Matt Myers CTFK

E-Cigarette Summit USA. Where was vape?

Oliver Kershaw Comment 28 Comments

About the Author

Oliver Kershaw

Founder of e-cigarette-forum.com and co-founder of vaping.com

The inaugural US E-Cigarette Summit took place in Washington DC on Monday.

Encouragingly, there does now finally appear to be a consensus amongst the tobacco control community: Smokers should be encouraged to use vaping products if they’ve been unable to quit using FDA approved stuff. To many in the vaping industry, this will appear to be missing the wood for the trees, but that’s just the nature of consensus. It’s a net positive, and could not have occurred even a year ago.

But the vaping industry remains unrepresented in this discourse. Delegates at yesterday’s Summit did not come away from the event with anything like an incremental understanding of the true nature and character of vaping. It just wasn’t in the room. The only industry present, either physically, or in the mind of the non-industry delegates, were the few larger players that are going through the PMTA motions.

Don’t misunderstand me – it’s great that companies are doing PMTAs, but for those of us that are actually part of the independent vape industry, Monday felt at times a little like being in a parallel reality. The vast knowledge, experience, insight and sum total of a billion human-to-human interactions in pursuit of “actually-existing harm reduction”, just did not surface. Instead, the conversation was around the PMTA agenda securing a future that consists of some (we don’t know how many) reduced-harm products. The dangerous assumption is that this is sufficient or desirable and that this constitutes a true harm-reduction approach.

If you attended the Summit and don’t recognize that as a truthful statement, let me prove it to you with a quick and easy task. Spend 10 minutes browsing my website, E-Cigarette Forum.Com. Get a sense of the vernacular, of the energy occurring between peers. Now realize (because you just have to trust me on this one), ECF (as we call it) is a big site, but it’s barely even a speck compared with the true overall picture. Was this what was under discussion at the Summit? I don’t believe so.

This is what harm reduction looks like now, in the actual world. It’s a thing that should be treated with respect, curiousness and seriousness and not exclusion. The fundamental element of harm reduction is peer-to-peer education and interaction: harm reduction is a communication intervention. Thanks to the wonders of information technology, you can witness this in real time. What a privilege! Did you get a sense of this at the Summit?

This peer-to-peer interaction is the reason, as we heard, that 65% of American smokers are correctly informed that vaping products are safer than smoking, compared with some 30% of non-smokers. This peer-to-peer interaction is entirely facilitated by the vaping industry. Why is the vaping industry so good at doing this? Easy: because independent vaping innovation and the market for independent vape products is radically user driven. The category was founded and occupied by people who make and use these products.

There exists an assumption that all this can be placed by a few “harm reduction products”. Matthew Myers, for example, stated that he’s in support of harm reduction, but he’s also in support of the deeming rule. This is a contradiction in terms,  and I think it’s a risky business killing this all off without any clarity over what will replace it.

So why is vaping underrepresented?

The dearth of anything like a literature on the true picture of vaping in America is a problem.

In my opinion the main reason for this is structural (but I will note that many of my colleagues do not share this interpretation, which they would consider charitable at best): The fragmentation in ownership of the industry has led to a fragmentation in efforts to represent it at research, regulatory or tobacco control levels. In a sense, this industry is invisible despite being found on every Main Street.

This had led to a hinterland between “anecdote” and “literature” that the FDA wishes to fill with PMTAs. The FDA’s impact assessments did not make evaluations of the existing public health contribution of vaping and, therefore, was not able to make any assessment of the effect on public health of its eradication. The entire issue was reduced to a footnote: “We anticipate 98.5% will exit”.

But it’s not entirely a structural issue. There has been no desire from the leadership in the research community to develop a knowledge base and to work with the user community. And, sadly, there’s deep reciprocal mistrust of the Tobacco Controllers from vapers and vape businesses.

Instead of working with what should be their natural allies (it’s not uncommon to hear vapers state: “Fuck Big Tobacco”!), for years the tobacco control community has occupied itself over an internal disagreement as to whether the notion of harm reduction can be countenanced. There are individuals that are responsible for this inertia. There are also individuals that are responsible for the dissemination of dangerously misleading information. But yesterday’s Summit appears to have generated a consensus. So what next?

 Why regulate?

During the first E-Cigarette Summit in London, 2013, a panel was asked: “why is regulation necessary?”. Professor Robert West replied (I’m paraphrasing): “I think we regulate when one of two things are true: Either we identify a problem that regulation needs to deal with, or we identify a way in which regulation can improve things. I don’t see either answer being true in the case of e-cigarettes.”

