E-cigarettes' Future Generates Questions, Not Their Efficacy For Smoking Cessation
FDA has made clear since e-cigarette sales emerged that they're not approved for labeling as products to help consumers stop using combustible tobacco. Agency also has acted on concerns about products' safety and appeal of flavored nicotine to minors. But likelihood of sales in US ending, not whether products help smokers quit, was discussed at FDLI conference.
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Examples of unfinished business from 2019 include no legislation passed to reform OTC monograph program; FDA putting off until May the planned publication of an NPRM to allow firms to submit OTC NDAs with extra-label information to help guide consumers' self-selection; and no OTC naloxone for opioid overdose approved even after FDA's unprecedented step of developing model DFLs sponsors could use for their own label comprehension studies.
"Balancing the need to address the existing public health crisis among today’s youth ... and the need to avoid creating an additional public health crisis if e-cigarette availability dropped so precipitously as to push users to combusted tobacco products," Judge Paul Grimm sets a May 2020 PMTA deadline for vaping products, noting the industry’s "lack of effort to obtain approval without an imminent deadline."
Research in JAMA Internal Medicine studied "longitudinal associations between [e-cigarette] use and tobacco smoking patterns in a large population-based cohort study" and found use was associated with reduction in smoking and an increased probability of smoking cessation. But the researchers saw that e-cigarette users who quit tobacco "tended to relapse to smoking more frequently than" former smokers who didn't use e-cigarettes.