On April 1 Dr. Brian King, the controversial director of the Food and Drug Administration’s Center for Tobacco Products (CTP), whose responsibilities included overseeing the authorization or rejection of vaping products for sale in the United States, emailed his staff.
“It is with a heavy heart and profound disappointment that I share I have been placed on administrative leave,” he wrote. According to the Associated Press, King was offered reassignment to the Indian Health Service.
He is far from alone in losing his job. The Trump administration is laying off up to 10,000 staff under the US Department of Health and Human Services (HHS), which includes the FDA, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).
Some HHS staffers were unaware that their positions were being eliminated until they were denied access to their office buildings on the morning of April 1, not having seen the emails they’d been sent at 5 am. Most employees are being placed on administrative leave prior to simply being terminated. But some senior staffers were given until the end of April 2 to accept or refuse alternative positions in other departments, with little or no detail provided about what their new roles would entail.
“The FDA as we’ve known it is finished,” posted former FDA Commissioner Robert Califf.
Dr. Matthew Farrelly, director of the CTP’s Office of Science, announced, “Apparently the news is hitting the Wall St Journal soon that as part of the HHS restructuring, I am being reassigned outside of the Center for Tobacco Products. I am proud of my work at CTP, supporting harm reduction and strong, science-based decisions. While I’d love to continue to serve in that role, I’ll be serving elsewhere within HHS.”
“The FDA as we’ve known it is finished,” posted former FDA Commissioner Robert Califf, “with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed. I believe that history will see this a huge mistake.”
“The revolution begins today!” posted HHS Secretary Robert F. Kennedy Jr., hours after the termination emails went out.
The cuts reach far beyond the realm of tobacco harm reduction (THR), covering myriad public health functions whose loss will be felt to a degree that cannot yet be quantified.
Thousands of people, many dedicated public servants, are now losing their livelihoods—and in a manner in which no employee should be treated.
King has been harshly criticized by both sides of the THR debate since becoming CTP director.
Given all of this, despite much anger over King’s record, people focused specifically on the THR debate will have a variety of feelings.
King has been harshly criticized by both sides of that debate since becoming CTP director in July 2022.
Even when his appointment was announced, many THR advocates distrusted him based on his prior record at the CDC, where he played a part in exaggerating harms related to vapes and downplaying their harm reduction role. His CTP tenure confirmed many of their fears, as he continued to prioritize fears of youth vaping over helping people who smoke.
King was always defiant about this priority, which struck many as a gross distortion of the hierarchy of needs, when adult smoking kills and youth vaping does not. An estimated 480,000 people in the US die of smoking-related causes each year.
It didn’t help that King sometimes came across in public as disdainful, leaving THR advocates feeling insulted and unheard. “It’s easy to criticize from a Twitter handle in your mother’s basement,” he said at least twice, when discussing social media interactions with people who use nicotine.
Wish I could tweet from my mother’s basement. She passed on after smoking her entire adult life. She refused to try vaping as it was “more dangerous than smoking”.
My son only knows her from photographs and the stories I tell.
Those basements have stories to tell, listen to them! https://t.co/NnvfK9CKqO— Kurt Yeo (@Kurt_Yeo) March 2, 2023
Besides maintaining a snail’s pace in authorizing even tobacco-flavored vapes, King’s CTP was stubbornly resistant to authorizing the flavored products that adults find most helpful in switching from cigarettes.
It took until June 2024 for something other than a tobacco flavor to be granted marketing orders, when the FDA authorized a few menthol pods. That authorization came one and a half years after Filter revealed how King’s office had previously overridden the CTP Office of Science’s recommendation to authorize menthol vaping products.
King showed signs of softening at times. He coauthored a commentary in 2023, for instance, which acknowledged the problem of adults who smoke misperceiving the relative risks of vapes and cigarettes—without, however acknowledging his own agency’s role in perpetuating these misperceptions.
He was also capable of humility. In late 2024 I sent him a letter, asking him to use more respectful language about people who use nicotine. He sent me a courteous personal email in response, which I much appreciated.
The bottom line, however, is that tobacco control groups and other organizations opposed to THR always seemed to have the FDA’s ear during King’s tenure, while people with lived experience with smoking and THR products felt ignored.
Many tobacco control groups, including the Campaign for Tobacco-Free Kids (CTFK), have also been highly critical of the FDA, arguing against vape authorizations and calling for heavier enforcement of the Tobacco Control Act (TCA). Nonetheless Yolonda Richardson, CTFK’s president and CEO, was quoted as calling the CTP layoffs “deeply irresponsible,” saying that they indicated “a troubling move away from science-based regulation.”
Many of the FDA’s actions have not been science-based, however, instead reflecting politics and moral panic. The FDA was known to fuel misperceptions about nicotine and vapes well before King became CTP director. FDA “educational” campaigns on vapes over the years have given a solid nod to Reefer Madness—from “Mind Control Menace” to Real Cost ads showing vaping infecting teens with worms crawling under their skin or their brains being “hacked,” and claiming vaping was a ”gateway” to smoking.
Those campaigns led to more misinformation, more outcry and a push for regulations to ban safer alternatives to smoking.
As upsetting and unfair as the recent changes have been, many have long felt that the system around THR is broken. But eliminating much of the system itself takes us into uncharted territory.
THR has been a contentious battle for years. A rare piece of common ground is that both sides are frustrated with the FDA’s bureaucratic mess that has left products waiting years, instead of the congressionally mandated 180 days, for marketing authorization or denial. The US vape marketplace is now dominated by products that meet consumer demand but lack FDA authorization to be sold legally, with attendant risks. The agency effectively ceded control long before the mass layoffs.
Where will the new developments leave people who smoke who want help quitting, and those who use reduced-risk products? Are manufacturers left in limbo, with the prospect of waiting even longer for product authorizations? Or will the Trump administration’s regulation-slashing tendencies have the side effect of improving THR access? We just don’t know.
The TCA is outdated, and doesn’t leave a viable pathway to get enough THR products authorized to meet consumer demand. The FDA and CTP have been intransigent, opaque, misleading and often chaotic. As upsetting, frightening and unfair as the recent changes have been, many have long felt that the system around THR is broken. But eliminating much of the system itself takes us into uncharted territory.
Photograph (cropped) by Felton Davis via Flickr/Creative Commons 2.0
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