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Over the past several years the e-cigarette marketplace has exploded with a cluster of new companies trying to carve out their own space in this growing industry. As electronic cigarettes and vapes have brought nicotine use in the 21st century, manufacturers have gone to great lengths to take advantage of the change. Conversely, as e-cigarettes have become more popular with adult-age smokers, they are also becoming more popular with teens. In fact, recent research shows that there were 1.3 million more high school age teens vaping in 2018 than in 2017. That is a massive spike. This is not the first time there has been an alarming surge in young people using vapes.
Now, the Food and Drug Administration (FDA) Commissioner, Dr. Scott Gottlieb, is taking a stern stance on fighting teen e-cigarette use. Just last Friday, Gottlieb made his most direct threat yet against e-cigarette companies. Now, this FDA boss says that if the companies don’t stop marketing to young people, he will start taking their products off the market.
FDA vs. E-Cigs
Gottlieb believes the rapid rise in teen vaping is horrifying, and therefore something needs to be done to curb the trend. He states that previous efforts urging companies to reduce candy-flavored products and heavy-handed marketing techniques voluntarily do not seem to have done much good. So now, it seems he is taking the fight directly to the companies.
The FDA does have the power to stop e-cigarette sales and force manufacturers to go through the formal FDA approval process. Despite calls from various organizations against the extensive availability of e-cigarette products, the agency has yet to take this step. However, Gottlieb says that he is about ready to flex that particular muscle of the FDA. During a recent meeting, Gottlieb stated,
“I’ll tell you this. If the youth use continues to rise, and we see significant increases in use in 2019, on top of the dramatic rise in 2018, the entire category will face an existential threat.”
“It will be game over for these products until they can successfully traverse the regulatory process.”
And there is plenty of evidence showing just how bad vaping among teens and even children have become. Last November, data from the Centers for Disease Control and Prevention (CDC) showed:
- 78% increase in vaping by high school students
- 6 million high school and middle school students now using e-cigarettes
Needless to say, more and more young people are being impacted due to these devices. Efforts to prevent teens from using tobacco were already facing an uphill battle before the evolution of nicotine technology. Furthermore, this is not the first time Gottlieb has brought the issue to e-cigarette makers. Gottlieb has repeatedly met with big names in the vape industry, asking them to discontinue the practice of selling fruity flavors in ways that remain easily accessible to kids. Starting in November, Gottlieb set out to:
- Limit sales of flavored e-cigarettes
- Ban menthol in combustible cigarettes
For now, it seems the FDA Commissioner is not content with the actions of the vape companies thus far.
Addressing Vaping Addiction
Gottlieb isn’t alone on this either. There are plenty of experts who believe more needs to be done to address the issue of children and teens using e-cigarettes. For example, Dr. Susanne Tanski, a pediatrician and past chair of the American Academy of Pediatrics Tobacco Consortium, thinks the FDA should do more.
“FDA’s recently announced regulatory actions regarding e-cigarettes do not go far enough and we urge much stronger action. Strong tobacco control policy aimed at keeping enticing products away from adolescents may be more effective in achieving adolescent cessation than medical interventions,”
E-cigarettes typically deliver nicotine in larger doses, and in formulations that can be even more addictive than traditional cigarettes. This makes nicotine dependence a key element of this discussion. Sadly, one difficulty Dr. Tanski points out is the lack of data on how to treat an adolescent with e-cigarette dependence. Therefore, there is not enough evidence to support a specific treatment plan for teens with a nicotine addiction brought on by vaping. In fact, experts say it requires years of studies to solve this issue.
Several experts believe that e-cigarettes should already have much harsher restrictions to avoid more vaping addiction. Dr. Bonnie Halpern-Felsher, who studies youth e-cigarette use at Stanford Children’s Health, also believes that sales of flavored vape products should be eliminated. Dr. Halpern-Felsher adds that most people, especially young people, do not understand the true nature of addiction.
The “Safer Alternative” Argument
Conversely, many of these same experts argue that the FDA is only making things worse by claiming that e-cigarettes are safer than combustible tobacco products. Dr. Bonnie Halpern-Felsher herself has stated,
“We need to stop saying that e-cigarettes are safe or safer and prevent e-cigarette companies from making these unauthorized risk claims… Youth hear them. We need to stop saying that e-cigarettes help adults stop smoking when there is not clear evidence that this is the case.”
Dr. Halpern-Felsher is not alone in her concern that teens hear claims that e-cigarettes are safer. Despite this being a common claim, many experts are not yet convinced that vapes and e-cigarettes are a safe alternative. However, this kind of talking point causes more young people to choose using vapes because they don’t truly understand the risk.
For now, some companies say they are at least trying to keep their products away from teens and children. Juul, which has become one of the dominant brands for the use of e-cigarettes, has an advertising campaign highlighting that e-cigarettes are for adults only. However, opponents still believe this only makes their products more seductive to teens. They compare it to the same forbidden fruit appeal “adults only” labels add to alcohol products and regular cigarettes.
So the question becomes, should the FDA be taking stronger steps to regulate e-cigarettes and vape products? How should they be restricted? Is the current FDA Commissioner heading in the right direction, or is there a better way to address teens using e-cigarettes?