FDA proposes ban on menthol cigarettes, restricts sales of sweet e-cigarettes

In sweeping moves intended to curb smoking and vaping among youth, the Food and Drug Administration on Thursday tightened tobacco enforcement, announced plans to ban menthol cigarettes and many flavored small cigars and moved forward with restrictions on sales of sweet-flavored electronic cigarette liquid.

The actions come in response to data released Thursday that show increases in vaping among young people. FDA Commissioner Scott Gottlieb called the use of nicotine-delivering e-cigarettes by youth an "epidemic."

E-cigarette use was up 78 percent among high school students and 48 percent among middle-school students from 2017 to 2018, according to the 2018 National Youth Tobacco Survey released by the FDA and the Centers for Disease Control and Prevention.

The total number of middle and high school students using e-cigarettes rose to 3.6 million, an increase of 1.5 million students.

"There's absolutely nothing in the data set that you can point to and say that's encouraging," Gottlieb told USA TODAY's editorial board Wednesday. "It's all discouraging." 

Gottlieb said vaping products flavored with anything other than tobacco, mint or menthol may be sold only in stores that can verify the age of all customers who walk in the door.

Sweet-flavored vape liquids may be sold online only when there is more stringent age verification. 

Flavors are the focus of the new measures, Health and Human Services Secretary Alex Azar said, because children choose flavored tobacco and nicotine products more often than adults, and "flavors are a major reason they use these products in the first place."

Some flavors are far more attractive than others. When it comes to vaping, mint- and menthol-flavored e-cigarettes are far more popular with adults than with kids.

One survey cited by the FDA showed 20 percent of e-cigarette users ages 12 to 17 used mint or menthol. More than 40 percent of adult vapers did.

E-cigarette manufacturers said the vapor-producing devices are intended to help adult smokers quit and not for use by children.

Many adult vapers prefer mint or menthol flavors. (Photo: Getty Images)

 

Juul Labs, the leading e-cigarette manufacturer and the most popular one with youths, got ahead of the FDA's announcement when it announced plans Wednesday to discontinue sales of its mango-, fruit-, creme- and cucumber-flavored e-liquid pods at more than 90,000 retail stores.

The company said it would require additional age verification measures for online sales of the flavors, 

Gottlieb said the new restrictions aim to strike a balance between helping adult smokers quit through less-dangerous vaping while reducing the chance more young people will become addicted to nicotine.

Public health professionals fear that taking up vaping could lead teens to try smoking when their electronic devices aren't available.  

If the FDA prohibited mint and menthol vape flavors, Gottlieb said, it could make cancer-causing menthol cigarettes more attractive. That would be especially risky, because many young people are already attracted to menthol.

More: Gasping for Action: Lab tests reveal popular e-cigarette liquids contain harmful chemicals

More than half of children 12 to 17 who start smoking will do so with a menthol cigarette, Gottlieb said.

Lyle Beckwith, senior vice president of government relations at the National Association of Convenience Stores, said a ban on menthol cigarettes will "only shift those sales to the black market."  

"Black market sellers of tobacco products do not check the ages of their purchasers, do not pay taxes on their sales and sell more than just menthol cigarettes," he said.  

Beckwith said the association supports enforcement of age verification for e-cigarettes but urged the FDA to share any information showing its proposal will assure underage children don't have access to the devices. 

The FDA will change its enforcement policy on flavored cigars so any that weren't on the market before February 2007 can no longer be sold without an extensive scientific and safety evaluation that the agency approves. 

Robin Koval, CEO of the anti-tobacco advocacy group Truth Initiative, said banning menthol cigarettes and all flavored cigars is "one of the most powerful actions FDA can take when it comes to saving lives." She urged the FDA to act quickly.  

 

"The regulatory process can be slow, and each day lost is measured in lives," Koval said. "FDA’s proposed sales restrictions on e-cigarettes are a step forward but by themselves are not enough to stem the youth e-cigarette epidemic." 

Truth Initiative wants the FDA to eliminate flavors, ban online sales, further restrict marketing to youths and conduct thorough scientific reviews of vaping company applications, so it's clear e-cigarettes have an overall benefit to public health "before they show up in every high school in America," she said. 

More: What teens – and many adults – don't know about e-cigarettes and vaping

"The bottom line," Gottlieb said, "is that these new proposals to address flavors and protect youth would dramatically impact the ability of American kids to access tobacco products that we know are both appealing and addicting." 

He could have banned all flavors, Gottlieb said – and he still might.