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If there is one issue that can be said to unite all of US president-elect Donald Trump’s picks for health positions, it is a degree of Covid scepticism.
That, of course, starts with the new nominee for secretary of the Department of Health and Human Services (HHS), Robert F Kennedy Jr., who is an infamous vaccine doubting Thomas. Joining him, nearly all other major picks have expressed similar views. These can be in the form of uncertainty over prevailing vaccine best practices in some regard – such as Trump’s pick to head the Centers for Disease Control and Prevention (CDC), Dave Weldon – or it can be questioning the wisdom of full lockdowns as the best methods for safeguarding public health during the Covid-19 pandemic.
Also in this group are nominees such as Martin Makary, picked to head the US Food and Drug Administration (FDA), who has expressed doubt about both lockdowns and Covid-19 boosters, and Jay Bhattacharya, Trump’s nominee to head the National Institutes of Health (NIH), who said lockdowns were causing irreparable harm.
Some form of dismay with the US’s approach to Covid-19 – whether vaccine or lockdown – is perhaps the only unifying factor across a wide array of nominees. But what does that have to do with vaping or nicotine alternatives? Not a whole lot, on the face of things.
Optimism in scepticism?
Looking a little more broadly, however, it does suggest a degree of general scepticism about medical science and research as well as an unwillingness to simply accept something because it is the established truth as laid out by the majority of experts.
This may stand vaping in good stead in the US, where prohibition rather than harm reduction remains the more accepted approach to tobacco control and public health. It suggests that rather than accepting what is commonly said about e-cigarettes – that they are a gateway to smoking, that flavours attract youth vaping, which is a dangerous issue, and that they offer little to no benefit as a cessation aid – they’re willing to listen and perhaps embrace alternative discourses.
There is some optimism that scepticism could lead to a willingness to listen to all scientific public health theories. Several of the nominees simply question aspects of the plan to tackle Covid-19 or use vaccines rather than take full-denial positions such as linking vaccines with autism – an opinion that is not supported by the vast majority of scientific research thus far.
The lure of bad science
The willingness of some to listen to fringe theories that disregard the majority of robustly conducted scientific trials on vaccines could also play against vaping and other nicotine alternatives. After all, most robust studies on vaping and other products such as snus have shown a direct public health benefit through their use as cessation aids that have reduced smoking rates to all-time lows.
And there has been little evidence that vaping is a gateway to smoking for youth. But it is these negative, sensationalist pieces that tend to turn the most heads and get the most coverage. It could be that – like with studies linking vaccines to autism – the bad science is more sensationalist and is the one that attracts the most interest from the Trump appointees.
Overall though, it should be remembered that vaping, pouches, heated tobacco and the rest – even combined with conventional cigarettes and other standard tobacco products – make up a tiny part of the government’s health remit. Chances are high the new boss will be much the same as the old boss, simply because there is so much else to do that takes priority.
Under the previous Trump administration, officials were not particularly friendly towards vaping or other alternatives – suggesting links to vaping-associated lung injury, or Evali, for tobacco vaping products and supporting the idea of a youth vaping epidemic being the next big tobacco-related public health concern.
Bigger fish to fry
This time, Trump has come in promising to save vaping. And it is true he does quite often do what he can to help those he perceives as his allies or supporters. But it would take significant oversight to change the current impetus of nicotine regulation in the US, and it just seems unlikely any of the new batch of nominees will be passionate enough about the subject to do it.
None have said much of anything on any of the most common alternative nicotine products, suggesting they may have bigger fish to fry.
A decision in favour of the vaping companies in the Supreme Court case just starting to be heard is the one wild card. A positive ruling there would not only make it easier to then address vaping, it would bring it back to the forefront of regulators’ thoughts.
In such a case, the US would see whether Covid-19 policy scepticism begets an open mind in other areas of policy and research.
– Freddie Dawson TobaccoIntelligence staff
Image: AI-generated
