With lofty ambition, the US surgeon general set a national goal this past January: Protect all “future generations” of Americans from taking up smoking of any kind. On Thursday, the federal Food and Drug Administration (FDA) took a big step toward that aim.
The agency proposed several rules on electronic cigarettes, notably one to restrict access of the battery-powered, nicotine-infused vapor devices to minors. Makers of e-cigarettes would also need to provide health warnings on their products and seek agency approval for the ingredients.
The FDA has strong political winds at its back as it tries to control the young and aggressive e-cig industry. Over the past half century, the United States has made tremendous progress in snuffing out a desire among Americans to pick up the habit of ingesting nicotine. The percentage of people who smoke has been cut in half. And among those who do smoke (18 percent), the number of cigarettes consumed per capita has fallen 72 percent.
This success even inspires experts to devise plans for an “endgame” to the use of tobacco. In 2012, for example, a surgeon general report laid out a “Vision for Ending the Tobacco Epidemic.” It stated that the US now has the tools – such as raising taxes on cigarettes or more nonsmoking zones – to rapidly drop the rate of tobacco initiation among youth “into the single digits.” Such hope for progress represents a shift in thinking about the ability of teens to resist the temptation to take up smoking. While media campaigns still evoke fear of nicotine addiction or tobacco’s effects, young people are also seen as able to make long-term choices about their well-being. Beyond its physical effects, addiction of any kind is demeaning.
The overriding objective in putting an end to tobacco use, stated the 2014 surgeon general report, is to “maximize health.”
Still, each day more than 3,200 young people under age 18 smoke their first cigarette. Many more these days take up the habit after trying e-cigarettes. Over half of the states already ban the sale of e-cigarettes to minors. The FDA regulations, if they take effect next year as expected, would further curb these devices, which may often act as a gateway to tobacco use.
The US is behind Europe in regulating e-cigarettes. But it is steadily in sync with a few other countries in contemplating a near-zero consumption of tobacco or nicotine products. New Zealand aspires to be the first nation to see the number of smokers drop below 5 percent, perhaps by 2025.
For the US to achieve a similar goal, the states would need to boost their nonsmoking and antismoking campaigns. In 2010 they spent only 2.4 percent of their tobacco revenues for control and prevention of tobacco use. The federal government wants them to spend an additional 13 percent, or $3.1 billion.
As a legal battle begins over the FDA proposals for e-cigarettes, the larger task of preventing addiction should not be lost. Attitudes have shifted against tobacco-related products. Now the endgame is in sight.