Brian King | |
---|---|
Born | Rochester, New York U.S. | September 5, 1982
Education | University at Buffalo (B.S., MPH, PhD) |
Occupation | Director of the Center for Tobacco Products (CTP) |
Employer | Food and Drug Administration |
Known for | Tobacco prevention and control |
Height | 5'10 |
Predecessor | Mitch Zeller |
Website | https://www.fda.gov/tobacco-products |
Brian King (born 1982) is an American Epidemiologist who currently serves as the Director of the Food and Drug Administration's Center for Tobacco Products (CTP). He was appointed to his role in July 2022. [1]
As the lead tobacco regulatory official for the United States, King is responsible for overseeing the Center's implementation of the Family Smoking Prevention and Tobacco Control Act. Signed into law on June 22, 2009, the Act gives the FDA the authority to regulate the manufacture, distribution, and marketing of tobacco products in the United States. [2]
Prior to joining FDA, he served as the Deputy Director for Research Translation in CDC's Office on Smoking and Health, [3] and more recently as the Executive Editor of CDC's Morbidity & Mortality Weekly Report Series. [4] Prior to his tenure at CDC, he was a Research Affiliate [5] in the Division of Cancer Prevention and Population Sciences at Roswell Park Comprehensive Cancer Center in Buffalo, New York.
He has authored more than 200 scientific journal articles related to tobacco prevention and control. [6] He served as a Senior Editor for multiple U.S. Surgeon General's Reports on tobacco, including “Smoking Cessation: A Report of the Surgeon General” (2020). [7] He was also lead author of CDC's 2014 evidence-based guide for states, “Best Practices for Comprehensive Tobacco Control Programs. [8] ”
Brian Alexander King was born on September 5, 1982, in Rochester, New York, to Elaine Louise (née Tripi; 1949- 2020) and Geoffrey Walrath King (1946). He is the second of three children born to both parents. His father is a University at Buffalo (SUNY)-educated Optical Physicist who has held various positions in the field with Xerox and at the University of Rochester. King's mother, an alumna of University at Buffalo (SUNY), was a Medical Technologist at Monroe Community Hospital prior to full-time motherhood. [9] He is the third generation of his family to earn a college degree.
King grew up in Webster, New York, a suburb of Rochester. He was an ambitious child interested in science, government, and the creative arts. In high school, he served as Vice President of the school's chapter of the National Honor Society, and as Captain of the Varsity Tennis Team. He is also an accomplished pianist, and performed at numerous community events, including The Great New York State Fair. In 1997, he earned the rank of Eagle Scout with the Boy Scouts of America. [10]
King attended Bishop Kearney High School in Irondequoit, New York (2000). After completing his primary and secondary studies, he was accepted to the University at Buffalo (SUNY) where he earned a Bachelor of Science degree in Biological Sciences with a minor in Music. (2004). King went on to earn Master of Public Health (2006), and Doctor of Philosophy (2010) degrees in Epidemiology at the University at Buffalo (SUNY). [11] His doctoral dissertation advisor was Andrew Hyland, current Chair of the Department of Health Behavior at Roswell Park Comprehensive Cancer Center in Buffalo, New York.
