Brian King (epidemiologist)

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.

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.

Prior to joining FDA, he served as the Deputy Director for Research Translation in CDC's Office on Smoking and Health, and more recently as the Executive Editor of CDC's Morbidity & Mortality Weekly Report Series. Prior to his tenure at CDC, he was a Research Affiliate 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. 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). He was also lead author of CDC's 2014 evidence-based guide for states, “Best Practices for Comprehensive Tobacco Control Programs. ”

Early life and education
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. 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.

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). 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.

Roswell Park Comprehensive Cancer Center
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. 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.

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.

Centers for Disease Control and Prevention (CDC)
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 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 that prohibited smoking in public housing nationwide. He is also credited with introducing the “Tobacco Control Vaccine” 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”; an author of the 2014 Surgeon General's Report “The Health Consequences of Smoking-50 Years of Progress”; a senior editor of the 2016 Surgeon General's Report “E-cigarette Use Among Youth and Young Adults”; and a senior editor of the 2020 Surgeon General's Report “Smoking Cessation”. He also led the 2018 Surgeon General's Advisory on E-cigarette Use Among Youth.

In March 2022, King was appointed the Executive Editor of CDC's Morbidity & Mortality Weekly Report series. 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). During 2020-2022, he served in various capacities for the agency's response to Coronavirus Disease 2019 (COVID-19), 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). 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.

U.S. Food and Drug Administration (FDA)
In July 2022, King was appointed the Director of FDA's Center for Tobacco Products (CTP) by FDA Commissioner Dr. Robert Califf. 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, 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 and a lawyer, respectively. King's appointment was applauded by public health organizations and the scientific community, and criticized by some industry organizations, most notably e-cigarette advocacy organizations. 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.

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; 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; 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. King has publicly referred to his first several months at FDA on several occasions as “baptism by blowtorch”.

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, 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; the agency's first marketing authorization decisions for menthol e-cigarettes, which were marketing denial orders for products by Logic that are presently under appeal by the company; and 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; and the first civil money penalties, for the maximum statutory amount possible (approximately $20,000), filed against e-cigarette retailers for the sale of illegal e-cigarette products. 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.

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, 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.

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, 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. 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. This development was lauded by public health organizations, as well as a majority of the U.S. House of Representative's Congressional Black Caucus. In contrast, it was criticized by several direct and indirect tobacco industry funded interests, including Al Sharpton's National Action Network. As of February 2024, both product standards remained on the White House's Unified Agenda, with a planned release date of March 2024; however, the fate of the product standards remains uncertain given concerns by the White House that they could affect President Biden's reelection prospects, most notably support by the African American community, who smoke the products at disproportionately higher rates. 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. 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. King has publicly stated that the Center has completed review of 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. As of February 2024, the agency had completed review of 94% of the AAP-required applications, with a revised target for completion by Quarter 2 2024; the agency has cited litigation and industry-submitted application amendments as reasons for the delay. 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.”

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. The independent evaluation was requested by the FDA Commissioner in July 2022, a few weeks after King's arrival as Center Director. The strategic plan was released on time in December 2023, following a year-long development process that included the solicitation of feedback from Center staff and external stakeholders, including through a public listening session held in August 2023. King has been an outspoken champion of health equity since his appointment. In May 2023, King appointed CTP's first Senior Advisor for Health Equity. 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.

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. 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, which was held in Panama City, Panama.

Notable publications
Califf RM, King BA. The Need for a Smoking Cessation "Care Package". JAMA. 2023 Jan 17;329(3):203-204. 10.1001/jama.2022.24398. PMID 36580350. King BA. Flavors Are a Major Driver of the Youth E-Cigarette Epidemic. Am J Public Health. 2020 Jun;110(6):773-774. doi: 10.2105/AJPH.2020.305670. Erratum in: Am J Public Health. 2021 Feb;111(2):e6. PMID 32374696; PMCID: PMC7204467. Kirkcaldy RD, King BA, Brooks JT. COVID-19 and Postinfection Immunity: Limited Evidence, Many Remaining Questions. JAMA. 2020 Jun 9;323(22):2245-2246. 10.1001/jama.2020.7869. PMID 32391855; PMCID: PMC8596300. King BA, Jones CM, Baldwin GT, Briss PA. The EVALI and Youth Vaping Epidemics - Implications for Public Health. N Engl J Med. 2020 Feb 20;382(8):689-691. doi: 10.1056/NEJMp1916171. Epub 2020 Jan 17. PMID 31951683; PMCID: PMC7122126. King BA, Gammon DG, Marynak KL, Rogers T. Electronic Cigarette Sales in the United States, 2013-2017. JAMA. 2018 Oct 2;320(13):1379-1380. 10.1001/jama.2018.10488. PMID 30285167; PMCID: PMC6233837. King BA, Graffunder C. The Tobacco Control Vaccine: a population-based framework for preventing tobacco-related disease and death. Tob Control. 2018 Mar;27(2):123-124. 10.1136/tobaccocontrol-2018-054276. PMID 29475955; PMCID: PMC5850888. King BA, Creamer MR, Harrell M, Kelder S, Norman L, Perry CL. Surgeon General's Reports on Tobacco: A Continued Legacy of Unbiased and Rigorous Synthesis of the Scientific Evidence. Nicotine Tob Res. 2018 Jul 9;20(8):1033-1036. 10.1093/ntr/ntx266. PMID 29300946; PMCID: PMC6023778. King BA, Peck RM, Babb SD. Cost savings associated with prohibiting smoking in U.S. subsidized housing. Am J Prev Med. 2013 Jun;44(6):631-4. 10.1016/j.amepre.2013.01.024. PMID 23683981; PMCID: PMC4572888. King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the National Adult Tobacco Survey. Am J Public Health. 2012 Nov;102(11):e93-e100. doi: 10.2105/AJPH.2012.301002. Epub 2012 Sep 20. PMID 22994278; PMCID: PMC3477973. King BA, Travers MJ, Cummings KM, Mahoney MC, Hyland AJ. Secondhand smoke transfer in multiunit housing. Nicotine Tob Res. 2010 Nov;12(11):1133-41. 10.1093/ntr/ntq162. Epub 2010 Oct 1. PMID 20889473; PMCID: PMC3436457.

Awards and honors
2020: Charles C. Shepard Award, Excellence in Assessment, U.S. Centers for Disease Control and Prevention 2016: George W. Thorn Award, UB Alumni Association, Status University of New York at Buffalo 2014: Alumni Inductee, Delta Omega Public Health Honor Society, Gamma Lambda Chapter, State University of New York at Buffalo 2010: Saxon Graham Award, School of Public Health and Health Related Professions, State University of New York at Buffalo