FDA cracks down on teenage vaping
Gilbert Berdine MD
On September 12, 2018 the Food and Drug Administration (FDA) announced a series of actions concerning the use of electronic cigarettes or ecigs by teenagers. In an interview with Bloomberg, FDA Commissioner Scott Gottlieb characterized teenage vaping as an epidemic.1
Previous data from the CDC showed that teenage vaping substantially increased from 2013 to 2014, peaked in 2015, and had decreased in 2016 and 2017. The CDC estimated that 1,730,000 high school students and 390,000 middle school students used electronic cigarettes in 2017.2 The FDA will soon release data showing a significant increase during 2018. This increase is the source of FDA concern about vaping.
Vaping is big business with about $10 billion in annual sales. Juul is the market leader with about 72% of market share.4 Juuling has become a verb with users of electronic cigarettes.
Figure 4 shows the popular Juul brand of electronic cigarette along with the four flavor pods. Shown are the mango (tan), cucumber (green), menthol (cyan), and Virginia tobacco (charcoal) flavor pods that have been very popular with teens.
Figure 1. Percentage of High School Students Reporting Use of Tobacco Products.2
Figure 2. Percentage of Middle School Students Reporting Use of Tobacco Products.2
Figure 3. Sales of Vaping Products in Millions USD.3
Figure 4. Juul Brand of Electronic Cigarette and 4 Flavor Pods.5
The FDA action included warnings or fines to over 1,300 retailers for selling electronic cigarettes to teenagers.6 It is against federal law to sell electronic cigarettes to children under the age of 18. The FDA has told five major manufacturers of e-cigs to develop measures that reduce vaping by teenagers within 60 days or the sale of flavored tobacco pods favored by teens would be banned.7 The FDA previously had hoped that vaping would aid adults in smoking cessation, but it is now concerned that teenage addiction to nicotine products such as Juul will outweigh any benefits to adults.8 Commissioner Gottlieb said, “Inevitably what we are going to have to contemplate are actions that may narrow the off-ramp for adults who see e-cigarettes as a viable alternative to combustible tobacco in order to close the on ramp for kids. It’s an unfortunate trade-off.”8
- Edney A. FDA threatens to pull e-cigarettes to fight the rise of youth vaping. Bloomberg. Sept 12, 2018. https://www.bloomberg.com/news/articles/2018-09-12/fda-threatens-to-pull-e-cigarettes-to-fight-rise-of-youth-vaping
- Centers for Disease Control and Prevention. Tobacco product use among middle and high school students – United States, 2011-2017. Morbidity and Mortality Weekly Report. June 8, 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a3.htm
- Durden T. FDA may pull e-cigarettes to fight youth vaping ‘epidemic.’ Sept. 12, 2018. https://www.zerohedge.com/news/2018-09-12/fda-may-pull-e-cigarettes-fight-youth-vaing-epidemic
- Richtel M, Kaplan S. Did Juul lure teenagers and ‘get customers for life?’ The New York Times. Aug 27, 2018. https://www.nytimes.com/2018/08/27/science/juul-vaping-teen-marketing.html
- For Smokers. By Design. Juul Labs, Inc. https://www.juul.com/
- Warning letters and civil money penalties issued to retailers for selling JUUL and other e-cigarettes to minors. US Dept of Health and Human Services. US Food and Drug Administration. Sept 12, 2018. https://www.fda.gov/tobaccoproducts/newsevents/ucm605278.htm
- CTP letters to industry. US Dept of Health and Human Services. US Food and Drug Administration. Sept 13, 2018. https://www.fda.gov/TobaccoProducts/Labeling/RulesRegulationsGuidance/ucm281784.ht
- Kaplan S, Hoffman J. F.D.A. targets vaping, alarmed by teenage use. The New York Times. Sept 12, 2018. https://www.nytimes.com/2018/09/12/health/juul-fda-vaping-ecigarettes.html
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