In 2005, King was hired as a quitline counselor at the New York State Smokers’ Quitline, which is housed at Roswell Park Comprehensive Cancer Center in Buffalo, New York. Concurrently, he was also working within the organization's Department of Health Behavior to complete the thesis for his Master of Public Health degree at University at Buffalo (SUNY); the thesis was focused on socioeconomic variation in tobacco product advertising across Western New York. In 2006, upon completion of his Master's degree, he was hired as a Research Affiliate within the Department of Health Behavior, Division of Cancer Prevention and Population Sciences, at Roswell Park Comprehensive Cancer Center. The Department was led at the time by Dr. K. Michael Cummings, and King reported directly to Dr. Andrew Hyland. Both had adjunct appointments at State University of New York at Buffalo, which enabled King to work at the Cancer Center concurrently to earning his PhD at the University. [12]
During his time at Roswell Park, King led multiple projects, including those related to the observational assessment of tobacco advertising in retail venues, environmental assessments of particulate matter from secondhand smoke in indoor environments, and population-based collection of data on tobacco related issues, including through the New York State Adult Tobacco Survey and the International Tobacco Control Survey. He also initiated seminal research on secondhand smoke exposure in multiunit housing, which was the first of its kind internationally. This included the first study to document secondhand smoke exposure between apartments in a single multiunit housing building using environmental assessments of airborne particulate matter. [13]
While at Roswell Park, King served as Principal Investigator of multiple grants, including a grant from the Flight Attendant Medical Research Institute (FAMRI) to assess secondhand smoke in multiunit housing, and an R36 dissertation grant from the U.S. Centers for Disease Control and Prevention to assess an intervention for enhanced adoption of smoke-free multiunit housing policies.
King first gained media experience during his time at Roswell Park, including serving as the organization's primary spokesperson during a press conference in 2008 to commemorate the 5-year anniversary of the 2003 New York State Clean Indoor Air Act.
In July 2010, King joined the Epidemic Intelligence Service (EIS) at CDC. He served as an EIS Officer during 2010-2012, during which he was assigned to the agency's Office on Smoking and Health (OSH) in the National Center for Chronic Disease Prevention and Health Promotion. He led multiple field investigations, including a study [14] of indoor air quality from secondhand smoke in hospitality venues throughout American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands.
Following completion of EIS, he was hired as an Epidemiologist in OSH, and promoted to Senior Scientific Advisor in 2014. In 2015, he assumed the role of Deputy Director for Research Translation in OSH. In this role, King led the agency's efforts related to a variety of high profile matters, including the rise in e-cigarette use among U.S. youth, and the 2014 update to the evidence-based state guide, “Best Practices for Comprehensive Tobacco Control Programs”. He also served a critical role in the development and implementation of the U.S. Department of Housing and Urban Development's 2016 rule [15] that prohibited smoking in public housing nationwide. He is also credited with introducing the “Tobacco Control Vaccine” [16] framework, which was featured on the cover of the scientific journal Tobacco Control in 2018.
In his role as Deputy Director for Research Translation in OSH, King was also responsible for leading the U.S. Surgeon General's Reports on tobacco for the U.S. Government under multiple presidential administrations. He served as a reviewer for the 2012 Surgeon General's Report “Preventing Tobacco Use Among Youth and Young Adults”; [17] an author of the 2014 Surgeon General's Report “The Health Consequences of Smoking-50 Years of Progress”; [18] a senior editor of the 2016 Surgeon General's Report “E-cigarette Use Among Youth and Young Adults”; [19] and a senior editor of the 2020 Surgeon General's Report “Smoking Cessation”. [20] He also led the 2018 Surgeon General's Advisory on E-cigarette Use Among Youth. [21]
In March 2022, King was appointed the Executive Editor of CDC's Morbidity & Mortality Weekly Report series. [22]
During his tenure at CDC, King also served in various leadership capacities for the agency's responses to public health emergencies. He served as senior official for the agency's 2019 response to E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI). [23] During 2020-2022, he served in various capacities for the agency's response to Coronavirus Disease 2019 (COVID-19), [24] [25] including as Deputy Lead of the Chief Medical Officer Unit, Deputy and then Lead of the Strategic Science Unit, and finally as Chief Science Officer.
King also served on various inter-agency committees during his tenure at CDC. During 2015-2022, King served as CDC's Ex Officio delegate to FDA's Tobacco Product Scientific Advisory Committee (TPSAC). [26] During 2015-2022, he served as lead for Tobacco Use Objectives for Healthy People 2020 and Health People 2030.
