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James Felsen: Regulating e-cigs, boutique pot -- what are the feds smoking?

By By James Felsen

Stories about regulating e-cigarettes (e-cigs) and marijuana (THC/pot) sales have been prominent in the health news. Both contain substances with possible, limited, legitimate medical indications — as well as the potential for adverse medical side effects. From a federal regulatory control and policy perspective, that is where the similarities end.

On April 24, the Food and Drug Administration issued a proposed 241-page regulation that primarily addressed e-cigs (non-tobacco, vapor producing, nicotine delivery devices), as well as a few, non-cigarette, tobacco products, e.g., cigars. Although stating, “We don’t know as much about the health and safety risks of e-cigarettes ,” Dr. Margaret Hamburg, FDA Commissioner, said, “The present time, when we can’t regulate E-cigarettes, it’s like the wild, wild west. Companies can do anything they want. They can market in ways that they want.” She stressed the urgency to move quickly — inferring such regulations will allow FDA to get the information needed to protect child safety, curtail adolescent “vaping”, and reduce potential nicotine addiction and other adverse health consequences.

Supporters of the regulation expressed that FDA did not go far enough, for example failing to prohibit the use of “flavors” and advertising intended to entice e-cigs use.

Opponents noted that there was little scientific evidence of the various alleged e-cigs, adverse side effects, including childhood poisonings (a relatively few) and the speculation that use will lead to tobacco addiction. They contend e-cigs represent a much healthier, major, “risk reduction” quit option for current smokers and that the regulations will thwart this option by increasing the cost and availability of e-cigs.

Meanwhile, in the actual “wild, wild west”, federal laws and regulations are being overtly and completely ignored in the case of marijuana, a Class 1, illegal drug (smoked and ingested) with well established, scientific evidence of adverse health effects. Evidently, neither the FDA nor any other federal agency seeks to — or see any need to — take action to protect children and others adversely impacted by the spiraling use of this harmful substance, despite even more recent evidence of its health dangers

The April 16 Journal of Neuroscience presented new evidence of how using marijuana a few times a week can produce critical physical damage to brain structures and changes in user emotions, motivation and decision making. The April Journal of the American Heart Association features an article on the serious cardiovascular risk of pot use, as well as an association with the increased abuse of alcohol and other drugs.

Out west, THC media advertising and promotion, including publically sanctioned celebrations and festivals, have mushroomed to promote the use of this illegal and dangerous substance. A recent television show featured a tour of a Colorado pot boutique. Attractive women pointed out glitzy glass countertops and display cases featuring various THC products and paraphernalia. The counters had stations where there were large jars containing bud samples and an individual i-pad to look up the claimed medical indications, characteristics, strength, etc. of each sample. The display cases featured multiple, flavored, brightly colored, THC laced candies (e.g., lollipops, gummy bears and chocolates) and food items for purchase.

It will take time to generate valid and reliable data demonstrating the increased adverse health and social, e.g., DUI, consequences of the feds ignoring their current laws and regulations, but anecdotal evidence has already surfaced, such as a recent Colorado news story about the arrest of several 10-years-olds for sharing and selling their parents’ THC products with other children at an elementary school.

From a medical, scientific and public health perspective I cannot explain a policy that advocates for an urgent and strident need to regulate e-cigs — despite serious knowledge deficiencies and primarily speculative dangers — while ignoring the mass advertising and public sale, unsubstantiated medical efficacy claims, child enticing characteristics, e.g., flavored lollipops, of a Class 1, illegal substance — with known, scientifically established, adverse health effects. Some say it involves politics, big money, big government and big business. Maybe, it just reflects what the feds are smoking.

James Felsen, of Great Cacapon, is a retired public health physician.

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