FDA Says Use Of
E-Cigarettes Is Epidemic Among Young People
Stricter Measures
Being Taken and More Are Anticipated
Saying the agency believes that e-cigarette use among youth has hit
epidemic proportions, the Food and Drug Administration has announced
the agency “intends to take new and significant steps to address this
challenge”. While FDA presented no new or updated data in support of
its view, FDA Commissioner Scott Gottlieb said that he sees an
epidemic of e-cigs among teens, and “deeply disturbing trends that
show no sign of abating.” He added, “The FDA is closely watching the
trends in youth use. And if, as we expect, preliminary data that’s in
our possession and will be finalized and released in the coming months
confirm our present observations that the youth use of e-cigs is
rising very sharply, we’ll swiftly change course.”
CDC Data
In
a recent report on tobacco product use among students in the US
between 2011-2017, CDC found that during this period prevalence of the
current use of any tobacco product decreased from 24.2% to 19.6% among
high school students and from 7.5% to 5.6% among middle school
students. E-Cigarettes were the most commonly used tobacco product
among high school students at 11.7% (rising from 1.5% in 2011 and
peaking at 16% in 2015) and among middle school students at 3.3% in
2017. E-cigarette use jumped dramatically higher in 2014 among these
two groups of students and has remained high since then. It increased
somewhat in high school students in 2017 and decreasing slightly in
middle school students last year, according to the CDC survey data.
Unintended Consequence
In a statement to the press, the agency acknowledged
that it did not predict or anticipate the increased use of
e-cigarettes among teenagers when it launched its new plan to regulate
tobacco as part of the Tobacco Control Act and permitted the use of
e-cigarettes to help people quit. According to Gottlieb, “The FDA
won’t tolerate a whole generation of young people becoming addicted to
nicotine as a tradeoff for enabling adults to have unfettered access
to these same products.”
To accomplish this, the FDA has a three-pronged
startegy:
1. Preventing youth access to tobacco products using
enforcement.
FDA has announced a coordinated initiative against
sales that violate the law. It is aimed at retail and online sales of
e-cigarettes to minors. It is the largest compliance effort in FDA
history.
2. Curbing the marketing of tobacco products aimed at
youth
3.
Educating teens about the dangers of using any tobacco products,
including a national campaign beginning shortly to warn teenagers of
the dangers of nicotine and e-cigarette use
FDA is requesting that the manufacturers of these brands and products
come back to the agency in 60 days with robust plans on how they will
convincingly address the widespread use of their products by minors.
This may require these brands to revise their sales and marketing
practices, including online sales; to stop distributing their products
to retailers who sell to kids; and to remove some or all of their
flavored e-cig products from the market until they receive premarket
authorization and otherwise meet applicable requirements.
Review of the Evidence
A
recent review of E-cigarettes by the European Public Health
Association reached the following conclusions:
1.
On Safety
The
health risks associated with e-cigarettes remain uncertain but they
cannot be considered safe. What is certain is that statements that
they are some percentage safer than conventional cigarettes are so far
unjustified.
2.
On Effectiveness against Smoking
Overall, e-cigarettes may help some smokers quit but, for most,
e-cigarettes depress quitting.
3.
On Gateway Role
The
net effect of making e-cigarettes widely available, at population
level, seems likely to be an increase in sole and dual use of
e-cigarettes and sole smoking unless there is very stringent
regulation.
4. Role of tobacco industry
E-cigarettes and “smoke not burn” products are
portrayed publicly by the tobacco industry as a means to reduce
smoking yet, at the same time, these companies are actively promoting
their combustible products.
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