The construction of the Tobacco Act excuses the FDA from asking either of these questions. On the one hand, it’s simply a statement of legal fact that it gives FDA a mandate to take action, and on the other, the onus is placed on the manufacturer to prove a product’s public health benefit.

The net result of PMTAs is that the overwhelming majority of vape businesses are eliminated, the peer-to-peer networks, which revolve around these businesses, fall apart, and this thing is lost forever.

Is there a case for regulation?

I think I know how Robert West’s questions can be answered in the US case.

The first question: “what problem are we seeing that needs to be fixed”, is problematic in the context of biased research agendas. This is solved by the rejection of bad research, and I think the overall picture that came out at the Summit was positive. The reason Professor West could say convincingly that he wasn’t seeing a problem (actually, he was just starting to see the opposite of a problem) is because he runs the Smoking Toolkit Study. The US counterpart, PATH, is only now beginning to provide a truthful picture of vape (and smoking) in the USA.

Can regulation “make things better”? I think it can, in two ways. Firstly, a standards-based system can be adopted and made to work, perhaps mimicking the US Cosmetics model. This would provide American vapers with assurance as to the quality of products, and would identify, over time, any compounds that are problematic in inhalation. Contrary to Matt Myers, there is not an abundance of “awful products” out there, but there is an abundance of misleading information.

Secondly, a program should be initiated that seeks to leverage what vape-stores are already doing. This program would create an information exchange helping to encourage best-practice in helping smokers making the change. but it should be facilitative rather than coercive.

Product innovation should be encouraged. It’s true that vape products are not yet good enough.  Is there a way of incentivising innovation in vape? I don’t know, but I do know that PMTA is disincentivising.

On flavors

The hand-wringing over flavors needs to stop. Flavors are great – smokers love them. To me, the constant refrain of “flavors are just aimed at children” only serves to underscore the lack of compassion for smokers. Which other groups would be denied their pleasures so cavalierly? And doesn’t the Declaration of Independence talk about the rights of Americans in the pursuit of their happiness?

In fact, I’ll go further on flavors. I think they’re a “hook”; a last ditch attempt to find something specifically problematic about e-cigs to justify a strongly held disgust-response to vaping. On the plus side, if people can get over the flavor issue, maybe the next step is a true change of mind.

Footnote

I’ll be following this piece up with an overview of the content of various presentations shortly. But I wanted to make note of a general sense of doubt over PMTAs. The new Administration, Cole-Bishop, lawsuits, and so forth have, I think, led to a general sense that the regulatory process embarked on in May last year will eventually take on a different character.

A Clarification

This piece was not intended to criticize in any way the Summit or Amanda Strange, who put on a masterful event, as usual (and who is, herself, a vaper).
I don’t think the Summit could have projected the above narrative in this, first, US incarnation. But I do think it’s worth noting that even those who now appear to provisionally support vaping, might only support a limited aspect of it – a “clean face” which is presented to them through access to a variety of social networks.
Amanda did, as she always does, make provisions for vapers to attend. I hope, as has happened with the UK Summits, that some connections were made that will prove fruitful for better understanding and co-operation in the future.

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  • Irish Lass

    An excellent and interesting post. I’m glad opinions are slooowly starting to change in the US, but saddened at the lack of engagement by those in positions of power with reps of the legion of smaller companies and vapers.
    I am encouraged a wee little bit by the doubts you encountered over the regulatory process currently being adopted, and just hope any beneficial change in the process does not come to late to save this wonderful opportunity for our generation to reduce the harm caused by smoking.
    (However, I cannot believe that this particular genie will ever go completely back into the bottle, whatever happens. The e-cig has been invented, is now part of history, and I believe that too many people love vaping to let it be ‘uninvented’ or forever forgotten….though it may have to be re-launched by a wiser, future generation if the ignorant and malicious have their way for now.)
    Is enough being done by the smaller companies and vapers themselves to organise into sizeable groups in order to be large and loud enough to be seen and heard by the Powers That Be??
    What about the media in the US? Is there any honest and unbiased review of vaping taking place (anything I’ve seen on American TV to date has been very negative) and, if not, can anything be done to improve media coverage?
    In the UK, despite appalling newspaper coverage (we do love a “shock, horror!” headline!), a sensible piece of TV journalism by a respected popular scientist, and the excellent report on vaping by the Royal College of Physicians, have been helpful in undoing some of the harm caused by misleading scare stories, particularly in the minds of some of our more reasonable politicians (a dying breed?). Is anything similar happening over there?
    Thanks for an informative post. After recent news, your assessment was no beam of sunshine, but maybe a small ray of light in the darkness. With some hope – and all digits crossed – that sense may prevail in time.