King served as a primary spokesperson on tobacco related issues for CDC during his tenure, and frequently participated in interviews with the news media from major national and international television, radio, and print outlets. [27]
In July 2022, King was appointed the Director of FDA's Center for Tobacco Products (CTP) by FDA Commissioner Dr. Robert Califf. [28] In this role, he serves as the lead tobacco regulatory official for the United States, and is responsible for overseeing the Center's implementation of the Family Smoking Prevention and Tobacco Control Act. Signed into law on June 22, 2009, [2] the Act gives FDA the authority to regulate the manufacture, distribution, and marketing of tobacco products in the United States.
King was the first scientist to be appointed as CTP Director, with his two predecessors being a medical doctor [29] and a lawyer, [30] respectively. King's appointment was applauded by public health organizations and the scientific community, [31] and criticized by some industry organizations, most notably e-cigarette advocacy organizations. [32] He has publicly championed four major areas of prioritization during his tenure as CTP Director, including robust science, stakeholder engagement, effective communication, and health equity. [33]
King assumed the role of CTP Director during a period when FDA was embroiled in multiple high profile controversies, including the agency's decision to issue an administrative stay of its June 2022 marketing denial order to JUUL labs for its e-cigarette products; [34] delays in the agency's review of premarket tobacco product applications, including its newly afforded authority by the U.S. Congress to regulate tobacco products containing synthetic nicotine; [35] criticism over the agency's compliance and enforcement actions, particularly against e-cigarettes; and the resignation of CTP's Office of Science Director, Dr. Matthew Holman, to assume a new role at Philip Morris International, the maker of Marlboro cigarettes. [36] King has publicly referred to his first several months at FDA on several occasions as “baptism by blowtorch”. [37]
During his first year as CTP Director, King led the Center to achieve several actions that were the first of their kind for the agency, including the issuance of the first injunctions, [38] in coordination with the U.S. Department of Justice, filed against manufacturers for the sale of illegal e-cigarette products; the first civil money penalty complaints filed against e-cigarette manufacturers for the sale of illegal e-cigarette products; [39] the agency's first marketing authorization decisions for menthol e-cigarettes, which were marketing denial orders for products by Logic [40] that are presently under appeal by the company; the agency's first warning letters issued to retailers for selling illegal tobacco products since the agency's 2020 deadline for submission of premarket tobacco product applications; [41] and the first judicial seizure of unauthorized e-cigarettes from a distributor in coordination with the U.S. Marshalls Service. [42] In December 2023, King also oversaw the Center's participation in a joint federal operation, in coordination with U.S. Customs and Boarder Protection, that resulted in the seizure of more than $18 million in illegal e-cigarettes at a cargo examination site at Los Angeles International Airport. [43]
Despite these activities, lawmakers remain critical of FDA’s enforcement efforts. On June 12, 2024, King testified to the U.S. Senate Committee to the Judiciary, along with the U.S. Department of Justice. [44] Earlier that week, both agencies announced the creation of a new interagency federal task force to address illicit e-cigarettes. [45]
King's tenure has coincided with several high profile efforts to push back on tobacco industry litigation against FDA; this included decisions by the U.S. Solicitor General to appeal a decision by the U.S. Fifth Circuit in RJ Reynolds v. FDA that blocked FDA's rule to require graphic warning labels on cigarette packs in the United States, [46] and to appeal a decision by the U.S. District Court for the District of Columbia in Cigar Association of America v FDA that vacated the agency's ability to regulate premium cigars. [47] In July 2024, at the request of FDA, the U.S. Supreme Court agreed to hear the agency’s defense of its premarket application decisions in FDA v Wages and White Lion. [48]
During his time as CTP Director, the Center has also worked to finalize product standards to prohibit menthol in cigarettes and to prohibit all characterizing flavors in cigars, [49] and has continued to relay its intent to propose a rule to cap the maximum level of nicotine in cigarettes and certain other smoked tobacco products to nonaddictive or minimally addictive levels. [50] Under King's leadership, the agency successfully submitted both the menthol cigarette and flavored cigar products standards to the White House Office of Management and Budget in October 2023, representing the farthest the agency has ever been able to advance the rules after more than a decade of challenges. [51] As of February 2024, both product standards remained on the White House's Unified Agenda; however, their fate remains uncertain given concerns by the White House that they could affect President Biden's reelection prospects. [52]
