Published: Thu, September 13, 2018
Medical | By Vicki Mclaughlin

FDA Threatens to Ban Flavored E-Cigarettes Over Rise of Youth Vaping

FDA Threatens to Ban Flavored E-Cigarettes Over Rise of Youth Vaping

USA health officials are sounding the alarm about teenage use of e-cigarettes, calling the problem an "epidemic" and ordering manufacturers to reverse the trend or risk having their flavored vaping products pulled from the market.

To gain clearance to return to the market, the companies would have to prove that the benefits to adults who use e-cigarettes in order to stop smoking traditional cigarettes outweigh the risks associated with youth vaping. "It's an unfortunate tradeoff".

The agency will also be increasing federal enforcement actions on e-cig sales to minors in convenience stores and other retail sites, Gottlieb said, and would look closely at a practice called "straw purchases", in which adults visit web-based stores and buy in bulk to resell to minors.

While e-cigarettes were first marketed to help adults quit smoking combustible cigarettes, they have now become a gateway to nicotine for teenagers. The companies sell Vuse, Blu, Juul, MarkTen XL, and Logic e-cigarette brands, which account for 97 percent of US e-cigarette sales, according to FDA. But it's not clear how quickly the decision could be reversed.

"In addition, today the FDA also issued 12 warning letters to other online retailers that are selling misleadingly labeled and/or advertised e-liquids resembling kid-friendly food products such as candy and cookies".

"We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion, and we must adjust certain aspects of our comprehensive strategy to stem this clear and present danger", FDA Commissioner Scott Gottlieb said in a press release.

Congress gave the FDA the authority to regulate tobacco products in 2009.

She said Altria could be well positioned because it has a long history of dealing with youth access to its products and has "limited/mature flavor profiles relative to Juul".

On the other side of the public health ledger, there is little reason to think that restricting information about ENDS, making them less cool, or banning e-liquid flavors would reduce morbidity and mortality among today's adolescents, either now or in the future.

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The agency sent more than 1,100 warning letters and 131 fines to retailers it said illegally sold JUUL and other e-cigarette products to minors during a nationwide undercover sting including brick-and-mortar and online stores this summer. The number of regular users is much smaller, and nearly all of them are current or former smokers.

The FDA is trying to set up a framework for regulating e-cigarettes.

To the extent that teenagers who otherwise would be smoking are vaping instead, that is an unambiguous gain in public health terms, since the latter habit is much less unsafe.

Juul e-cigarette starter pack is seen in this picture illustration taken July 16, 2018.

The ability of manufacturers to prevent underage consumption is, in any case, pretty limited.

"We're especially focused on the flavored e-cigarettes".

At that time, Gottlieb said, the agency didn't foresee the "epidemic'"of adolescent use that has become one of the plan's biggest challenges". If underage consumption does not justify a ban on tobacco cigarettes (and I don't think it does), it can not possibly justify a ban on competing products that are much safer.

However, Gottlieb claims e-cigarette brands haven't done enough to stop kids from using the products. "In the coming weeks, we'll take additional action under our Youth Tobacco Prevention Plan to immediately address the youth access to, and the appeal of, these products". The FDA claims that more than 2 million middle schoolers and high school students were regularly vaping past year, with underage use reaching "an epidemic proportion".

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