Robert Fairman is a 2CI Fellow at Georgia State in the Tobacco Center for Regulatory Science. Regulatory science is an arm of research that aims to develop new tools, standards, and to assess the safety, efficacy, quality, and performance of FDA-regulated policies—tobacco regulatory science helps the FDA inform regulations and policies they create regarding tobacco products. Fairman works within the health behavioral area of this informative process.
“I am a social and behavioral epidemiologist. Epidemiology is the study of diseases: how they spread, what causes them, and their outcomes. Simply, social epidemiology is looking at what social structures are more or less likely to cause an outcome.”
Arriving this past summer, Fairman did research on the modification of vaping devices—now he does research at Georgia State on the implications of vaping, and the use of other tobacco products. The recent headlines regarding vaping-related illness or death is a cause of concern for Fairman.
“What this has done is it has polarized how we view vaping. If we ban everything, we’re going to have a lot of people who are addicted to nicotine and are going to have to stop cold turkey. That could be dangerous—their only other way to get nicotine is to turn to cigarettes. That’s a slippery slope.” Fairman also mentioned that the FDA has a list of resources on how to quit smoking or vaping.
In regard to the outbreak of lung injury associated with e-cigarette use, Fairman said cases are all over the place. Of those deaths, the median age is 52, while the median age of those hospitalized are 24 years of age. This raises the question of what other health factors cause death. Many deaths are related to e-juice that contain THC, or e-juice that was altered or in some way.
Many of the deaths are associated with e-juice containing THC, often added by the consumer, or from what the CDC call’s “informal sources”. When THC or CBD oil is added to the e-juice, it is no longer what the FDA approved it for. “With the little approval there has been, the e-cigarettes and e-juice are being used outside what their intended use was: as a way to get nicotine.”
Fairman also looks at what social structures and risk factors lend themselves to people using vape and other tobacco products, such as marketing from tobacco companies on social media and how that influences what they do.
His current area of research is the rising popularity of vaping in the United States, specifically the increase in youth vaping. He studies access, frequency and effects of vaping, and how these values are being made more public with the recent movement to ban certain types of e-juice, or vaping liquid.
“The FDA approval for e-cigarettes and e-juice is a grey area,” Fairman said. “ “The FDA has three pathways for new products to be marketed. A lot of the e-cigarettes on the market undergo what we call a “Premarket Tobacco Product Application.” This is where the company has to provide information that will allow the FDA to determine if the product protects public health or not. But they don’t have the health claim approval to allow them to say vaping is healthier than smoking or that it is not.”
Fairman said this is where Tobacco Regulatory Science would inform the FDA, such as offering information that would support whether or not vaping is healthier than smoking, as well as inform the FDA on who is using products, how products are being used, and what puts someone at greater risk for developing negative outcomes.
The answer as to whether vaping is safer than smoking cigarettes is still unclear, Fairman said, but he’s concerned with what is going to be done about the subset of people who are addicted to nicotine with potential bans in place.
The FDA has had policies in a pipeline for a while, but these issues have prioritized them—such as outright banning flavored e-juice.
But a ban on the devices and e-juice could backfire, Fairman said. It could cause people to vape illegally, which has already caused issues in the cases of the illegal THC vapes. “If they are outright banned, we have to consider if there will be regulations on how e-juices are being made.” This could prove more harmful as there will be more people not knowing what they’re doing and harming themselves.
Moving forward, Fairman said that Georgia State is collaborating with other institutions to research tobacco regulatory science, including the University of South Carolina, Emory University, Stanford University, and the College of New Jersey, among others.
“We really enjoy collaborating, and we enjoy collaborating with organizations and the community as well. It allows us to get special insight and understand from different perspectives how vaping and tobacco use impact our health.”
Fairman is currently enrolled as a PhD student in the School of Public Health, with a concentration in Health Promotion and Behavior. Before his time at Georgia State, Fairman earned his Master of Public Health from Emory University, and an undergraduate degree in Public Health from the University of North Carolina at Wilmington. Fairman worked at the Centers for Disease Control and Prevention in the Division of Healthcare Quality and Promotion supporting the Hospital Infection Prevention Team. This allowed Fairman to “marry” the fields of social and healthcare epidemiology to address complex issues around hospital acquired-infections in various healthcare settings. Fairman was previously an HIV and STI Outreach Coordinator and Health Educator at the New Hanover County Health Department in southeastern North Carolina. This aligns with his additional work locally, where Fairman is on staff at Emory looking at better ways to address HIV in correctional populations. His work looks at various county jails across the US, but overall his research aims to find more effective ways to approach and prevent HIV in the prison system.
—Braden Turner, Graduate Administrative Assistant, Office of the Provost