During King's tenure as Director, the Center completed acceptance review of 100% of the 1 million applications received for non-tobacco nicotine (e.g. synthetic nicotine) products following the April 2022 law clarifying FDA's authority to regulate this products. [53] However, the Center continues to receive criticism over its delays in reviewing all premarket tobacco product applications received by the agency by the 2020 deadline, including those court-ordered in American Academy of Pediatrics (AAP) v. FDA. [54] King has publicly stated that the Center has completed review of more than 99% of the 26 million applications received, and is on track to complete review of the remaining AAP-required applications by the end of 2023. [55] The agency has cited litigation and industry-submitted application amendments as reasons for the delay. [56] King has been unapologetically blunt in response to critics of the agency's delay in review of the applications, stating the critiques are coming from the “cheap seats” and that the situation is “a very complex chess match, not a game of tic-tac-toe.” [57]
King has also provided leadership over a high profile update to the Center's programmatic activities. In February 2023, King announced the Center's plans to address the recommendations from an external evaluation by the Reagan-Udall Foundation; this included a new 5-year strategic plan for the Center. [58] The independent evaluation was requested by the FDA Commissioner in July 2022, a few weeks after King's arrival as Center Director. [59] The strategic plan was released on time in December 2023.
King has been an outspoken champion of health equity. In May 2023, King appointed CTP's first Senior Advisor for Health Equity. [60] He also oversaw the discontinuation of the Center's use of the term “grandfathered” when referring to preexisting tobacco products (i.e. those on the market before 2007, which are excluded from FDA regulation by the Tobacco Control Act) due to the term's historical ties to 19th Century racist voting laws. [61]
In addition to domestic tobacco regulatory activities, King also regularly engages with international tobacco regulatory counterparts. In September 2023, he spoke at the 2nd Global Tobacco Control Policy Forum hosted by the Ministry of Health and Welfare of South Korea in Seoul, Korea. [62] In February 2024, he was part of the U.S. Delegation to the 10th session of the Conference of the Parties to the World Health Organization's Framework Convention on Tobacco Control, [63] which was held in Panama City, Panama.
A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. Cigarette smoking is the most common method of tobacco consumption. The term cigarette, as commonly used, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white.
Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.
Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult.
Smoking bans, or smoke-free laws, are public policies, including criminal laws and occupational safety and health regulations, that prohibit tobacco smoking in certain spaces. The spaces most commonly affected by smoking bans are indoor workplaces and buildings open to the public such as restaurants, bars, office buildings, schools, retail stores, hospitals, libraries, transport facilities, and government buildings, in addition to public transport vehicles such as aircraft, buses, watercraft, and trains. However, laws may also prohibit smoking in outdoor areas such as parks, beaches, pedestrian plazas, college and hospital campuses, and within a certain distance from the entrance to a building, and in some cases, private vehicles and multi-unit residences.
Passive smoking is the inhalation of tobacco smoke, called passive smoke, secondhand smoke (SHS) or environmental tobacco smoke (ETS), by individuals other than the active smoker. It occurs when tobacco smoke diffuses into the surrounding atmosphere as an aerosol pollutant, which leads to its inhalation by nearby bystanders within the same environment. Exposure to secondhand tobacco smoke causes many of the same health effects caused by active smoking, although at a lower prevalence due to the reduced concentration of smoke that enters the airway.
Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.
The Public Health Cigarette Smoking Act is a 1970 federal law in the United States designed to limit the practice of tobacco smoking. As approved by the United States Congress and signed into law by President Richard Nixon, the act required a stronger health warning on packages, saying "Warning: The Surgeon General Has Determined that Cigarette Smoking Is Dangerous to Your Health". It also banned cigarette advertisements on American radio and television.
