Public Health

Vaping: Move to ban some flavors only 1st step in addiction fight

What’s the news: Amid pressure from the AMA and other physician and public health organizations, the Trump administration is moving to ban the sale of flavored e-cigarette cartridges used in closed system e-cigarettes such as those made by Juul, a subsidiary of Marlboro owner Altria Group Inc.

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However, the new Department of Health and Human Services (HHS) announcement leaves untouched—for now—the sale of tobacco- or menthol- flavored cartridge-based products, as well as open systems in which users refill their e-cigarette devices with exotic flavors of nicotine juices widely sold at vaping shops.

The “new policy to address the youth e-cigarette epidemic by limiting flavors in some vaping products is a step in the right direction, but does not go far enough,” said AMA President Patrice A. Harris, MD, MA. “The AMA is disappointed that menthol flavors—one of the most popular—will still be allowed, and that flavored e-liquids will remain on the market, leaving young people with easy access to alternative flavored e-cigarette products.”

Why it matters for patients and physicians: HHS Secretary Alex Azar noted that “the United States has never seen an epidemic of substance use arise as quickly as our current epidemic of youth use of e-cigarettes.”

More than 5 million American middle- and high-schoolers have used e-cigarettes within the previous month, according to the 2019 National Youth Tobacco Survey, whose results were published in JAMA. About 1.6 million of these users are vaping 20 or more days over the span of a month.

“E-cigarette use among young people continues to spike, creating another generation at risk of nicotine dependence who will face significant health problems as a result,” Dr. Harris said. “If we are serious about tackling this epidemic and keeping these harmful products out of the hands of young people, a total ban on all flavored e-cigarettes—in all forms and at all locations—is prudent and urgently needed.”

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What’s next: HHS officials also announced that the Food and Drug Administration will start enforcing their removal from the market in 30 days. Enforcement priorities are outlined in the guidance for industry and include:

  • Flavored, cartridge-based e-cigarette products—except tobacco and menthol flavors.
  • All e-cigarette products for which the manufacturer has failed to take adequate measures to prevent minors’ access.
  • Any e-cigarette product targeted to, or whose marketing is likely to promote, use by minors.

“We are pleased the administration committed today to closely monitoring the situation and trends in e-cigarette use among young people, and to taking further action if needed,” Dr. Harris said.

Learn more about e-cigarettes and vaping, which the AMA has declared a public health epidemic.