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Public Health Experts Press FDA to Act on E-Cigarette Regulation

May 6, 2015

A year ago Food and Drug Administration (FDA) issued proposed new regulations for e-cigarettes that would, among other things, prohibit their sale to minors and require health warning labels, but the new rules have yet to go into effect.

Last week, 31 health and medical groups including the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Heart Association wrote to President Obama asking the federal government to finalize the "long-overdue" regulation. The medical groups say cigar and e-cigarette brands are using marketing tactics that seem to appeal directly to young people, like promoting candy and fruit-flavored products. The letter writers want regulations that end this practice, Time magazine reports. "This process has already taken far too long," the letter reads. "We cannot afford more delays that allow tobacco companies to target our kids with a new generation of tobacco products."

The letter writers are concerned over recent results from the National Youth Tobacco Survey reported by the Centers for Disease Control and Prevention (CDC). E-cigarette use among middle school and high school students tripled in just one year and hookah use had doubled. Among high school students, e-cigarette use increased from 4.5 percent in 2013 to 13.4 percent in 2014, from approximately 660,000 students to 2 million, according to Time.

Shyam Biswal, a professor in the department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health, expressed concern about first-time users. "We don't have the data that e-cigarettes are a gateway [to other tobacco products], so we just wait. It should not be like that."

The FDA, in a statement to Time, said it remains concerned about e-cigarette and hookah use among youth. "FDA is committed to moving forward expeditiously to finalize the rule that will extend its authority to additional tobacco products such as e-cigarettes, cigars, pipe tobacco, and other currently unregulated tobacco products." But rulemaking is a complex process, the agency said, and it must review more than 135,000 public comments about the proposed rule.

Several states and some local governments have regulated e-cigarettes on their own; at least 42 states and one territory currently prohibit the sale of e-cigarettes or vaping/alternative tobacco products to minors, Time reports. The medical groups warned, "further delay will only serve the interests of the tobacco companies, which have a long history of using product design and marketing tactics to attract children to harmful and addictive products." In a recent op-ed piece in the New York Times, former FDA commissioner David Kessler noted, "The cigarette industry has long understood that virtually all new tobacco users in the United States are children and that if it doesn't hook them as kids, it probably never will."

Dr. Thomas R. Frieden, director of the CDC worries about introducing an addictive substance like nicotine to a broad population of teenagers. Frieden noted that research has found that nicotine harms the developing brain, according to the New York Times.

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