Tobacco products, especially when smoked or used orally, have serious negative effects on human health. Smoking and smokeless tobacco use are the single greatest causes of preventable death globally. Half of tobacco users die from complications related to such use. Current smokers are estimated to die an average of 10 years earlier than non-smokers. The World Health Organization estimates that, in total, about 8 million people die from tobacco-related causes, including 1.3 million non-smokers due to secondhand smoke. It is further estimated to have caused 100 million deaths in the 20th century.
Prevalence of tobacco use is reported by the World Health Organization (WHO), which focuses on cigarette smoking due to reported data limitations. Smoking has therefore been studied more extensively than any other form of consumption.
A menthol cigarette is a cigarette infused with the compound menthol which imparts a “minty” flavor to the smoke. Menthol also decreases irritant sensations from nicotine by desensitizing receptors, making smoking feel less harsh compared to regular cigarettes. Some studies have suggested that they are more addictive. Menthol cigarettes are just as hard to quit and are just as harmful as regular cigarettes.
Flavored tobacco products — tobacco products with added flavorings — include types of cigarettes, cigarillos and cigars, hookahs and hookah tobacco, various types of smokeless tobacco, and more recently electronic cigarettes. Flavored tobacco products are especially popular with youth and have therefore become targets of regulation in several countries.
Tobacco has a long cultural, economic, and social impact on the United States. Tobacco cultivation in Jamestown, Virginia, in 1610 led to the expansion of British colonialism in the Southern United States. As the demand for Tobacco grew in Europe, further colonization in British America and Tobacco production saw a parallel increase. Tobacco use became normalized in American society and was heavily consumed before and after American independence.
Tobacco smoking has serious negative effects on the body. A wide variety of diseases and medical phenomena affect the sexes differently, and the same holds true for the effects of tobacco. Since the proliferation of tobacco, many cultures have viewed smoking as a masculine vice, and as such the majority of research into the specific differences between men and women with regards to the effects of tobacco have only been studied in-depth in recent years.
Smokingamong youth and adolescents is an issue that affects countries worldwide. While the extent to which smoking is viewed as a negative health behavior may vary across different nations, it remains an issue regardless of how it is perceived by different societies. The United States has taken numerous measures, ranging from changes in national policy surrounding youth cigarette access to changes in media campaigns, in attempts to eliminate the use of tobacco products among teenagers. Approximately 90% of smokers begin smoking prior to the age of 18.
Regulation of tobacco by the U.S. Food and Drug Administration began in 2009 with the passage of the Family Smoking Prevention and Tobacco Control Act by the United States Congress. With this statute, the Food and Drug Administration (FDA) was given the ability to regulate tobacco products.
There are smoking cessation policy initiatives by the United States government at federal, state and local levels.
The Center for Tobacco Products (CTP) was established by the United States Food and Drug Administration as a result of the Family Smoking Prevention and Tobacco Control Act signed by President Obama in June 2009. The FDA center was responsible for the implementation of the Family Smoking Prevention and Tobacco Control Act.
Regulation of electronic cigarettes varies across countries and states, ranging from no regulation to banning them entirely. As of 2015, around two thirds of major nations have regulated e-cigarettes in some way. A 2023 report by the World Health Organization (WHO) found that 34 countries had banned the sale of e-cigarettes.
The health effects of electronic cigarettes (e-cigarettes) include a range of potential risks such as exposure to toxic chemicals, the possibility of increased likelihood of respiratory and cardiovascular diseases, and concerns about their possible role in cancer development. Upon their introduction, there were marketing claims that they were a safer alternative to traditional tobacco products.
Tobacco-free college campuses are institutions that have enacted comprehensive policies banning the use of tobacco products across all indoor and outdoor areas of their grounds. These policies stem from the well-documented health risks associated with tobacco, not only for users but also for those exposed to secondhand smoke, as well as the environmental damage caused by tobacco waste. In response to these concerns, colleges and universities have increasingly adopted tobacco-free policies to enhance public health, create a more pleasant campus atmosphere, and mitigate the environmental impact of tobacco use.