FDA commissioner says e-cigarettes are an “epidemic” among teenagers and wants manufacturers to come up with a plan.
In a dramatic turn, the Food and Drug Administration (FDA) has denounced electronic cigarettes as an “epidemic” among teenagers.
The agency has also warned five major manufacturers, including JUUL, Logic, and blu, of potential impending enforcement action.
“I use the word epidemic with great care,” FDA Commissioner Scott Gottlieb publicly stated this month. “E-cigs have become an almost ubiquitous — and dangerous — trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end.”
The FDA also issued warning letters to manufacturers of e-cigarettes requesting them to respond with “robust plans” for how they intend to address the widespread use of their products by minors.
Gottlieb suggests that brands will likely have to revise their sales and marketing practices to ensure their products stop falling into the hands of teens.
E-cigarettes, vaporizers, and other noncombustible forms of tobacco consumption — referred to as electronic nicotine delivery systems (ENDS) — have created a debate among members of the healthcare community.
However, the potential benefits of ENDS as cessation devices has largely become overshadowed by the dangers they pose in initiating youth into tobacco use and addiction.
Use is on the rise
Use of e-cigarettes among adolescents has skyrocketed in recent years, with some new data likely prompting the FDA into action.
According to data published in the Washington Post, e-cigarette use among high school students jumped by 75 percent between 2017 and 2018.
That data, which hasn’t yet been formally released to the public, reportedly comes from the National Youth Tobacco Survey — data compiled by the Centers for Disease Control and Prevention (CDC).
With increasing use among teens, scrutiny of electronic cigarettes has risen, especially for the fruity and candy flavorants that appeal to young children and teens. Flavors for e-cigarettes run the gamut from strawberry to vanilla ice cream.
Flavoring in traditional cigarettes (excluding menthol) has been banned in the United States since 2009 for exactly this reason.
Effects on the brain
Experts say that growing use of tobacco products is particularly troubling because of how nicotine interacts with a young person’s developing brain.
Francis Leslie, a professor of pharmacology at the University of California Irvine, has studied the effects of nicotine on adolescent brains through animal models for many years. She says e-cigarettes are a worrisome trend.
“Our animal data actually seems to track fairly well with human epidemiological data that shows that the adolescent brain is uniquely sensitive to the negative effects of nicotine, and we’ve been studying what those effects are and what the mechanisms are for a number of years,” Leslie told Healthline.
One of the main conclusions from Leslie and her fellow researchers is that nicotine use among adolescents can enhance the rewarding effects of other drugs, particularly cocaine.
“It produces profound long-term changes in brain and behavior,” she said.
Therefore, she applauds the FDA’s action.
Is the FDA late to the game?
For many advocacy groups, however, the efforts of the FDA to curb use of e-cigarettes among teens have been delayed for far too long.
“The American Lung Association strongly agrees that this is an epidemic; that this has reached epidemic levels and this is a fear that the Lung Association has had for a number of years, which heretofore has unfortunately fallen on deaf ears,” Erika Sward, assistant vice president of national advocacy for the American Lung Association, told Healthline.
The FDA officially began regulating tobacco products in 2009 under the Tobacco Control Act.
However, it wasn’t until August 2016 with the finalization of the “deeming rule” that the FDA had the power to regulate nontraditional tobacco products, such as e-cigarettes and e-liquids.
The rule allows the FDA to “deem” whether certain tobacco products are subject to regulation.
E-liquids, for example, aren’t explicitly tobacco products, although they may contain nicotine. But FDA officials say the liquids still meet the statutory definition for a tobacco product.
The deeming rule also extends to other tobacco products, including snuff, cigars, small cigars (cigarillos), pipe tobacco, and hookah.
Since the FDA has technically had this power for more than two years, advocacy groups say they are frustrated the organization has dragged its feet on actual regulation.
“The Lung Association has been urging the Food and Drug Administration to take meaningful action for quite a while now,” Sward said. “Our organization with our partners filed a lawsuit against the FDA for what we believe was an arbitrary and capricious delay in implementing the deeming rule, which would have required every product to be reviewed on a case-by-case basis.”
As use of e-cigarettes among vulnerable teenage populations continues to balloon, there is a palpable sense of worry and consternation about the potential widespread health effects of these products.
“I’ve been very concerned that we’re actually using this generation of teenagers as guinea pigs to see what the long-term effects of e-cigarettes are on their brains and their behavior,” said Leslie.