FDA Proposes Tighter Regulations as Youth e-Cigarette Smoking Skyrockets

US health officials said Thursday the number of high school students who reported being current e-cigarette users skyrocketed 78% between 2017 and 2018 to 3.05 million, as the FDA moved to create tougher regulations on e-cigarettes, although the agency did not propose the type of ban that some public health advocates hoped for.

The National Youth Tobacco Survey also showed there was a 48% jump in middle school children using the devices as well, the FDA and CDC said.

“These data shock my conscience,” said FDA Commissioner Scott Gottlieb, MD, in announcing the agency’s plans to tighten rules regarding the sale of most flavored versions of e-cigarettes, as well as ban menthol from regular cigarettes and cigars and outlaw flavors in all cigars.

Gottlieb said he wanted to be careful that the agency did not go too far in restricting device sales such that adults who are trying to quit combustible cigarettes discover the electronic devices are too hard to find.

As industry leader Juul Labs did earlier this week when it announced a variety of ways that it planned to keep flavored e-cigs, or vapes, away from children, Gottlieb said he is proposing that flavored devices must be sold in in age-restricted retail locations and, if sold online, under stricter age verification procedures.

Tobacco, mint, and menthol flavors or non-flavored products would not be subject to those rules, he said, citing data that said the mint- and menthol-flavored products are more popular with adults than with kids.

In the same statement, however, the FDA said it will look to ban menthol in combustible tobacco products, including cigarettes and cigars, citing data that say menthol is likely linked with increased smoking initiation by youth and young adults.

In addition, a higher proportion of youth who smoke cigars use flavored cigars, the FDA said.

The advocacy group Campaign for Tobaco-Free Kids said the FDA proposal is a good beginning, but it does not go far enough.

“The proposals by the FDA today to prohibit menthol cigarettes and flavored cigars have enormous potential to drive down tobacco use and the death and disease it causes in the United States,” said Matthew L. Myers, president of the group, in a statement. “If adopted, these two proposals will have a greater impact in reducing tobacco use by youth and the African-American community than any regulatory measure ever undertaken by the federal government.”

But the group criticized the FDA for not banning menthol and mint electronic delivery devices.

“It stops short of banning the flavors that have made e-cigarettes so popular with kids,” said Myers about today's action. "Menthol and mint flavors will remain widely available despite new data being released today that shows 51 percent of high school students who currently use e-cigarettes use menthol- or mint-flavored products.”