THE HILL
 

FDA’s drug and e-cigarette warnings counterproductive

By Jeff Stier, associate director, American Council on Science and Health - 09/14/09 05:50 PM ET

A major policy shift is underway, and it is bound to have a dangerous unintended consequence. The new team at the FDA has slapped a black box warning on an important class of drugs that treat inflammatory diseases such as rheumatoid arthritis, Crohn’s disease, and colitis.

The cancer risk highlighted by this new bold warning has been known for years — and hasn’t gotten worse. We already knew of the cancer risk in children and adolescents, and responsible doctors were cautious in using them. The new warning signals only a change in perception of risk, not any change in actual risk.

Physicians should still give due consideration to the benefits of the drugs, especially in light of the paucity of other treatments for debilitating and often dangerous inflammatory diseases. Consider the benefit versus risk analysis for inflammatory diseases with secondary risks.

For example, by not using these drugs out of possibly inflated concerns due to the new additional cancer warning, might inflammatory bowel disease patients face a higher risk of colon cancer as a result of years of inflammation? You won’t see that risk in bold print. But it is just as real. And this is precisely the problem with the FDA’s new policy, which is based on the assumption that erring on the side of more warnings is the safest way to go.

Similarly, this summer, the FDA warned about the safety of e-cigarettes, a product many smokers are using to quit smoking real cigarettes. E-cigarettes are devices that supply users with vaporized nicotine and look like cigarettes, many even having an LED light at the tip. These products, which contain no tobacco and are non-combustible, eliminate virtually all the risks of smoking. For the vast majority of smokers unable to quit even with the help of drugs and counseling, e-cigarettes could be a lifesaver.

Yet the FDA found tiny levels of carcinogens in the product and warned smokers to stay away, essentially telling them to go back to deadly cigarettes.

Unfortunately, it is no surprise that the new leadership at the FDA is taking a more aggressive stance with regard to warnings.

These warnings are a harbinger of how the agency will weigh benefits versus risks: with a thumb weighing down the risk side. This distorted approach has numerous downsides:

• Fewer patients will get the treatment they need, out of an “abundance of caution” and physicians’ fear of litigation.

• Black box warnings, originally meant for only the most dangerous drugs, will become more widespread but less meaningful.

• The FDA, newly armed with regulatory power over tobacco, will make it harder for people to quit smoking cigarettes by warning them away from disfavored alternatives.

• Investors and researchers (innovative drug companies) will have less incentive to pursue new medications that may attract scary warnings.

The old adage “better safe than sorry” is too simplistic in today’s world to be the guiding principle at the FDA.

New York City

ACSH is a non-profit group that accepts funding from a wide array of foundations, corporations and individuals.

Race trumps ethics

From Shyron M. Beavers

(Regarding article, “CBC members rally around embattled chairman Rangel,” Sept. 11.) Another disgraceful episode in a long line of pathetic exhibitions by the Congressional Black Caucus. Support for Reps. Charles Rangel (D-N.Y.) and John Conyers Jr. (D-Mich.), and ex-Rep. William Jefferson (D-La.), is a gross dereliction of leadership.

My fellow minorities must demand politicians cease offering alibis for repugnant conduct of highly educated, successful professionals who recognize the magnitude of their position. It’s official: Race trumps ethics!

The CBC’s hubris of established indifference to the needs of low-income black families in their districts are glaring, yet unreported. They’re modern-day plantation owners, enslaving constituents in economically depressed districts to lives of poverty, disease, death, incarceration, unwed, dropouts and broken homes.

An overwhelming majority of blacks under 50 aren’t represented by these arcane relics; en masse, blacks oppose abortion and support a partial birth abortion ban. We favor school choice, oppose outright racial quotas and heavily oppose gay marriage. We support financial independence and traditional values, not welfare and government paternalism.

The CBC is radically liberal. … Nothing in American history has ruined more black families than Democrats and their destructive Marxist/socialist ideology.

Alexandria, Va.

Source:
http://thehill.com/opinion/letters/58659-fdas-drug-and-e-cigarette-warnings-counterproductive

Comments (11)

