Biden’s Health Team and Vaping: What Do We Know?

President-Elect Joe Biden named several key members of his healthcare team Monday, and although there is still one major position to be filled that could affect vaping (FDA commissioner), we decided to go over the appointees and consider how they might matter to the vaping debate and future policy. We’ve also discussed how some of the FDA possibilities might fit in.

Biden has chosen California Attorney General Xavier Becerra to lead the Department of Health and Human Services. The HHS secretary oversees the FDA, CDC, National Institutes of Health (NIH), and the Centers for Medicare and Medicaid Services (CMS). HHS has a budget of more than $1 trillion—the largest of any cabinet department—and more than 80,000 employees.

Becerra is a somewhat odd choice for the job. His history as a 12-term Congressman representing Los Angeles and as California’s Attorney General since 2017 doesn’t include much experience with healthcare issues. As a prominent Hispanic political leader, he ticks an obvious box for Biden—but New Mexico Governor Michelle Lujan Grisham would also have been popular among Latinos, and she has extensive healthcare policy experience and the benefit of having run a state government.

In fact, Lujan Grisham—who supported and signed a compromise vaping bill in New Mexico that did not include a flavor ban—was a frontrunner for the job until last week, when news leaked that she had turned down an offer to be Interior secretary. Other names that were mentioned as possibilities—Rhode Island Gov. Gina Raimondo and former Obama Surgeon General Vivek Murthy—probably would have been much worse for vaping than either Lujan Grisham or Becerra. (Murthy wound up being tapped for an encore stint as Surgeon General.)

Becerra has only a minor history with vaping since becoming California’s top law enforcement official, but he seems generally opposed. He filed comments with the FDA supporting a flavor ban except for products able to prove an “overall public health benefit,” and also supported the FDA scheme to reduce nicotine in cigarettes below addictive levels (which would actually require supporting the availability of non-combustible nicotine products like vapes). He also indicated support for an online sales ban of all tobacco products.

Becerra recently filed a brief defending the California Assembly’s ban on all flavored tobacco products (including vape products) against a lawsuit brought by tobacco companies. (Attorneys General are always expected to defend state laws against challenges, so don’t make too much of this.) And last year Becerra filed a lawsuit against Juul Labs, charging the San Francisco-based vape company with marketing and selling its products to minors.

Becerra was a surprise as HHS nominee. His name had circulated as a possible Biden choice for Attorney General, or as a Senate replacement for Kamala Harris (California Gov. Gavin Newsom will appoint someone to serve the balance of Vice President-Elect Harris’ Senate term).

Becerra’s most important job at HHS, if he is approved by the Senate, will be to coordinate the federal response to the coronavirus pandemic, along with COVID “czar” Jeffrey Zients (who, like Becerra, has no medical background), National Institute of Allergy and Infectious Diseases Director Anthony Fauci (who will also serve as chief medical adviser to Biden), new CDC Director Rochelle Walensky, and Surgeon General Murthy.

In fact, the coronavirus crisis is likely to be the main focus of every HHS agency for the foreseeable future. Expanding COVID testing and distributing vaccines will be full-time jobs for the administration’s health team. While the FDA Center for Tobacco Products’ work will not be interrupted by the pandemic, it’s unlikely that the HHS secretary will have time to put his thumb on the scale of vaping regulations (even if he’d like to). That doesn’t mean that an FDA commissioner dedicated to anti-nicotine ideology won’t do that, of course—but Becerra himself is unlikely to take his eye off the coronavirus ball for the next two years, assuming his nomination is confirmed by the Senate.

Biden will replace current CDC Director Robert Redfield with Rochelle Walensky of Massachusetts General Hospital and Harvard Medical School. Like Dr. Fauci at NIAID, Walensky is an infectious diseases expert, specializing in HIV/AIDS. She will be tasked with leading the agency during the COVID crisis, and rebuilding its reputation

Researching Walensky, I could find nothing on vaping issues at all, and no obvious connections to the Bloomberg Philanthropies tobacco policy empire (aside from receiving her medical degree in the early 1990s from Johns Hopkins University, which later received billions from alumnus Michael Bloomberg), which is the source and funding mechanism for most prohibitionist anti-nicotine activism.