Did the FDA Ban E-Cig Flavors? Here’s What to Know
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By Shawn Radcliffe
The Food and Drug Administration (FDA) announced Thursday that it will take action to remove most unauthorized flavored e-cigarette cartridges from the market.
This would apply to mint, fruit, and dessert flavors, but not menthol or tobacco-flavored products. Also, it would apply only to flavored cartridges, not open tank systems.
This action is intended to strike a balance between protecting youth from the health risks of vaping — including nicotine addiction — and allowing adult smokers to use e-cigarettes as a way to quit combustible cigarettes.
"The enforcement policy we're issuing today confirms our commitment to dramatically limit children's access to certain flavored e-cigarette products we know are so appealing to them — so-called cartridge-based products that are both easy to use and easily concealable," said FDA Commissioner Dr. Stephen M. Hahn in the news release.
FDA Targets Most Popular Vape Products
Cartridge-based e-cigarettes have long been popular among minors, as have non-tobacco flavors.
Data from the 2019 National Youth Tobacco Survey show that more than 5 million U.S. middle and high school students reported using an e-cigarette within the last 30 days. Nearly 60 percent of high school students who vaped used cartridge-based JUUL products.
Other research shows that the most popular e-cigarette flavor among high school students was mint, followed by mango and fruit.
Last fall, in anticipation of an FDA crackdown on flavored e-cigarette products, JUUL took most of its flavors off the market, although it continued to sell mint and menthol products.
The FDA emphasized that this week's action is not a "ban" on these products. Instead, the agency is enforcing its existing authority to regulate e-cigarettes.
Since 2016, all e-cigarettes have been required to seek "premarket authorization" from the FDA before being sold in the U.S.
So far, no e-cigarettes have this approval — so all products on the market "are considered illegally marketed and are subject to enforcement, at any time, in the FDA's discretion," the agency wrote in its release.
The FDA, though, is currently reviewing several premarket applications for flavored e-cigarette products. If any of those applications are approved, the products could be legally sold in the U.S.
E-Cigarette Restrictions 'Better Than Nothing'
The FDA's current effort falls short of the commitment the Trump administration made in September to remove all unauthorized nontobacco-flavored e-cigarettes from the market, including mint and menthol.
According to The New York Times, this "partial retreat" is in response to the intense lobbying efforts of the vaping industry, as well as a desire to avoid a legal battle with the tobacco industry.
President Trump's advisers have also warned him that, with the 2020 election looming, a complete flavor ban would hurt him with his base, The New York Times reports.
Dr. Timothy Connolly, a pulmonologist and medical director of Respiratory Care Services at Houston Methodist Hospital in Texas, said the approach announced by the FDA is "certainly better than nothing," although he would prefer the agency target all types of e-cigarettes.
"The decision by the Trump administration to ban flavored e-cigarette cartridges is definitely an excellent step to discourage American youth from beginning to vape," said Connolly.
Patricia Folan, RN, DNP, director of Northwell Health's Center for Tobacco Control in Great Neck, New York, said because e-cigarette flavors like mint and fruit are so popular among youth, restricting the sale of these products may keep teens from starting to vape, and "could also motivate some youth to seek help to quit using these products."
However, she is concerned that youth may simply switch to menthol, which is made from mint.
"Since the FDA will not be restricting the manufacture of menthol-flavored e-cigarettes, many of our youth may continue to use e-cigarettes," said Folan.
How to Reduce Youth Vaping
The current debate over a flavor ban was prompted last year by a sharp increase in rates of youth vaping and the recent outbreak of vaping-related lung injuries.
As of Dec. 27, 2019, 2,561 people have been hospitalized with severe lung injuries due to vaping, with 55 confirmed deaths, reports the Centers for Disease Control and Prevention (CDC). Most of these are related to vaping tetrahydrocannabinol (THC), the high-inducing compound in marijuana.
A growing body of research, though, shows that even nicotine e-cigarettes can damage the heart, lungs, and immune system.
The FDA's actions will also not apply to THC-vaping products, which are regulated by states that have legalized marijuana.
Health officials and legislators have made other efforts to protect youth from vaping.
In December, Trump signed a new minimum age law. "It is now illegal for a retailer to sell any tobacco product — including cigarettes, cigars, and e-cigarettes — to anyone under 21," the FDA said on its website.
These regulatory efforts may help slow the rise in youth vaping, but are only part of the solution.
"Although a ban on flavored vaping products makes it more difficult to purchase legally," said Connolly, "individuals interested in smoking via this mechanism will still find ways to procure novel devices and abuse nicotine."
Folan said more must also be done to help current young vapers break free of the nicotine addiction that occurs when using these products.
"Parents, school officials, and healthcare providers should not underestimate the discomfort and unpleasant symptoms associated with withdrawal from e-cigarette use," said Folan.
Reposted with permission from Healthline.
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