December 03, 2018
Area(s) of Interest: Public Health
The Food and Drug Administration (FDA) has announced it will take steps to prevent youth access to flavored tobacco products, including electronic nicotine delivery systems (ENDS). The agency said it also plans to ban menthol cigarettes and flavored cigars.
Youth use of e-cigarettes is a serious and growing public health crisis. According to the 2018 National Youth Tobacco Survey, 3.6 million people under 18 report using e-cigarettes, up from 1.5 million the previous year. More than two-thirds (67.8 percent) are using flavored e-cigarettes. The survey found a 78 percent increase from 2017 to 2018 in current e-cigarette use among high school students and a 48 percent increase among middle school students.
While the FDA stopped short of an outright ban on flavored e-cigarettes—despite recent suggestions it would do just that—the agency said stores would only be allowed to sell such products from closed off-areas inaccessible to teenagers.
“I will not allow a generation of children to become addicted to nicotine through e-cigarettes,” said FDA Commissioner Scott Gottlieb, M.D., in a statement. “We won’t let this pool of kids, a pool of future potential smokers, of future disease and death, to continue to build. We’ll take whatever action is necessary to stop these trends from continuing.”
The policy would apply to all ENDS products, including e-liquids, cartridge-based systems and cigalikes, in all flavors except tobacco, mint and menthol. For instance, the proposed policy would apply to flavors such as cherry, vanilla, crème, tropical, melon and other flavors that specifically appeal to children.
The FDA said it would also take steps to ensure strong age-verification procedures for retail and online sellers.
“This policy will make sure the fruity flavors are no longer accessible to kids in retail sites, plain and simple,” said Dr. Gottlieb. “That’s where they’re getting access to the e-cigs and we intend to end those sales.”
The FDA also announced it will pursue a ban on menthol in combustible tobacco products, including cigarettes and cigars, informed by the comments on its Advanced Notice of Proposed Rulemaking. Menthol cigarettes account for about 35 percent of cigarette sales in the United States. Scientific data shows that menthol use is likely associated with increased smoking initiation by youth and young adults.
The California Medical Association (CMA) has long recognized that tobacco use is a costly habit that often leads to illness and poor health. In 2016, CMA produced a white paper that assessed evidence and research on the impact of flavored and mentholated tobacco products on public health, particularly among priority populations. The white paper found that flavored and menthol tobacco products are “starter” products that establish daily habits and promote addiction to tobacco products, make it harder to quit and increase use of multiple tobacco products concurrently. Flavorings used in tobacco products do not reduce the health impacts and risks associated with tobacco use, and are not safer than non-flavored tobacco products. Further, youth, certain racial/ethnic groups, and other targeted priority populations are particularly vulnerable to sweet flavors and menthol, and are largely driving the uptake and sustained use of flavored tobacco products.
CMA submitted comments urging the FDA to weigh these concerns as it moves forward with its regulatory action.
For more information, see CMA’s white paper: “Flavored and Mentholated Tobacco Products: Enticing a New Generation of Users.”