The Honorable Margaret Hamburg
Commissioner
U.S. Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
Dear Commissioner Hamburg:
We write urging the Food and Drug Administration (FDA) to investigate e-cigarette companies that are making unsubstantiated and potentially false therapeutic claims about products that have not been approved by your agency. Manufacturers of electronic cigarettes ("e-cigarettes"), battery-operated devices designed to deliver nicotine, flavor, and other chemicals, have often made unsubstantiated health and therapeutic claims. For example, NEwhere electronic cigarettes advertised on its website using a graphic with the text "Quit Smoking with Electronic Cigarettes."
At the same time, growing evidence suggests that electronic cigarette use is not associated with many of the companies' therapeutic claims that these products can help people quit smoking. We urge the FDA to review the evidence related to these therapeutic claims. Enclosed is an article outlining a recent small sample study published in JAMA Internal Medicine out of the University of California, San Francisco which concluded that e-cigarette use is not correlated with smoking cessation. This adds to evidence that e-cigarettes may not be effective cessation devices, including a longitudinal, international study published in the American Journal of Preventive Medicine which found that although 85% of smokers who used e--cigarettes reported using them to quit, e-cigarette users did not quit more frequently than others. Yet another study published in Nicotine and Tobacco Research examined quitline callers in the United States found that e-cigarette users were less likely to have quit at 7 months than nonusers.
We recognize that the FDA has been working to regulate these products, and that a proposed "deeming" regulation that could clarify that FDA has authority to regulate electronic cigarettes as tobacco products has been pending at the Office of Management and Budget for more than six months. However, the FDA's Center for Drug Evaluation and Research does not need this regulation or any new authority in order to investigate companies making unsubstantiated and potentially false therapeutic claims.
Not only has the research noted above failed to find an association between e-cigarette use and smoking cessation, but these products can also be hazardous through means other than intentional use. Last week, the Centers for Disease Control and Prevention (CDC) released new data that shows calls to poison centers involving e-cigarettes rose from 1 per month in September 2010 to 215 per month in February 2014. The CDC also found that roughly 50 percent of all poison calls regarding e-cigarette exposures were about a child under the age of 6. Without proper oversight of e-cigarette companies and their marketing practices, the progress we have made in this country over the past few decades to reduce nicotine addiction could stall if not reverse. Please respond with the current activities that the FDA is undertaking to ensure that consumers are getting evidence-based information.
Sincerely,