us and you're going to give us our time to talk. And we got it. And I think that was great. I think the biggest thing that came out of it was Brian King admitting that there was no youth epidemic, even though they still use that term and all these organizations are still touting that as something that's still going on. In reality, it's not. He was able to admit that, which was great.
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Brent Stafford: Overall, do you think Dr. King was honest and fair when it came to addressing your questions?
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Allison Boughner: No. I've seen Brian King speak a few times. He's very personable. He's funny. He has a way of saying things without saying anything at all. So he says a lot of things and it's a great thing, but he always reverts back to the youth issue. And if it's appropriate for public health, which obviously at this point in time, we can see that the FDA does not consider anything that's not made by big tobacco or anything that has a flavor other than tobacco flavor as appropriate for public health.
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Brent Stafford: And I think this is a good point to make the point that what is appropriate is whether or not they think teens are going to like.
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Allison Boughner: Right. Yeah, I think that's the whole deciding. And it's crazy because going back to California, we saw a 2021 filter covered an article about the ban in San Francisco and that youth smoking actually went up because of the flavor ban. So clearly, if you're thinking about the kids, you're not taking all of the data into consideration.
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Brent Stafford: Let me ask you about tobacco harm reduction. Is it a concept you think that most Americans could understand?
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Allison Boughner: Most Americans I know? Yes. Most Americans, I don't think, see vaping or any of the other options to quit smoking other than patches and things that are recommended by their doctors as harm reduction. I think, unfortunately, because of this mess that public health has created, most Americans see it as just as or equal to the harms of smoking.
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Brent Stafford: Is tobacco harm reduction a term used widely within vaping advocacy in the US?
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Allison Boughner: It is between advocates, yes. We do use the term tobacco harm reduction quite a lot, but that being said, it's between us and we understand what we're talking about. I don't think that most Americans would understand what that means without having an explanation followed by that statement.
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Brent Stafford: Overall, how strong is the vaping advocacy community in America?
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Allison Boughner: It's strong, I think, mostly when things are wrong. When something bad is happening, you see a lot of people get active. Unfortunately, when you advocate for something, especially something that's constantly under attack, we need advocates to be more active year round, not just when something's happening in their state or at the federal level. It's something that you should constantly be talking about. It is hard. It's a thankless job. And most of us that are doing it, like me, are not getting paid for it. But we do it because it's what we're passionate about. But I do see that it takes a toll. It's hard to constantly get hit in the chest and you keep trying to stand up. That's definitely an issue. But when people are really needed, this community is amazing, really comes together. I think that the friends that I've made on Twitter and elsewhere, have gotten me through this last few years. I think they keep me sane. And I think it's just a really great group of people, very kind and always willing to help. And I guess that's the silver lining out of all of this is finding a community like that and they'll be lifelong friends now.
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Brent Stafford: Allison, COP10, the Conference of the Parties for the WHO's Framework Convention on Tobacco Control, is coming up next month in Panama. If you had an opportunity to send a message to delegates there, what would that message be?
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Allison Boughner: I would want to know, how they justify the hostility, the new take on harm reduction and how you can ignore the UK's amazing success, Sweden's amazing success. And how do you sleep at night? Coming up with these ideas to do flavor bans, knowing how many people die every single day from smoking related diseases. Continue the success. This is something that you should be cheering on and wanting it to go as far as it possibly can go and doubling down on harm reduction rather than taking a non-scientific approach.