Opinion: Why the FDA was unable to prevent a crisis of vaping among kids

When it comes to the public’s health, it always seems to take a crisis before protections are put in place. The Food, Drug, and Cosmetic Act of 1938 — the bedrock law that first required companies to conduct safety studies of medications before they could be sold — was passed only after a tainted drug killed scores of children.

In 1962, a scare over birth defects caused by thalidomide led to groundbreaking standards for clinical trials. Medical device controls? Enacted in 1976 after the Dalkon Shield caused infertility and infections in thousands of women. Food safety legislation? It received bipartisan support only after the recall of 500 million eggs tainted by salmonella.

My public health students often ask an obvious question: Why is it so challenging for regulatory agencies to prevent calamities in the first place? In years past, I have struggled with a concise answer to this question — until now.

Now, I tell them to examine why the Food and Drug Administration was unable to keep millions of youths from becoming addicted to electronic cigarettes, how the agency wound up taking much of the blame for hundreds of people with severe lung injuries, and why long-overdue action to protect the public still remains out of reach.

Lesson 1: Imminent economic harm beats the threat of injury to the public

The story starts in September