Recently, Biden administration officials shared a status update on the president’s Cancer Moonshot, one of the most ambitious domestic health policy initiatives in recent memory, inspired by the tragic death of President Joe Biden’s son, Beau, from brain cancer at the age of 46.
One of the key objectives of the Biden Cancer Moonshot – a whole-of-government approach to cut U.S. cancer rates in half by 2050 – is to “prevent more cancers before they start,” including by “reducing tobacco use.” Smoking is the leading cause of preventable death overall in the U.S. and, according to the U.S. Centers for Disease Control and Prevention (CDC), is responsible for 90% of all lung cancer deaths – about 114,000 deaths annually.
According to the CDC and the American Cancer Society, Black and LGBTQ+ Americans smoke and suffer from cancer at disproportionately higher rates than their white and straight counterparts. Because health equity for marginalized groups has always been at the top of the president’s public health agenda, I was surprised to see that his own Food and Drug Administration (FDA) – specifically, the Center for Tobacco Products – has become a roadblock for his ambitious goals to reduce tobacco use and preventable lung cancer, especially for Black and LGBTQ+ Americans.
Harm reduction saves lives. E-cigarette and vaping products are proven to help adults reduce their smoking, or quit entirely, and contain none of the 7,000 carcinogenic or otherwise toxic ingredients contained in cigarettes. In fact, the only ingredient that vaping products share with cigarettes is nicotine.
And yet, over the last several years, the FDA has systematically refused to approve vaping or e-cigarette products – ignoring the latest science around both e-cigarettes and harm-reduction. Harm-reduction is work I have done through the entirety of my career in Black and LGBTQ+ advocacy.
Out of 6.7 million e-cigarette product applications filed, only 1.2 million were even formally reviewed by the FDA. Of those reviewed, just 23 related products – including only eight individual vaping devices, all made by Big Tobacco – have been technically approved for sale. At the same time, the FDA approved 900 new cigarettes during the same period.
My organization, the Center for Black Equity (CBE), one of the leading Black and LGBTQ+ public health advocacy organizations in the country, recently released a new econometric analysis authored by Dr. Robert J. Shapiro, a noted Democratic economist and advisor to the last three Democratic administrations. The new research quantifies the significant health and economic benefits of vaping nicotine as an alternative to cigarettes, with particular focus on the impact on and benefit to the communities I serve in my role at CBE.
The analysis confirms the findings of hundreds of other studies – that vaping is a legitimate and effective harm-reduction and smoking-cessation tool for adults, and that the risk profile of vaping nicotine is extremely low both on its own and as compared to smoking cigarettes. But more than that, the report has, for the first time, quantified the health and economic benefits of switching from smoking to vaping.
Dr. Shapiro’s analysis used advanced statistical modeling techniques and massive amounts of public health data to determine that between 2010 and 2022, the availability of vaping products saved 113,000 lives, preserved $137 billion in GDP, saved $39 billion in healthcare costs, and reduced the number of smokers in the U.S. by 6.1 million.
The science is clear – if reducing smoking and preventable cancer is a priority for the Biden administration, approving a wide variety of e-cigarettes would be the easiest and most impactful place to immediately improve health outcomes. Allowing consumers to access lower-risk nicotine products would directly improve the health profiles of Black and LGBTQ+ Americans who smoke and die in higher numbers than the rest of the population.
Other government health agencies understand this. Britain’s Department of Health and Social Care launched a program called “Swap to Stop” that urges British citizens to exchange their carton of cigarettes for a vaping kit. The U.S. is far behind in its approach, but the FDA and the Center for Tobacco Products could easily implement a policy that broadly approves vaping products – especially flavored vaping products – whose availability makes it two to three times more likely adults will quit smoking as compared to non- or tobacco-flavored products.
Less smoking means less cancer, especially for Black and LGBTQ+ Americans. And supporting broad access to and availability of vaping products means supporting the Biden Cancer Moonshot. It means more adults quitting smoking; it means fewer cancer diagnoses; and it means eliminating the most preventable cause of death in the U.S.
The benefits of shifting from smoking to vaping will be felt most acutely among those communities most at-risk. Americans, especially Black and LGBTQ+ Americans, need regulatory policies that reflect modern science.
Anything less stands in the way of achieving essential health equity and harm-reduction goals critical to the president’s agenda.
