According to the 2018 National Youth Tobacco Survey (NYTS), vaping increased nearly 80 percent among high schoolers and by 50 percent among middle schoolers in the past year, with one in five students saying they have used an e-cigarette in the past month. These numbers represent 20 percent of all high school students, and five percent of middle school students.
These data indicate a reversal of years of success in the ongoing fight to prevent youth addiction to tobacco products.
In announcing the restrictions on e-cigarettes, Dr. Gottlieb seemed to recognize the dilemma faced by retailers, including pharmacies, that sell the products as a way to assist adult smokers. “This approach is informed by the potential public health benefit for adult cigarette smokers who may use these ENDS products as part of a transition away from smoking,” he explained.
CVS Health, which in 2014 became the first (and so far the only) national pharmacy chain to discontinue cigarette sales, and which has never sold e-cigarettes or vaping devices, was quick to praise the FDA’s initiatives, saying in athey represent “the most important step the agency has taken to date to curtail youth use of e-cigarettes and flavored nicotine products.”
Pharmacies that do sell e-cigarettes, as evidenced by research conducted among London community pharmacies, tend to carry the products as a way to However, according to , their success in this role is heavily debated.with smoking cessation efforts.
“Recent evidence regarding the efficacy of e-cigarettes for smoking cessation is conflicting,” the analysis reported. “A systematic review and meta-analysis found that smokers using e-cigarettes as a cessation aid were 28 percent less likely to quit, whereas other studies have shown short-term, but not long-term, efficacy of e-cigarettes as a cessation aid.”
Further, the analysis noted: “In a comparison of e-cigarettes and tobacco cigarettes, there was no significant difference in abstinence from tobacco after 24 months. Patients using e-cigarettes may reduce the number of cigarettes smoked per day; however, they rarely abstain from the use of tobacco products, instead becoming dual users.”
Regardless of whether or not a pharmacy sells tobacco products, the FDA’s action reinforces the traditional role of the pharmacist as a key player in smoker cessation efforts. This includes an integrated approach tailored to the unique characteristics of each patient. While counseling and behavioral analysis are central to any cessation outreach, with possible treatments including nicotine gum and patches, the role of e-cigarettes as part of that strategy is debatable.
Pharmacists are no doubt watching the FDA’s recent actions carefully, and will continue to heed available e-cigarette-related research and findings as they become available.