FDA takes aim at flavored tobacco

FDA takes aim at flavored tobacco

(HealthDay)—In an effort to discourage teens from lighting up, the U.S. Food and Drug Administration said Tuesday that it's considering regulating flavors in tobacco products more closely.

"The concerns around flavors in are not new. For years, we have recognized that flavors in these products appeal to kids and promote youth initiation [of smoking]," said FDA Commissioner Dr. Scott Gottlieb.

"Youth consistently report product flavoring as a leading reason for using ," he noted in an FDA news release. "Flavors may disguise the taste of tobacco. But flavored cigarettes and little cigars are every bit as addictive as any other tobacco products, have the same harmful health effects and may even make it harder to quit.

"In fact, there's evidence indicating that youth tobacco users who reported their first tobacco product was flavored [with menthol or other flavors] had a higher prevalence of current tobacco product use compared to youth whose first product was not flavored," Gottlieb added.

Because almost 90 percent of adult smokers started smoking by the age of 18, it's crucial to find new ways to be certain that kids don't progress from experimentation to regular use, Gottlieb said.

Electronic cigarettes pose a unique challenge because in these devices, "it's possible for flavors to do both harm and good," Gottlieb said.

E-cigarettes are the most widely used smoking product among middle and high schools students, and flavors are among the top three reasons why students use the devices, according to the FDA.

That's exactly why it's imperative to regulate flavoring in e-cigarettes, one lung specialist said.

"Putting flavors in e-cigarettes that can be vaped is yet another mechanism that can lead to vaping nicotine—and ultimately tobacco," said Dr. Len Horovitz, a pulmonary specialist from Lenox Hill Hospital in New York City.
"This tactic must be addressed and stopped, since it is clear that e- cigarettes are the gateway to smoking 'real' cigarettes."

Gottlieb said that flavorings in e-cigarettes can help adult smokers make the switch to less harmful nicotine products.

In the meantime, "we must give serious consideration to the ways in which we might further address flavors in combustible tobacco products like menthol in cigarettes and the fruit and candy-flavored little cigars and cigarillos," Gottlieb said.

An anti-smoking group that targets smoking among youth applauded the FDA move.

"We are pleased that the FDA has taken this important step toward protecting Americans, particularly youth and young adults, from flavored tobacco products," said Robin Koval, CEO and president of Truth Initiative.

"Banning menthol cigarettes should be the agency's number one priority, along with eliminating flavors in other combustible products such as little cigars," she added.

And, "while a limited availability of flavors in reduced harm products such as e-cigarettes may play a role in encouraging smokers to quit, there is no role for [flavored] products" that bear names that target youth, such as fruit loops and peanut butter and jelly, Koval added.

Christine Fardellone is with the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y.

"As a certified tobacco treatment specialist, I hear from patients who wish they hadn't had access to tobacco products as teenagers and young adults," she said. "Their lives are often filled with illness, regret, and the difficult experience of trying to quit tobacco use.

"We must continue to provide research to the FDA about the health hazards of flavorings in tobacco products to reduce the public health burden of tobacco related illness," she added.

As it weighs its next step, the FDA is accepting public input on flavored tobacco products for 90 days.

Last week, the agency announced that it would consider new regulations to lower nicotine levels in to minimally or non-addictive levels.

More information: Len Horovitz, pulmonary specialist, Lenox Hill Hospital, New York City; Robin Koval, CEO and president, Truth Initiative; Christine Fardellone, DNP, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; U.S. Food and Drug Administration, news release, March 20, 2018.

The U.S. Centers for Disease Control and Prevention has more on youth and tobacco.

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