(regarding "FDA’s drug and e-cigarette warnings counterproducti ve") I doubt that this is merely a random FDA action. Punitive taxation is profitable; therefor any attempt at truly encouraging constituents to quit smoking will severely affect their coffers.As to finding tiny amounts of carcinogens in the e-cigarettes; will they warn us about the carcinogens in all the plastic food beverage containers?BY Nita Younger on 09/16/2009 at 17:51
They found tiny bits of carcinogens. Laughable. Does the FDA ever intend to admit to the fact that your conventional NRTs have the same carcinogens in them? Heck, right now they're JUST putting warnings out for Chantix and peoples suicidal tendencies while using the drug even though the drug has been out killing for years. All because the FDA is in the back pocket of Big Pharma. Maybe the FDA should run safety tests on real cigarettes and compare the results to the electronic ones. I'd love to see that. But the FDA won't. It will only prove the electronic ones are far safer, and $$$ is at stake. Public health? The FDA is a joke and should be abolished.BY BigJimW on 09/16/2009 at 21:09
The worst part is how obviously tilted the FDA is toward big pharma and away from the well being of the people in this country. Doctors have been saying this for years, but I never really understood it until they attacked the e-cigarette. I switched to e-cigarettes after being a smoker for 15 years. Consequently, I am MUCH healthier, which my doctors can certify. The FDA would have rather have us switch back to harmful cigarettes, or try and have us use an FDA approved method, which I have tried almost every one, including Chantix.They say you can't quit if you don't want to, and I never did want to. Even when I ordered the e-cigarette I had cost savings in mind. Quitting was an unexpected consequence! That's how effective they are.BY Sam Layne on 09/18/2009 at 00:17
The first thing I noticed is that my heart rate is not going up by ten beats per minute upon the first "drag" of the day.I am going to have to see my doctor and see about getting off of my beta blocker for PVC's as I feel that I may not need them anymore.My chest feels lighter, I have no wheeze in the morning after the first full day of not smoking analogs. My resting HR as I type this is 66 bpm and normally at this time of the night it would be 84 bpm.That to me is remarkable to say the least.Do you think it has something to do with the fact that I am not breathing in Carbon Monoxide anymore? Nothing short of remarkable, I got my e cig on Monday Sept 14 and I have not smoked an analog cigarette since nor have I had any desire to.BY christine  on 09/19/2009 at 02:12
I have been using a e-cig for almost a year now .. almost down to NO NICOTINE .. get that?? Yea .. I'm off tobacco and all the harmful ingredients they put in cigs .. and even enjoy a "bubble-gum" flavor when I smoke my e-cig .. Everyone comments on how good the bubble gum smells .. a lot better than the smell of a regular tobacco cig.BY DeAnna on 09/21/2009 at 01:52
I got my e-cig 2 days ago and I haven't looked back. In just 2 days I feel so much better. I was smoking 1.5-2 packs per day, and constantly coughing and wheezing. Like others I have tried everything to quit… never really wanting to though because I enjoy smoking (except for the obvious health problems they cause and the way you feel after smoking 2 packs). The e-cig is MY solution to MY nicotine addiction. The FDA can sit on a broomstick and spin.BY David on 09/21/2009 at 13:00
FOLLOW THE MONEY TRAIL. This statement reveals the TRUTH behind most political motivations, unfortunately.The Fascists Duping Americans (FDA) are clearly not regulating anything based on the best interests of the general population of this or any other country.The States receive way too much money from the Big Tobacco companies to allow e-cigs to flourish. The Big Pharmaceutical companies receive way too much money from their ineffective tobacco replacements to allow e-cigs to flourish. Right now the ecig business is valued at around $100 million a year or so. At its exponential rate of growth, the States, Pharmaceutical Companies and Big Tobacco stand to lose BILLIONS of dollars if this isn't addressed and contained.FOLLOW THE MONEY TRAIL. To HELL with what is ethical, moral or even better for the health of the individuals involved.What a sad thing is human greed.BY Nikko Daniels on 09/24/2009 at 08:52
I smoked 35 years, 1 to 2 packs a day. With my e cig, I have no desire to smoke tobacco. It's a great relief to me and those around me to not fill a room, or my car with smoke. My taste sensation is so much better, my breathing, so much easier. My hearing, and even my far sightedness improved. I was obviously suffering many maladys from the smoke and carbon monoxide. I read this article because I, too, have had various acquaintances tell me that e cigs. are more dangerous than tobacco. That terrible chemicals are in e cigs. Until I hear definitive, unbiased facts to support those kind of allegations, I will continue to use my e cig.BY Margaret Bednarski on 09/27/2009 at 22:27
Just got my e-cig and so far so good. The way I see it now with all the unknowns about ecigs, if regular and electronic cigs are both bad for me, then I rather take the much cheaper, less smelly (no smoke) alternative - electronic. Have previously tried other methods of quiting reg cigs, and now I rather do without the vivid dreams and other side effects associated with those other methods. Those other methods are also too expensive given my economic downturn like others. I hope to stick with ecigs only until I no longer 'want' to smoke at all. Wish me luck.BY MJ on 09/29/2009 at 08:44
California's attempts to ban e cigs "until the FDA approves them" shows just who the real "addicts" are — legislators who are so addicted to tobacco tax dollars that they are willing to throw voters' health under a truck just to collect them! Of course the cigarette industry doesn't object — big tobacco wants their old customers back — and the FDA and California legislators are helping them get them, by banning e cigs. Neither politicians nor the FDA have no credibility anymore when they say that they are "concerned with public health" — they are just concerned with collecting their blood money!BY KMel on 10/06/2009 at 22:11

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