    • Thanks, er, Lass!

      What concerns me is the overall agenda which I can only describe as corporatist. The SMEs in this industry are both being ignored and, simultaneously, being cast as the bad guy (Matt Myers’ “awful liquid”). Yes, it’s a contradiction, but it’s also true.

      Accordingly, only the corporations get to play, while this industry which has done more than anyone or anything to create a harm-reduction knowledge-base amongst smokers.. Well, screw ’em because they make bad liquid.

      In the US an enormous amount of energy and money IS being poured into advocacy. But they’re having to advocate at State level, and this drains resources away from representation amongst the DC circles.

      In fact, there’s a whole chapter to be written under what I perhaps glibly described as “fragmentation”. But the central point remains, this industry cannot create a unified voice that represents its true nature. But, again, I don’t blame the industry for that.

      Is anything similar happening “over there” to what’s occurred in the UK? Well, I think so, to some extent. RCP’s report exists. This is important even in the US context. Also, there are people in the US who do have influence and who are starting to fight back against the misinformation. Finally, FDA now has two years of PATH data, and other data is showing a big drop in teen use (which makes vaping look like it was perhaps a fad).

      BUT, even as those incremental improvements occur, the real-business of harm reduction remains ignored. The people doing it are being ignored. When tobacco-controllers talk about harm reduction, I honestly think they just mean “products that are less harmful”. That’s not the whole story, not by a long chalk.

  • castello

    Where did you hear the optimistic info from Tobacco Control? This is the first I’ve heard of any major movement in their tone about vaping.

    • Hey, I’ll try to cover that on Monday. Sorry, I know I said I’d update today but these posts take time.

      • castello

        Thanks.

  • jb0nez

    “And doesn’t the US constitution protect Americans in the pursuit of their happiness?”

    No, the Constitution (capitol C!) does not. The Declaration of Independence opens with it, but is not law.

    Good post otherwise!

  • The problem with most e-liquid, device, and combination manufacturers is that they do not want to retain on an affordable, short-term, contract basis competent regulatory scientists to review the chemistry and toxicology of their ingredients and materials used in manufacture and the stability and performance of their products over a range of typical consumer behaviors. I have approached several such entities and been approached by others. Our fees for such work are minor compared with the costs of attorneys specializing in FDA regulation. However, it appears that companies do not want to know adverse information about their products or receive recommendations about needed changes in formulations, materials, and/or designs.

    Sooner or later, such companies will need to provide the same information to the FDA and may have their products ruled off the market on the basis of improper ingredients, materials, and/or processing conditions. For example, some e-juice companies are using sugars in their formulations. Sugars pyrolyze when heated to give toxicants on the FDA HPHC list. Other components are not shelf-stable and some devices are likely to overheat the e-liquid. It is time that all in the e-vapor industry get their products up to the same standards as those coming from the major tobacco companies and know what is in the aerosol stream being inhaled by the consumers.

    JHL

    • Hi John,

      Many thanks for responding. May I, respectfully, ask that you’re seeing this issue from a particular set of lenses?

      I, and many like me, have long advocated for a standards-based regulation. One which would draw from the expertise of individuals such as yourself to create a workable format for the industry.

      The FDA could, years ago, have enabled this to take place. The reason they didn’t is one for the historians to mull over.

      Here’s the problem: diacetyl and sugars taste great. The market loves them. Any manufacturer who refuses to sell them may be acting in the correct way but, in this market, will be hobbling themselves compared with their less ethical competition. And, some of those manufacturers justify this saying: “doesn’t matter, we’re reduced harm”.

      AEMSA proved that, in this industry, voluntary standards do not work. AEMSA were criticised for being too top down at the time, but the truth is, even if they’d had 100% buy-in from all the industry in 2012, by 2013 there were 10 times the participants.

      So, what’s the solution? Would you work with AEMSA in creating something that the FDA could work with, much as the cosmetics industry operates?

  • Paul Muad’Dib

    How many people have died from using ecigs so far?

  • Norm Bour

    Great overview and insight, Oliver, thanks for sharing.

  • Rain Man

    Oliver- Very well reasoned and astute observations!

    Are you available for cloning and relocation to the colonies?
    I have a room walking distance to FDA HQ and not far from downtown D.C., that could be available rent free. 😀

  • Reply to Oliver Kershaw.

