Five health care organizations have urged the FDA to prohibit all candy- and fruit-flavored tobacco products, including e-cigarettes, cigars and hookah tobacco, asserting that these products are undermining national efforts to reduce youth tobacco use and placing children at health risks from tobacco use and nicotine addiction.
The joint report released by the AAP, American Lung Association, the American Heart Association, the American Cancer Society’s Cancer Action Network and Campaign for Tobacco-Free Kids also criticized recent legislation introduced in Congress that could limit FDA oversight of e-cigarettes and cigars, as well as the growing market of flavored products.
“Despite the FDA’s ban on flavored cigarettes, the overall market for flavored tobacco products is growing. Continuing a long tradition of designing products that appeal explicitly to new users, tobacco companies in recent years have significantly stepped up the introduction and marketing of flavored other tobacco products — OTPs — particularly e-cigarettes and cigars, as well as smokeless tobacco and hookah,” the organizations wrote. “Although tobacco companies claim to be responding to adult tobacco users’ demand for variety, flavored tobacco products play a key role in enticing new users, particularly kids, to a lifetime of addiction.”
The report highlights data from the 2013-2014 Population Assessment of Tobacco and Health (PATH) demonstrating the prevalence of flavored OTP use in youth demographics.
According to this study, two-thirds of children who currently use tobacco products claim enticing flavors, including gummy bear, cotton candy, peanut butter cup and cookies ‘n cream, as their reason for use.
Additionally, 80.8% of children aged between 12 and 17 years who have ever used a tobacco product began using with flavored products.
In May 2016, the FDA issued a deeming rule in which its authority on tobacco products would stretch to include all previously unregulated OTPs, including e-cigarettes, cigars and water pipes. This rule included several additional provisions, including refusal of sale to those under 18 in the U.S., vending machine sales in adult-only facilities, required addiction and health warnings, and disclosure of ingredients.
The deeming rule also allows the FDA to control the contents of tobacco products and forbids introducing OTPs without FDA review and additional scientific support of public health benefits. However, the White House Office of Management and Budget deleted a suggested provision that prohibited characterizing flavors.
E-cigarette use involves inhaling nicotine, a solvent (such as glycerin) and other additives. Although there are limited studies on the long-term effects of their use, studies have revealed that toxins such as formaldehyde, acrolein, toluene, tobacco-specific nitrosamines, and metals like lead and nickel are found in their make-up.
OTP use can lead to cancer of the oral cavity, larynx, esophagus and lung; aortic aneurysms; COPD; and increased risk of poisoning due to varying levels of nicotine. The effects of inhaling the flavoring in these products is unknown, according to the 2016 Surgeon General’s report.
“Congress must reject any proposals to weaken FDA oversight of these products. In fact, the FDA should strengthen its new rule by prohibiting all flavored tobacco products, including menthol products,” the organizations wrote. “As the FDA itself has demonstrated and as this report documents, there is more than sufficient scientific evidence to support such a prohibition. Eliminating all flavored tobacco products is a critical step in preventing tobacco companies from addicting another generation of kids and reversing our nation’s progress in the fight against tobacco.” — by Katherine Bortz