An August 24 article in The New York Times provides insight into the negative consequences of well-intended policies. The article describes a cigarette that is taking over social media and the hipster scene, with young adults preferring combustion over safer cigarette alternatives.
With the massive misinformation campaign on the relative risks of the variety of tobacco products available to adults — and state and federal laws and regulations hindering progress — it is no wonder smoking seems cool again.
The article spotlights Hestias, a brand of combustible cigarettes manufactured by what the company markets as an “honest tobacco company.” An April 2023 article in Airmail referred to the company’s owner as the “Millennial Marlboro Man.” The founder attempts to “convert the casual smoker into someone who values a premium product when they do decide to light up.”
Given the extensive restrictions on tobacco advertising, Hestias is limited in how it can market its product, so the company is using influencers and social media and attempting to tap into the social scene in markets (like California and New York) where flavored tobacco and vapor product sales are banned.
This is troublesome, but it indicates a more significant problem permeating decades-long tobacco control efforts. This issue dates to the 2009 Family Smoking Prevention and Tobacco Control Act (TCA), which gave the Food and Drug Administration authority to regulate tobacco products.
Under the TCA, the Center for Tobacco Products was created to regulate tobacco products, including reviewing new products before being introduced to the market. Per the TCA, there are two pathways a product can use: substantial equivalence (SE) or the premarket tobacco product application (PMTA).
Under the SE pathway, a product can be introduced to the market (after a review and authorization by the FDA) if it is “substantially equivalent” to a product that was on the market as of February 15, 2007 — two years before the FDA being given regulatory authority over tobacco products.
Unfortunately, all those products are combustible and smokeless tobacco products and fail to capture the entire tobacco harm reduction product category.
Between 2019 and 2022, the FDA issued 421 SE marketing orders for various new products that are similar to predicated products — including 126 orders for new combustible cigarette products. Comparatively, between October 2021 and June 2022, the FDA issued only 23 marketing orders for e-cigarette products using the PMTA pathway.
It has been long known that it is the smoke that causes the most harm in combustible tobacco products. Yet, the public and health professionals are misinformed about a continuum of risk that exists among the differing tobacco products.
In 2017, the FDA announced a “comprehensive regulatory plan to shift the trajectory of tobacco-related disease (and) death,” including placing nicotine “at the center of the agency’s tobacco regulation efforts.” Specifically, under the new strategy, the agency claimed it would begin “demonstrating a greater awareness that nicotine (while highly addictive) is delivered through products that represent a continuum of risk and is most harmful when delivered through smoke particles in combustible cigarettes.”
Yet, between 2019 and 2022, for every e-cigarette product the agency authorized, it authorized marketing orders for more than five combustible cigarette products.
And it’s not just federal agencies making cigarettes cool again — state and local lawmakers remain steadfast in restricting adult access to e-cigarettes and other tobacco harm-reduction products.
While Hestias’ cigarettes are available for sale online and in retail stores in Florida, Minnesota, Mississippi and Texas, the company seeks influencers in major cities in California and New York. Both states ban the sale of flavored e-cigarettes, with California going further and banning all flavored tobacco product sales in 2022. Unsurprisingly, a combustible cigarette company would seek a market with little competition — and technically zero competition from products marketed to adults to help them quit smoking.
And the data in New York show an alarming trend that smoking rates are rising among young adults, making a perfect opportunity for up-and-coming combustible cigarette brands.
In 2021 (according to data from the Centers for Disease Control and Prevention), 6.2 percent of New York adults aged 18 to 24 were smoking, which was a 12.7 percent increase from 2020, when 5.5 percent were smoking. In fact, there were 22,691 more young adult smokers in 2021 than in 2020 — again, a perfect market for a “trendy” cigarette brand.
This is a major failure for public health, but it sums up tobacco control in America. The FDA’s regulatory process favors combustible cigarettes over harm reduction. Coupled with state and federal policymakers’ continued resistance and reactionary bans on safer alternatives to smoking, it is no wonder cigarettes are cool again.