    Thank you for your comments. One venue for the development of consensus standards is the US Technical Advisory Group (TAG) to SC3 of ISO TC 126 on Tobacco and Tobacco Products. The US TAG works under the auspices of ANSI and SC3 operates quite independently of TC 126 and its two other SCs. Unfortunately, most US-based e-vapor companies have not joined that TAG.

    Just a word about my background: Ph.D. in carbohydrate chemistry from “Sugar Alley” at The Ohio State University (12/70). First 10 years in industry were mostly in adhesives, coatings, food ingredients and foods. Joined a major US tobacco company, 9/80, with responsibilities for detailed analyses of tobacco and tobacco smoke, later on to include routine analyses, before becoming part of the company’s scientific and regulatory affairs (S&RA) group, 9/96, with focus on chemistry of ingredients added to tobacco, processing, cigarette nontobacco materials and packaging. Also, became company’s representative for in vitro toxicology work done at outside labs. Passed exams for board certification in general toxicology (DABT) in 2001 and current certification good through 2021. Was early retired 10/1/04 and immediately started my own company, Lauterbach & Associates, LLC, to provide “big-company” S&RA services on “hourly” basis to small business tobacco (and now e-vapor) manufacturers. We have been involved in e-vapor since 2008 and have given more than several presentations on chemistry of e-vapor products.

    While there is an increasing body of evidence that most vaping is much safer than smoking of combustible tobacco products, that doesn’t give license for e-vapor manufacturers to use anything at any level to make a product attractive to consumers. Sooner or later, the FDA is going to compare HPHC levels produced by various brand-styles e-liquids in presumably some sort of standard device(s) for e-liquids not packaged in cartomizers or single-use devices. The Agency may also require that e-liquids be analyzed before and after heating to simulate high temperatures that may be encountered in commercial transit and consumers leaving products in hot environments. If I were an e-liquid manufacturer, I would want to compare my products with those marketed by the Nu Mark subsidiary of Altria both from detailed analytical information on product composition and on generation of HPHC.

    Questions and comments, please.

    JHL

    • Lessifer

      Have you tried any of the products from Altria? I have, they’re horrible, which I think is the point Oliver was hinting at.

      At the same time, the only significant levels I’ve seen produced of HPHC’s in vapor products are when the products are used outside of normal operations, like running a device at 5v when it should not ever be run higher than 4v.

      Now, some would make the argument that if that device shouldn’t be run above 4v, then make it so that it can’t be run above 4v. Well, that doesn’t necessarily fit with the way that vaping is structured. Most of the power sources, tanks/atomizers are interchangeable but each will have it’s own operating specifications, and there is a built in mechanism for vapers to learn how to correctly operate their equipment, when you use it incorrectly it tastes horrible.

      • Thank you, Lessifer. You have made some very good comments. Yes, I have last year’s and current Mark Ten XLs (also Green Smokes). Right now, I am vaping some XLs that were used (only first 25 puffs) a couple of months ago on our experimental work on e-cig aerosol pH.

        You wrote, “At the same time, the only significant levels I’ve seen produced of HPHC’s in vapor products are when the products are used outside of normal operations, like running a device at 5v when it should not ever be run higher than 4v.”

        First remember that diacetyl is on the full list of HPHC. Second, and more importantly, the “mix and match” of devices and running devices at abnormal power levels is a difficult challenge for regulators. Regulators in most cases would like to see devices than cannot be abused.

        You also wrote, “Now, some would make the argument that if that device shouldn’t be
        run above 4v, then make it so that it can’t be run above 4v. Well, that doesn’t necessarily fit with the way that vaping is structured. Most of the power sources, tanks/atomizers are interchangeable but
        each will have it’s own operating specifications, and there is a built in mechanism for vapers to learn how to correctly operate their equipment, when you use it incorrectly it tastes horrible.” Good point, but if you were the chief governmental regulator for e-vapor products would you be willing to allow that to happen? Also, what is the legal liability of companies that make products that are designed to permit abuse? Note, for example, the threaded connections on each major brand are different. You can put a V2 baterry section on a Mark Ten XL cartomizer.

        JHL

        • Lessifer

          When you view things from the perspective of tobacco control, with the history of cigarette regulations I can see exactly where you’re coming from. However, take a moment to view vaping with fresh eyes. With over a decade of use there are no reports of significant health effects. Also, imagine that vapor products were not “tobacco” products, no other industry has the ridiculous standard of zero potential for harm. When you buy a stove there is no device regulator ensuring you don’t abuse the product and burn your food, which is essentially what vaping at too high power is, and the same mechanism is in play to dissuade you from ingesting it, it tastes bad.

