The long-overdue shake-up at the Food and Drug Administration (FDA) has finally arrived. The FDA’s Center for Tobacco Products (CTP) Director Brian King has been placed on administrative leave, and dozens of employees at the FDA’s CTP have been dismissed, including two entire offices responsible for drafting new tobacco regulations. While this marks the welcome end of one of the most dysfunctional agencies in U.S. government history, the question remains as to what happens next.
The Trump administration has taken decisive action, but it must ensure that this move is followed by a coherent and science-based approach to tobacco regulation, one that prioritizes harm reduction over bureaucratic inertia and misinformation.
The failures of the CTP are well-documented. In 2022, an independent review by the Reagan-Udall Foundation found that the agency was in disarray, manipulated by outside interests rather than driven by scientific evidence. Internal FDA comments to the inquiry revealed accusations of scientific best practices being ignored, suppression of dissenting views, and product reviewers being overruled when their assessments didn’t align with the FDA’s political agenda.
At the center of this dysfunction stood Brian King, who has now been sidelined. During his 1,004 days in office, King oversaw a regulatory process that effectively blocked safer alternatives to smoking while enabling the continued dominance of combustible cigarettes. Under his leadership, the FDA approved more than 600 new combustible tobacco products but only a handful of vaping products, most of which were outdated, tobacco-flavored devices that consumers have little interest in purchasing.
The impact of this anti-vaping stance has been catastrophic. With legal vape options stifled, the illicit market has exploded. Instead of regulating a transparent and competitive legal market, the FDA’s inaction has driven consumers toward unregulated products. The absurd reality is that, under King’s tenure, introducing a new cigarette has been easier than bringing a far safer alternative to market.
King’s tenure also perpetuated some of the most damaging public health misconceptions of the past decade. The public was not dissuaded that the 2019 "EVALI" crisis - a wave of lung injuries linked to illicit THC cartridges laced with Vitamin E acetate - was caused by nicotine vaping. This deliberate obfuscation devastated small vape businesses, leading to bankruptcies nationwide as states rushed to impose knee-jerk bans on flavored nicotine products.
The result of this misinformation campaign is a public utterly confused about the risks of nicotine products. The U.S. National Cancer Institute’s Health Information National Trends Survey (HINTS) found that a mere 2.6 percent of Americans correctly believe that vaping is "much less harmful" than smoking. This confusion has real-world consequences. Millions of adult smokers who could have switched to safer alternatives continue smoking, wrongly believing they are just as harmful. Worse, this misinformation has even infiltrated the medical community, with studies showing that approximately 80 percent of doctors incorrectly believe that nicotine directly causes cancer.
Dismantling the CTP is not enough, what replaces it must be significantly better, smarter, and more focused on science and consumers. If the U.S. government is serious about reducing smoking rates, it must adopt a harm-reduction approach grounded in science and transparency.
The current system, which requires years of review and enormous financial investment, disproportionately favors large corporations while shutting out small businesses and independent innovators. The FDA’s statutory mandate is to review applications within 180 days, yet some have languished for over three years. This must end. Regulators should set clear and achievable safety and quality standards, allowing thousands of vaping products to be authorized rather than just a select few.
Many countries that have successfully reduced smoking rates allow vaping products to be registered rather than requiring exhaustive pre-market applications. A simple registration process, where products meeting established safety criteria are automatically cleared for sale, would foster competition, innovation, and consumer choice—while also undercutting the illicit market.
The FDA must drop its ingrained suspicion of new nicotine products. Instead of stifling innovation, it should encourage the development of safer alternatives, including nicotine pouches, heated tobacco, and next-generation vaping devices. Countries like the UK and Sweden have embraced these products, leading to some of the lowest smoking rates in the world. The U.S. should follow suit.
One of the FDA’s most damaging failures has been its inability, or unwillingness, to accurately inform the public about the relative risks of different nicotine products. It must launch a dedicated public education campaign to correct misconceptions, ensuring that smokers understand that vaping is a far safer alternative to cigarettes.
If the Trump administration is serious about public health, it must replace the FDA’s failed tobacco policies with a framework that prioritizes harm reduction, embraces innovation, and tells the truth about relative risks. Anything less would be yet another failure in a decades-long saga of misguided tobacco control policies that have cost far too many American lives.
Martin Cullip is International Fellow at The Taxpayers Protection Alliance's Consumer Center and is based in South London, UK.