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FDA restriction of flavored e-cigarettes ‘may have unintended consequences’

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Becka Bowyer

The F.D.A. has authorized for the first time an electronic cigarette to be sold in the U.S. The agency says the benefits of the three Vuse products in helping smokers quit outweigh the risks of hooking youths. The following Cornell University experts discuss what this means for those trying to quit combustible cigarettes.

Donald Kenkel

Joan K. and Irwin M. Jacobs Professor

Donald Kenkel, professor of policy analysis and management, is an expert on health and public sector economics. He has studied cigarette taxes to prevent youth smoking and advertising to promote smoking cessation.

Kenkel says:

“To date, the F.D.A. has denied the marketing applications for e-cigarettes with flavors like fruit and candy which are popular among youth. Unlike the applications that the F.D.A. has denied, the Vuse products are tobacco-flavored e-cigarettes. This makes it an easier call that the benefits of these e-cigarettes to smokers who are trying to quit combustible cigarettes outweigh any possible risks to youth.

“However, many adult smokers who are trying to quit also prefer flavored e-cigarettes, including menthol. Restricting the availability of flavored e-cigarettes might have the unintended consequence of discouraging smoking cessation.

“When the F.D.A. takes further actions about flavored e-cigarettes including menthol, the large benefits of helping adult smokers to quit should not be overlooked.” 

Alan Mathios

Professor of Policy Analysis and Management

Alan Mathios, professor of policy analysis and management, studies the effect of F.D.A. regulatory policies on consumer behavior. His most recent research examines the effectiveness of health warning labels on cigarette packages and electronic cigarettes.

Mathios says:

“The approval decision likely rested on evidence that these products can contribute to adult smokers successfully quitting (or reducing the consumption) of combustible cigarettes.  Despite declines in smoking rates over time, combustible cigarette smoking still contributes to hundreds of thousands of deaths on an annual basis in the U.S. – so actions that lead to fewer smokers of traditional cigarettes can be an important part of public health harm reduction. The decision also likely rested on what types of actions the manufacturer will take to deter and prevent youth from using these products. 

“One key additional question that was left unresolved was whether menthol flavored versions would be approved. This too will likely depend on whether there is evidence that availability of menthol flavored vaping products also contribute to adult quitting of traditional cigarettes.”

Donna Cassidy-Hanley

Research Faculty

Donna Cassidy-Hanley is a senior research associate in the microbiology and immunology department at the College of Veterinary Medicine. She developed a learning module for high school classrooms that encourages students to directly test the effects of e-cigarette vapor on living cells.

Cassidy-Hanley says:

“While I understand the potential benefits of using of e-cigarettes for adults as a temporary measure to break an addiction to traditional tobacco cigarettes, I find the F.D.A. approval of e-cigarettes unfortunate. The statement indicates that e-cigarettes are less hazardous than combustible tobacco products, but it does not significantly address the potential immediate and long-term impacts of e-cigarette vapor on children.

“Recent studies show 28.2% of 12th graders and 23.5% of 10th graders reported any vaping in the past 30 days in early 2020. Even some elementary students now routinely use e-cigarettes. The F.D.A. is apparently aware of the heavy use of vaping products by children but approved three Vuse vaping products on the basis that the benefits in helping tobacco smokers quit outweighed the risks of e-cigarette use by children, a somewhat troubling risk/benefit analysis.

“The response of approving “tobacco flavors” that are less appealing to teenagers seems an unrealistic approach to curbing vaping by children. Limiting choice of flavors is hardly an adequate response to the growing problem of children who vape, nor is not likely to significantly deter the high percentage of children trying and getting hooked on vaping products, often as a result of real or perceived peer pressure.

“Traditional tobacco cigarettes generally don’t “taste good” on first use, but that initial unpleasant taste has not deterred generations of young cigarette smokers.”

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