          As for diacetyl, I’ve read every bit of research I can find on the subject, and I have yet to see a causal relationship to any health effect. Consider also that in all but very few cases the levels seen in e-liquids are a minute fraction of what is seen in traditional combustible cigarettes, and of course without the accompanying tar and other carcinogens.

          • Thank you, Lessifer. From a regulatory view point, one of the key issues is inhalation (as opposed to your analogy to the stove). In the mainstream cigarette smoke matrix, the concentration of diacetyl at say 250 ug/cigarette does not appear to be on of the driving forces for smoking-related diseases. In an e-cigarette aerosol, at likely much lower concentrations, we still do not know. Since you can make acceptable (at least to some) e-liquids without diacetyl, some regulators, would argue, using the precautionary principle, that any amount, given the current state of knowledge, is too much. On the other hand, commercial demand may result is some company making the investment in advanced toxicological methods [see, for example, PMI journal articles related to iQOS device (most open access in Regulatory Toxicology & Pharmacology)] that will show diacetyl, at least at some use level, is not a probem. JHL

          • Lessifer

            The current state of knowledge is based on unfounded assumptions though, and when those assumptions lead to the decimation of an industry, the precautionary principle becomes a prohibitionary principle. Precaution would dictate identifying a possible risk and making the consumer aware of its presence.

            It is true that inhalable consumer products are a new field, the only real cohort is combusted tobacco at this point. Forget for a moment that it is inhalation, and then compare it to other consumer products. There are an untold number of products that people consume on a daily basis, with KNOWN harms associated with their ingredients. Consider sugar, alcohol, and trans fats.

            How much of the “precaution” is due to vapor products association to smoking, and everything that smoking means? Consider how much actual association there is.

            I am not against testing, or standards, but the approach so far has been to hold vapor products to a higher standard than any other product that I know of. It would be easier to get a prescription drug with an effect rate of 5% approved than it would be to get a PMTA for an e-liquid.

            As for Altria’s products, I have a few of the XL’s. I got them because I got free coupons and I thought they might be a good place for my wife to start, she still smokes. To me they taste like stale coffee, and mentholated stale coffee.

    • Thanks John,

      Firstly, I’m aware of your experience and expertise. I am not in any way discounting the importance of what you do, and I’m certainly not in a position to evaluate the the work of the TAG.

      The question to be addressed is: “why aren’t businesses engaging in an existing standards framework?”. I think the answer is simple: The real-world business and social dynamics prohibit it. Although there may be more specific criticisms of the TAG that others might have.

      In other words, I don’t think the answer is: “because people don’t believe John Lauterbach” or “people don’t want to do standards”.

      Importantly, it must understand that for most businesses the current working assumption is that even were they to participate in any existing standards framework, they’re gone at the end of next year, so why bother?

      That doesn’t make them bad people. Most are operating under the assumption that everything they are doing is good for smokers (accepting, of course, that there will be some bad actors – there always are).

      May I ask you on this point: “most vaping is much safer than smoking of combustible tobacco products”. Is there any evidence that any vaping is ever more dangerous than combustible tobacco? And I’m not talking about laboratory conditions, but real-world use.

      This letter I wrote to Addiction remains my perspective: http://onlinelibrary.wiley.com/doi/10.1111/add.13068/full In summary, bad product is not problematic due to chronic exposures, but due to putting smokers off vaping.

      Back to standards. There’s only a dozen or so flavor manufacturers and thousands of vaping manufacturers (which are, in the main, “compounders”). Is this not the place to start?

      • You are very welcome, Oliver.

        The tobacco industry has been into standards and recommended test methods for decades. Please see https://www.coresta.org/documents/search/?f%5B0%5D=im_field_technical_document_type%3A36190, for the CORESTA Recommended Methods. More recently, many CRMs have become ISO Standards and scientists from the FDA are taking part is both CORESTA and ISO TC126 activities. CORESTA is basically for those in the tobacco industry and my company is a member. ISO Standards (test methods not product standards) for tobacco products are referenced in the FDA draft guidances for tobacco products and there is heavy participation by US tobacco companies, suppliers, and testing labs in the US TAG to ISO TC 126, including SC1 and SC2. My company is also a member of that TAG and is also a member of the US TAG to TC 126 SC3 (e-vapor products).

