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May 23, 2022

With No Regulatory Experience, Brian King Will Be CTP Director

FDA Commissioner Robert Califf has selected Brian King to be the new director of the agency’s Center for Tobacco Products. King is currently working at the Centers for Disease Control and Prevention (CDC), in the CDC Office on Smoking and Health.

King will take over in July. Until then, CTP Deputy Director Michele Mital will continue serving as acting director. Mital has held that position since early April when longtime CTP Director Mitch Zeller retired.

“After a robust executive search, I have selected Dr. Brian A. King as FDA’s new Center for Tobacco Products Director,” Califf announced on Twitter. “Dr. King brings extensive and impressive expertise in tobacco prevention and control and has broad familiarity with FDA from his more than 10-year tenure at CDC.”

By choosing King, recently confirmed FDA Commissioner Califf and his boss, Health and Human Services Secretary Xavier Becerra, dashed hopes that the new CTP leader might be someone sympathetic to low-risk nicotine products like vapes and nicotine pouches. King’s history suggests he has deliberately misunderstood vaping and worked to damage its potential to replace cigarettes as the dominant form of nicotine consumption.

Brian King and the “EVALI” debacle

King is believed responsible for naming the condition caused by the 2019 spread of tainted THC cartridges “e-cigarette, or vaping, product use associated lung injury (EVALI).” While medical officials at CDC were willing participants in the blaming of nicotine vaping products for those lung injuries, King was allowed to make numerous speculative public statements about the situation, some of which were downright bizarre.

“So there’s a variety of harmful ingredients identified [in nicotine vaping products], including things like ultrafine particulates, heavy metals like lead, and cancer causing chemicals,” King told reporters on Aug. 23, 2019. “And flavoring used in e-cigarettes to give it a buttery flavor, diacetyl, and it’s been related to severe respiratory illness. That being said we haven’t specifically linked any of those specific ingredients to the current cases but we know that e-cigarette aerosol is not harmless.”

King’s vaping presentations always start the same way, with a laundry list of scary-sounding constituents and a baker’s dozen of mights and maybes. By adapting that boilerplate anti-vaping elevator speech to the “EVALI” outbreak, King helped frighten smokers (and vapers) away from vaping and convince THC vapers that they could continue buying sketchy black market vape carts without consequence.

It got worse. A few days later, King implied on a conference call with reporters that the “EVALI” injuries may have been occurring since the advent of nicotine vaping, but that “we weren’t necessarily capturing them” in epidemiological surveillance.

“But now there’s increased diligence in terms of the current investigation that we’re better able to capture those,” he continued. “That being said, the available science does suggest that the constituents in the aerosol could be problematic. We know there’s a variety of intended and unintended constituents in these products so as we continue with the investigation it’s important to keep all options open and identify a variety of ingredients. At present we haven’t isolated a specific source but we know there’s a variety of constituents in e-cigarette aerosol that could be problematic in terms of illness.”

In his zeal to smear nicotine vaping, King repeatedly steered reporters, his own agency, and the public away from the real cause of “EVALI.” In the process, 68 THC oil vapers were killed and nearly 3,000 hospitalized and left to deal with possibly permanent lung damage.

King’s history is one of playing fast and loose with the facts. To the uninitiated, he appears to be a well-informed scientist, but in reality he is merely using science to achieve the political result he wants: vaping prohibition. He has never explored any potential benefits of vaping or other non-combustible forms of nicotine—only the risks.

FDA leader wanted – no experience required!

Since receiving a doctorate in epidemiology from the State University of New York at Buffalo in 2010, King has worked only for the CDC, advancing within the Office on Smoking and Health (OSH) from Epidemic Intelligence Service Officer to Senior Scientific Advisor, and then in 2015 to his current role as Deputy Director for Research Translation at OSH.

It is unusual for someone with little or no regulatory experience to jump immediately into an FDA job as significant as director of a major office at the agency. King has never held a regulatory job of any kind, but will now be in charge of the CTP’s scientific work and its legal activities.

King’s predecessor Mitch Zeller was an attorney, and held several positions at the FDA before leaving to work in the nonprofit sector at the American Legacy Foundation (now called Truth Initiative), and then in the public sector at Pinney Associates. He returned to the FDA in 2013 to become the agency’s second CTP director.

Despite Califf’s claim that he conducted a “robust executive search,” it appears the effort was geared toward finding someone with dogmatic anti-tobacco views who would be willing to rubber-stamp policies preferred by Califf and Becerra, and would pass muster with the Campaign for Tobacco-Free Kids—the real powerhouse of Washington, D.C. tobacco policymaking.

The FDA is still deciding how to handle thousands of pending Premarket Tobacco Applications (PMTAs), including 240 PMTAs submitted by major mass-market manufacturers. The agency is also defending dozens of lawsuits and appeals by manufacturers that have already received Marketing Denial Orders (MDOs). The FDA announced new criteria for authorization of flavored products a year after the 2020 deadline to submit applications.

On top of all that, the FDA recently announced it will ban menthol cigarettes and all flavored cigars—actions destined to land the agency in court for years. It’s a weird time to choose a CTP director with no legal knowledge or regulatory experience, incapable of steering the agency through a stormy ocean of court challenges.

King may seem a strange choice for the CTP’s current situation—unless his role will be to simply approve whatever actions his anti-vaping bosses want. If Commissioner Califf and HHS Sec. Becerra want to make vaping and other low-risk nicotine products less attractive to use, harder to find, and demonized in public messaging, Brian King may be the perfect choice.

Image courtesy YouTube.

Smokers created vaping without any help from the tobacco industry or anti-smoking crusaders, and vapers have the right to keep innovating to help themselves. My goal is to provide clear, honest information about the challenges vaping faces from lawmakers, regulators, and brokers of disinformation. I recently joined the CASAA board, but my opinions aren’t necessarily CASAA’s, and vice versa. You can find me on Twitter @whycherrywhy
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