Teenagers' use of e-cigarettes at epidemic levels - United States health officials

US government considers ban on flavored e-cigarettes over youth 'epidemic'

In April the agency launched a Youth Tobacco Prevention Plan, created to address some of the known public health risks, such as flavors, that contribute to adolescent use of e-cigarettes.

FDA commissioner Scott Gottlieb said the agency will soon release data that show a "substantial increase" in youth vaping this year compared with 2017. "It be simply no longer tolerable".

In the letters, the agency is demanding that within 60 days, these companies, namely Juul, Vuse, MarkTen XL, blu e-cigs and Logic, present proof that they are able to keep the nicotine-containing products out of the hands of minors.

More than 2 million middle school and high school students used e-cigarettes in 2017, according to a report from the FDA.

The FDA's suggestions include rigorous age verification procedures for online direct sales (which Juul, the market leader, says it already has) and "discontinuing sales to retail establishments that have been subject to an FDA civil monetary penalty for sale of tobacco products to minors within the prior 12 months".

"The FDA should immediately move to regulate flavored e-cigarettes, instead of waiting until 2022, as it is now planning to do", Bloomberg said in a statement.

"We're committed to the comprehensive approach to address addiction to nicotine that we announced past year", Gottlieb said.

His comments came as the agency revealed it issued more than 1,300 warning letters and fines to retailers who illegally sold e-cigarette and vapor products to minors during "a nationwide, undercover blitz" of retail stores and online sites this summer.

The agency said it allowed the extra time to strike an appropriate balance between regulation and encouraging the development of innovative tobacco products that may help older smokers quit.

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. Many researchers say the devices are less unsafe than traditional, combustible cigarettes because they don't contain tobacco's cancer-causing ingredients.

It cited estimates from Public Health England that e-cigarettes are 95 percent less harmful than normal cigarettes.

Each company must submit to FDA within 60 days plans on how they will address the widespread youth access and use of their products.

To gain clearance to return to the market, the companies would have to prove that the benefits to adults who use e-cigarettes to stop smoking outweigh the risks associated with youth vaping.

"I've been warning the e-cigarette industry for more than a year that they needed to do much more to stem the youth trends", Gottlieb said.

The Food and Drug Administration (FDA) has called on the industry to address the problem or risk having their flavoured products taken off the market.

Traders said proposed FDA action was less harsh than feared.

"I think it became clear to FDA that if they didn't get their arms around this issue the use of these products by kids across the nation would undo decades of progress", said Matthew Myers of the Campaign for Tobacco-Free Kids.

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

On Wednesday, Gottlieb put manufacturers on notice that the agency's balancing act will lean more heavily on preventing youth addiction.

Gottlieb said the agency could also target "cartridge-based products" such as the USB-sized Juul, which is favored by teens and sold in convenience stores. Other big players are owned by big tobacco conglomerates; Camel parent British American Tobacco makes Vuse e-cigarettes, and Marlboro parent Altria makes MarkTen e-cigarettes.

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