        One area the standards and CRMs do not cover (except for routine tobacco chemistry and humectants) are flavor related tobacco ingredients as well as mixtures of ingredients that yield flavorful compounds when applied to tobacco and the tobacco is heated. The tobacco company S&RA groups (including my company) get confidential disclosures from the flavor houses to review and let the suppliers know if their formulations are acceptable or not. These S&RA groups are “firewalled” from others in the companies and when a S&RA group says “no, we recommend against using it”, it generally does not get used in the product and/or packaging.

        Based on the journal articles I have read, there is unlikely to be health-related problems with major-brand cigalikes and major brand e-liquids in low-power devices, especially when the user puffs on them in the same manner a pipe smoker would puff on a pipe. Even if the user takes a bolus of aerosol in her/his mouth before inhaling as in smoking a cigarette, the hydrophilic properties of most e-cig aerosols would appear to result in absorption of much of the aerosol in the mouth. I don’t have first hand experimental data to back up what I just wrote, however. I see the main problem with high-power devices and users inhaling large volumes of aerosol that may contain levels of HPHCs and other toxicants from the flavorings. Unfortunately, the producers of e-liquids and prefilled devices do not appear to have published maximum use levels (MULs) such as Altria/PMUSA has done for cigarettes (see PDF download at http://www.altria.com/our-companies/philipmorrisusa/our-products-and-ingredients/Pages/default.aspx). When we see same data for all e-liquids and prefilled devices we can make better judgments as to the potential of e-vapor devices to produce adverse health effects.

        JHL

  • Lessifer

    Great post Oliver. This line is worrisome to me though “Product innovation should be encouraged. It’s true that vape products are not yet good enough.”

    I’m definitely not against innovation. What worries me is the idea that the products are “not yet good enough.” Good enough for what? This suggests the notion that vapor products need to become better treatments for smoking addiction. While many vapers do quit smoking by vaping, I believe that viewing vapor products in this light is heading in a dangerous direction.

    It is perfectly acceptable for consumers to enjoy a product with minimal to zero harm, purely for the sake of enjoyment.

    • Lessifer, I don’t think they’re good enough. Sincerely. I set up ECF because I thought those early products were an incredible proof of concept, and that the underlying technology could eventually produce a “better cigarette”.

      The problem is, the cigarette is a really hard thing to better (except in one obvious respect).

      I think that vape products available now can produce an experience that rivals smoking. BUT that doesn’t mean that, taken as a whole, they’re good products.

      There’s whole set of reasons why the vast majority of smokers continue to smoke and not vape, and product is actually only a subset of these reasons.

      The danger behind the regulations is in the assumption that regulators can identify what makes a “good” vape (they can’t), and that innovation becomes set on a pathway delineated by this regulation. That’s what’s happening now.

      • Lessifer

        Right, I think the interaction between industry and consumer can lead to better and better products, as it has, if it’s allowed to continue in that direction.

        That line just reminded me of something that someone, I can’t remember who, said that was along the lines of “we need to make e-cigs more addictive so that they are a better cessation product.” That, I believe, is the wrong approach.

        • I agree. I’ve got a lot of thoughts about this that I don’t have time to set down. But “good enough” can absolutely emerge only from a continued dynamic industry with multiple competing businesses.

          Instead, we’re in a situation where the smart money that should be coming in to create these product just isn’t, because the regulatory uncertainty is too much.

          Jean-Francois Etter said that at Summit 1 in 2013, although he didn’t say anything about “cessation product”, as far as I remember. To be fair, his comment was really just saying: Products need to deliver nicotine more effectively.

          I agree with this – you know as well as I that for some people (maybe most), nicotine is a centrally important part in the satisfaction of vaping. Whether that makes it more addictive is a whole separate topic.

  • Bill Godshall

    Vapor prohibitionists acknowledging that vaping is less harmful than smoking isn’t new (and cannot be considered progress), as FDA’s Mitch Zeller, former CDC director Tom Frieden, DHHS funded Stan Glantz, etc. have all acknowledged that vaping is less harmful than smoking as they continue to demonize and lobby for FDA’s Deeming Ban.

    But its nice to read your skepticism about this event.

    • Bill, it was not skepticism about the event. Please read my clarification.

      I’ve another post in me about the event. I think it was a step forward, and I think Summit 2 will be even more so.

  • Chase Richardson

    BRILLIANT piece Oliver, thank you so much for your recap! And a big thank you to the commenters for such a great discussion!

    • Hey Chase! Thanks buddy, and a pleasure it was to meet you in DC 🙂