Dr Evan Stepp on the FDA’s Decision to Authorize an e-Cigarette

An on-demand session at CHEST 2021, Taking Action in the Vaping Epidemic, presented how clinicians are trying to combat the prevalence of e-cigarette use in young adults. Evan L. Stepp, MD, FCCP, CPE, a pulmonologist at National Jewish Health, director of the Highlands Ranch Clinic, and an assistant professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, discussed the recent FDA decision to authorize an e-cigarette intended to help current smokers quit combustible cigarettes.

Transcript

I don't agree with it. And I think it need more study before you give, like, kind of a blanket indication that it might be helpful for most people, because it's certainly more complicated than that. I've definitely known folks that have been trying to get back to combustible cigarettes just to get off of vapes—it's just trading one addictive substance for another. One is socially more acceptable and perhaps less injurious, but not noninjurious, to lungs and brain and everything else. So, no. I think the studies that these are based off of might be kind of, usually, I think they're 12 months of, say, abstinence from combustible cigarettes, or something like that. But we're really talking about a lifetime of trying to deal with getting your brain away from nicotine. And it's really hard to predict. Different brains are very different. Some folks can do the cold turkey, and plenty of other folks just have a lot more difficulty just kind of peeling their brain away from nicotine, even though they have all the motivation in the world. There's not a not a shred of intellectual kind of misunderstanding or anything. It's still a very powerful and addictive drug. And to consider that it [this e-cigarette] might be kind of a useful tool—I don't know. I mean, it just seems very premature to me, especially given the explosion and use of vaping products. It’s not like they need any help with marketing, you know. It just strikes me as premature at the very least.