As the president of a leading consumer group whose mission is to safeguard the public interest, I am alarmed by the growing number of Americans losing faith in the public health institutions Congress designed to keep them safe.
According to 2021 polling from the Robert Wood Johnson Foundation and Harvard T.H. Chan School of Public Health, nearly half the country does not trust the Center for Disease Control and Prevention a “great deal.” Only two-thirds place a great deal of trust in the Federal Food and Drug Administration and the National Institutes of Health, while just 33 percent do for the Department of Health and Human Services. This growing public distrust of America’s leading health authorities is causing an alarming percentage of the country to ignore the important research conducted and counsel provided by these agencies.
Recognizing the need to restore America’s faith in these critical institutions, President Joe Biden signed a January 2021 Presidential Memorandum on Scientific Integrity and Evidence-Based Policymaking. This memo stipulated that America’s health agencies appoint an integrity officer to ensure they follow science-based approaches in their research and mandated that their research come under a task force’s review.
Biden’s proclamation was a sorely needed step in the right direction. That said, it is troubling to see that many agencies appear to be flouting the president’s directive as they continue issuing new rules and guidance backed by suppositions rather than science. No entity is more emblematic of this problem than the FDA’s Center for Tobacco Products (CTP).
In response to a request from (and concerns expressed by) FDA Commissioner Robert Califf, the Reagan Udall Foundation — a nonprofit created by Congress to “advance the mission of the FDA” — issued a December 2022 report detailing how the CTP is addressing tobacco with “a lack of consistent implementation” of policies and radical policy shifts. Its findings seemingly corroborated leaks made by a former CTP staffer-turned-whistleblower, who disclosed that a 2019 CTP memorandum directed scientists to stop using objective, quantitative data to evaluate applications.
The CTP responded to the report exposing deficiencies in the CTP rulemaking process by promising to do better. That response includes no fewer than 10 mentions of “transparency” yet does little but outline new layers of bureaucracy. And despite the Reagan Udall Foundation’s brow-raising findings, the CTP is still pursuing regulatory action with no scientific basis.
In April, the FDA proposed a rule to curtail menthol cigarette use even though the menthol smoking rate for minors is down to nearly zero. Also, in recent years, the FDA has become adamant about curtailing vaping and e-cigarette products even though studies show them to be as much as 95 percent safer than combustible tobacco and more effective in weaning smoking than over-the-counter cessation products. The agency clearly appears to have ignored the empirical evidence in informing its actions.
Similarly, years ago, the FDA decided to regulate premium cigars based on its claims that they pose serious health risks and fuel a youth smoking epidemic. After a six-year court battle, a federal judge rejected these regulations and ruled the FDA’s decision to regulate to be “arbitrary and capricious,” while noting the low daily use of premium cigars by adults and also citing 0.1% as the percent of cigar smokers aged 12-17.
All this evidence and the court’s decision, coupled with the Reagan Udall Foundation’s recommendations that the CTP become more grounded in science, would presumably cause the agency to reconsider some of its actions and priorities. However, the CTP has not done so and instead is continuing to pursue its efforts to ban vapes and cigars for consenting adults even though it lacks a sound scientific (or legal) basis.
The public has historically demonstrated a willingness to comply with reasonable, scientific, or data-driven laws, and regulations that exist to protect the general welfare. Unfortunately, well-intentioned regulators like those at the CTP are slowly but surely eroding their positive disposition. Large swaths of the country now perceive America’s health officials as perpetrators of a nanny state rather than good and reasonable stewards of the public interest. As a result, they are ignoring all their guidance — even the items that are scientifically grounded. That is in no one’s interest.
The time is now for the agency and department heads of each of America’s public health institutions — the CDC, FDA, HHS, NIH, and the rest — to demand that their subordinates comply with President Biden’s evidence-based policymaking memorandum. If they are unwilling, then the president or Congress should consider taking swift and immediate action. Only then will public faith in the U.S.’ healthcare leaders — and compliance with America’s critical public health orders and proclamations — slowly become restored.
This was published in Real Clear Health.