Trump’s FDA Pick Faces Big Test on Tobacco Policy

President Donald Trump’s nominee to head the Food and Drug Administration (FDA), Martin Makary, is an incredibly credentialed Harvard graduate, John Hopkins University surgeon, and bestselling author. Perhaps of greater note, he has also been unafraid to challenge healthcare establishment views on a variety of topics ranging from pricing to federal agency policy. He may be uniquely suited to reform the FDA, and there’s no better target for reform than one of its subagencies, the Center for Tobacco Products (CTP).

Dr. Makary has a rare opportunity to move CTP away from outdated, prohibitionist policies.

He could lead the CTP toward a more credible position - recognizing established scientific consensus around tobacco harm reduction, and refocusing the CTP to equip individuals with evidence-based solutions. That would allow consumers to make educated decisions on the products they see every day on store shelves.

To be clear, adult smokers should quit smoking. However, that’s their decision. If they want to continue using nicotine products, they should have a reliable information source that can draw distinction between the relative risk of different products. That, in fact, is the mandate of the CTP and one that it has failed to meet.

If properly reformed, CTP can empower individual consumers to make informed decisions related to nicotine products. Research has well established that vapor and heat-not-burn technologies are far less harmful than traditional cigarettes. And, new products like nicotine pouches are even less harmful, in some cases on par with traditional cessation products like nicotine gum.

Adult consumers need to appreciate these distinctions and the relative risks. Not all products are created equally. And, CTP's purpose is to draw these distinctions and approve products for the marketplace.

When the CTP fails in its mission, the marketplace is flooded with unregulated and unapproved products. Unfortunately, that is the reality today. Consumers cannot trust products on the shelves and responsible actors - that are going through the FDA approval process - are undercut by actors, often Chinese-based companies, that are not. This environment is not in the interest of public health, consumers, or responsible companies trying to play by the rules.

Dr. Makary is under consideration by the U.S. Senate HELP Committee this week. Policymakers should elevate this issue, along with others, as he continues through the confirmation process.

Julio Fuentes is president and CEO of the Florida State Hispanic Chamber of Commerce