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An Overdue First Step; Immediate Follow-up Needed


(Nov. 15, 2018) – In response to today’s shocking data from the CDC documenting a 78 percent increase e-cigarette use among high schoolers and a 48 percent increase among middle schoolers, the FDA is finally taking concrete action to regulate tobacco products.

The American Thoracic Society strongly supports the initial announcement, but more concrete action is needed.

Combustible Tobacco Products  
The FDA announced its intent to issue a proposed rule to ban menthol cigarettes, as well as characterizing flavors in cigars.  While we regret it took the FDA so long to ban menthol and characterizing flavoring in these products, the ATS congratulates the Agency for taking bold action on flavorings.   We also expect that the “menthol rule” will extend to similar compounds that retain the pharmacologic properties of the signature flavoring. 

We are concerned that FDA has not taken as bold an approach on e-cigarette products.  While the ATS appreciates the Agency’s attempt to reduce youth access to e-cigarette products by limiting the point of sale of flavored tobacco products, we note that limiting where these products can be sold is an incremental step.  Effective regulation to prevent children from using e-cigarettes requires regulating flavors in the product itself – not just the point of sale.   To truly address youth e-cigarette use, we strongly urge the FDA to ban characterizing flavors in all e-cigarette products.

An Urgent Response is Required
In responding to the data on youth e-cigarette use, FDA Commissioner Gottlieb stated, “We’ve been aware of these data for several months and are pursuing a robust set of new policies to address this epidemic-level of e-cigarette use by kids.” 

“If the FDA has been aware of this information for months, why aren’t they taking concrete actions today?” said Harold Farber, MD, MSPH, chair Tobacco Action Committee of the ATS.  “The promised future regulatory action, while welcomed, seems to lack the urgency this public crisis requires.”

And while we congratulate the FDA for taking action, our celebration is tempered by the knowledge that 3.5 million American high school children are current e-cig users. Commissioner Scott Gottlieb, MD, has called the rise in youth e-cigarette use an epidemic.  We agree. We hope today’s announcement is only the first of several actions the agency will take to reduce both the access and appeal of e-cigarettes to our nation’s youth.