Former North Carolina Department of Health and Human Services Secretary Mandy Cohen will become the new director of the Centers for Disease Control and Prevention (CDC), replacing Rochelle Walensky on June 30th. Unlike the FDA commissioner, the CDC director position does not require Senate confirmation. Cohen is a trained internal medicine specialist who previously worked as chief operating officer and chief of staff at the Centers for Medicare and Medicaid Services as well as the Department of Veterans Affairs.

A History in Public Health: No Record on Vaping

Cohen’s experience in public health has equipped her well for her new position. However, there is no public record of her position on vaping, and she has not been vocal in her support or opposition to the harm reduction strategy. During the early days of the COVID pandemic, she urged people quitting cigarettes not to vape.

CDC’s role in the regulation of tobacco and nicotine products is limited to surveying data and measuring trends in smoking and vaping. The agency does not set administration tobacco or nicotine product policy. In recent years, the CDC Office on Smoking and Health has been criticized by some as amplifying the talking points of anti-vaping tobacco control groups.

As CDC directors usually take a hands-off approach to the agency’s tobacco and vaping work, it is unlikely that Cohen’s appointment will have a significant impact on the agency’s position on vaping as a harm reduction strategy.

CDC and Vaping Policy

The CDC, through its surveys and research, has an outsized influence on policy planning on vaping. In 2019, a CDC response to an outbreak of lung injuries caused by black market THC oil led to the creation of the term ‘E-cigarette, or vaping, product use associated lung injury (EVALI)’. Despite the fact that no nicotine product was implicated in any of the thousands of EVALI cases, the agency never backed off its claim that nicotine products couldn’t be ruled out as a partial cause. This led to criticism that agency anti-vaping idealogues had steered the situation.

One previous CDC director, Obama-appointee Tom Frieden, used the position to attack vaping, ignoring a huge decline in teenage smoking to instead raise concerns about e-cigarettes. As a result, it is crucial that Cohen promotes balanced policymaking at the CDC that is based on evidence and recognizes the potential of vaping as a harm reduction strategy.

It will be interesting to see if, under Cohen’s leadership, the CDC continues to prioritize abstinence-only tobacco control approaches or embraces the potential of vaping as a harm reduction strategy. Surely, striking the right balance is crucial for reducing smoking rates while also giving current smokers a safer alternative.