Warning to vaping device makers, retailers is the “the largest single enforcement action in agency history.”
With electronic cigarette use among kids reaching “epidemic proportions,” the Food and Drug Administration (FDA) yesterday announced a series of crackdowns directed at e-cigarette retailers and manufacturers. The FDA gave top vaping device makers 60 days to produce a plan for lowering sales to minors. The agency also sent warning letters and fines to more than 1,300 retailers as part of its “largest coordinated enforcement effort in agency history.” In addition, the public health organization is considering restricting the use of kid-friendly flavors, such as strawberry, chocolate, and bubble gum. The FDA commissioner, Scott Gottlieb, MD, said that these flavors are “principal drivers of the youth appeal of these products.”
Growing Popularity Among Minors
E-cigarettes are currently the most popular form of tobacco product among young people. The National Youth Tobacco Survey, conducted by the FDA and the Centers for Disease Control and Prevention (CDC), found that more than 2 million middle school and high school students were using electronic cigarettes in 2017, compared with 1.4 million who were smoking regular cigarettes. According to an article published September 12, 2018, in The Washington Post, soon-to-be-released data is expected to show a 75 percent jump in e-cigarette use among high school students this year compared with 2017.
Manufacturers May Have to Pull Products
“Today, we asked five e-cigarette manufacturers to put forward plans to immediately and substantially reverse these trends,” said Dr. Gottlieb in a statement. The five brands that make up almost the entire U.S. cigarette market are Vuse, Blu, Juul, MarkTen XL, and Logic. If companies fail to act accordingly, these brands may have to remove certain flavored products from the market, according to the FDA. Juul Labs, which is the biggest of the e-cigarette companies, issued a response saying that it is committed to working proactively with the FDA’s requests and keeping cigarettes out of the hands of minors. From June through August 2018, the FDA conducted an undercover nationwide blitz to crack down on the sale of e-cigarettes to minors at both brick-and-mortar and online retailers. The agency plans to indefinitely continue efforts to monitor, penalize, and prevent e-cigarette sales to underage users. On August 23, 2018, the FDA announced that 17 manufacturers, distributors, and retailers have stopped selling nicotine-containing e-liquids used in e-cigarettes with labeling or advertising resembling kid-friendly food products, such as juice boxes, candy, or cookies.
Broad Campaign to Stop Nicotine Addiction
Gottlieb added that the FDA is committed to a comprehensive approach to nicotine addiction, recognizing that e-cigarettes may be a useful tool for adults who want to quit smoking regular cigarettes. He said they offer a “satisfying levels of nicotine, but without all of the harmful effects that come from combustion.” But he stressed that the FDA is committed to reversing the current trends in youth access to e-cigarettes, even if that means adults will find it harder to get these products as well. The agency says it has made its battle on the underage use of nicotine products a top priority because the developing adolescent brain is particularly susceptible to nicotine addiction. In addition to nicotine, a study published February 21, 2018, in the journal Environmental Health Perspectives found that the vapor can contain hazardous chemicals, lead, and other toxic metals.
A Gateway to Regular Cigarettes
Wendy Sue Swanson, MD, a pediatrician at Seattle Children’s Hospital in Washington, warns that the addictiveness of the nicotine is the biggest problem because it can easily lead young people to smoking cigarettes. Dr. Swanson points to an article published in March 2018 in the journal Pediatrics that concluded: “Among adolescent cigarette experimenters, using e-cigarettes was positively and independently associated with progression to current established smoking.” “The big risk with e-cigarettes is that a child is exceedingly vulnerable to nicotine addiction,” says Swanson. “Teenagers take a lot of risks and are really curious about what adults do. When they’re experimenting with this really addictive substance, an addiction begins and then a habit is established.” The health risks caused by a smoking habit have been well proven. The CDC says that smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer. Nearly 1 in 5 deaths are caused by smoking. The FDA is continuing to explore meaningful ways to “make tobacco products less toxic, appealing, and addictive, with an intense focus on youth.” To that end, the FDA has expanded The Real Cost Campaign to educate teens about the dangers of e-cigarettes and other electronic nicotine delivery systems (ENDS). The agency will launch a new, full-scale e-cigarette campaign targeted to youth next week.
Healthcare Providers Applaud the Measure
“While some may consider e-cigarettes a safer alternative to combustible cigarettes for adults, it is great to see that the FDA is taking steps to prevent youth initiation to nicotine through these addictive products,” says Patricia Folan, RN, director of the Center for Tobacco Control at Northwell Health in Great Neck, New York. “Teens who would not have considered smoking traditional cigarettes are indulging in e-cigarettes in record numbers, thinking they are safer and attracted by the interesting flavors,” Folan says. While Swanson sees the FDA effort as a step in the right direction, she says that more can be done. “We were doing a good job reducing teen use of traditional tobacco, and then enter the e-cigarette,” she says. “The data showing how fast teens have adopted them is terrifying. We need to do more.”