The announcement earlier this month by the Trump administration that the Food and Drug Administration would being work to ban all flavors used in e-cigarettes — also known as vape pens — is a welcome response to the explosion in vaping by youths and young adults.
The makers of e-cigarettes and vaping devices have long relied on the claims that their products are a practical alternative to traditional tobacco products and can help people quit smoking because they deliver nicotine but reduce the exposure to a range of cancer-causing and other toxic chemicals.
At the same time, however, the makers of vaping products, such as the industry-leading Juul, have built a growing market around younger customers by developing and promoting a cornucopia of flavors focused on fruit, candy, desserts and the like. Ask yourself: How many adults trying to quit smoking would enjoy the rich, full flavor of something called “fruity pebbles”?
Juul earlier removed its flavored products from retail shelves, but they’ve quickly been replaced by products from other makers, and Juul continues to sell its flavored pods — including mango, creme and fruit — on its website. Online customers are required only to affirm they are over the age of 21 by clicking a box.
The result: Just a year ago, the FDA’s commissioner at that time, Dr. Scott Gottlieb, admitted the agency wasn’t prepared for “what I now believe is an epidemic of e-cigarette use among teenagers,” then as many as 3.6 million U.S. youths.
That growth has not slowed since. Recent data collected by federal health officials show that more than 1 in 4 high school students reported vaping this year, up from 1 in 5 in 2018. And more than 80 percent of youths using e-cigarettes surveyed said they picked their product because it “comes in flavors I like.”
The numbers are little different in Washington state’s Healthy Youth Survey, undertaken by the state Office of the Superintendent of Public Instruction, the Department of Health and other agencies, which surveys students in the eighth, 10th and 12th grades every two years on a range of health issues.
The survey, asked of students in 2018, found a decrease in smoking rates among those grades from rates in the 2016 survey, but a marked increase in vaping. About 30 percent of 12th graders used e-cigarettes, up 10 percentage points from two years previous; among 10th graders, vaping increased to 21 percent from 13 percent; and among eighth graders, use increased to 10 percent up from 6 percent.
The realistic fear among advocates for youths and health is that, while e-cigarettes may help many adults quit smoking, at the same time it has introduced millions of teens and young adults to nicotine addiction, whether by continued vaping or a transition to traditional smoked tobacco.
Youth health advocates have long asked for a ban on vaping flavors, but the FDA’s recent annoucement is a welcome change from the typical model of further study and pushed-backed deadlines seen elsewhere with e-cigarette regulation.
And it’s the recent rash of reports of illnesses — and even a handful of deaths — among e-cigarette users that should prompt the FDA to reconsider its timeline for fuller regulation of vaping products, including the nictotine-containing liquids and salts used that are heated in e-cigarettes and vape pens.
The FDA has had the authority to regulate e-cigarettes and their components since 2016, but a process requiring makers to submit their wares for review and approval by the FDA that was intended to begin in 2017 has since been delayed until 2022.
That lack of review now lingers around a spate of more than 200 reports of pneumonia-like lung illnesses in the U.S. and at least six deaths linked to vaping. At least one King County teenager was diagnosed last week with a severe lung disease linked to his vaping habit.
The causes remain under investigation; and some may involve vaping of liquids derived from marijuana to deliver THC rather than nicotine, products that would not be regulated by the FDA because they are considered illegal by federal law.
Until those investigations provide a less-clouded picture of what is responsible for vaping illnesses and deaths, e-cigarette users might consider setting aside their vaping products. And if a link is shown between contaminated e-cigarette components and the health scare, they might not want to pick them up again until the FDA is performing the product inspections it promised to provide.