FDA Needs to Go Further in Curbing E-Cig Use by Teens

The FDA has new powers to regulate e-cigarettes. It should use them to restrict vaping advertising and ban flavored liquids that appeal to teens.

In early August, the FDA began doing something that was years in the making: It finally started to regulate e-cigarettes in a similar fashion to traditional cigarettes. I was relieved to say the least, given that although traditional cigarette smoking has plummeted in recent years among teens, the rate of e-cigarette smoking (also known as vaping) has been skyrocketing.

In a nutshell, the new rule prohibits the sale of e-cigarettes to anyone below the age of 18 and requires that stores ask for identification from purchasers. Warning labels on e-cigarettes are required, ingredients must be listed and any health claims are banned.

It sounds like the FDA has finally gotten tough on the e-cigarette industry, right? Well, not exactly.

An excellent opinion piece published recently in JAMA Pediatrics points out that the new rule doesn’t go far enough to curb the use of e-cigarettes by young people. So what’s missing? To my surprise, although the FDA has authority to regulate e-cigarettes, that power doesn’t extend to restrictions on e-cigarette advertising to teens, nor can they ban flavorings in e-cigarettes, the latter a key reason young people find the product so appealing.

“Some e-cigarette companies are using youth-resonant themes such as rebellion, glamour, and sex; celebrity endorsements; and sports and music sponsorships — all strategies taken from the cigarette companies’ old playbook,” Micah L. Berman, JD, and Y. Tony Yang, ScD, of respectively, Ohio State University and George Mason University, write.

Indeed, a CDC study published in April found that the more exposure youths have to e-cig ads, they more likely they are to start using them.

I decided to Google e-cigarette flavors to find what’s out there. I was shocked with what I discovered. Literally hundreds of flavors are available as e-liquid or vape juice. And many of those choices were candy flavored, which to me is a clear indication of trying to appeal to teens. Cotton candy, fruit cereal and yummy gummy were just 3 flavors I came across at one online retailer.

Interestingly, a ban on flavorings that would appeal to young people was included in the original rule proposed by the FDA. However, as MedPage Today reported, that provision was cut from the final version of the rule by the White House Office of Management and Budget (OMB).

The new rule does give the FDA the authority to establish restrictions on e-cig advertising that might appeal to young people. However, as Berman and Yang point out, because such restrictions were not included in the rule, a long, drawn-out process — that could take years — would now be required.

The FDA has the authority to do much more in regulating e-cigarettes. Here’s hoping that Congress and other parts of the federal government help, rather than stymie, the agency in accomplishing this.

Jonathan Block

Jonathan Block is a freelance writer and former MedShadow content editor. He has been an editor and writer for multiple pharmaceutical, health and medical publications, including BioCentury, The Pink Sheet, Modern Healthcare, Health Plan Week and Psychiatry Advisor. He holds a BA from Tufts University and is earning an MPH with a focus on health policy from the CUNY Graduate School of Public Health & Health Policy.

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