The Trump administration announced plans on Wednesday to remove all flavored e-cigarettes from store shelves in a crackdown on vaping after a handful of deaths and potentially hundreds of lung illnesses were tied to the practice.
President Donald Trump and top US officials expressed concern about data showing that flavored vaping products had drawn millions of children into nicotine addiction.
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Health and Human Services Secretary Alex Azar told reporters that, with Trump's blessing, the US Food and Drug Administration was working on a "guidance document" that would lead to a ban of all vape flavors aside from tobacco flavoring.
"Once the FDA would finalize this guidance, we would begin enforcement actions to remove all such products from the marketplace," Azar told reporters during a meeting with the president and first lady Melania Trump in the Oval Office.
The ban would include mint and menthol flavoring as well as bubble gum, candy, fruit, alcohol and other flavors, he said.
Tobacco flavoring would be allowed to remain, subject to companies' filing for approval from the FDA. Even that would be at risk if the government determined children were attracted to it or that it was being marketed to them, Azar said.
The move is the most sweeping action yet by the US government to crack down on e-cigarette usage.
The FDA in March formally proposed guidelines that would prohibit the sale of flavored e-cigarette products, except mint and menthol, in traditional retail outlets. Under that proposal, which had not been finalized, e-cigarette makers could still sell flavored products online and in age-restricted stores, such as vape shops.
Wednesday's proposal goes much further, banning the sale of all flavored e-cigarette products across all retail channels, aside from tobacco-flavored products.
Six deaths have been linked to vaping and US public health officials are investigating 450 cases of potential vaping-related lung illness across 33 states and one US territory.
"We have a problem in our country, it's a new problem ... and it's called vaping, especially vaping as it pertains to innocent children," Trump said. "There have been deaths and there have been a lot of other problems."
Surge in use by adolescents
Juul Labs Inc, which dominates the US e-cigarette market, has faced withering criticism over the last two years after becoming wildly popular among teenagers. The company has taken steps to try to reduce its appeal among youth, including pulling flavors except mint and menthol from traditional retail stores, suspending its social media accounts and toughening age verification online.
In December, Marlboro maker Altria Group Inc made a US$12.8 billion (NZ$19.9 billion) investment in Juul, taking a 35 percent stake.
Wednesday's move by the White House comes after more than a year of mounting pressure from lawmakers, public health advocates and parents looking to end marketing of products aimed at youths.
In recent months state and local governments have also stepped in. In June, San Francisco approved a ban on the sale of all e-cigarette products, and last week Michigan Governor Gretchen Whitmer announced plans to ban flavored e-cigarettes in her state.
The nationwide investigation led by the US Centers for Disease Control and Prevention and the FDA has not definitively linked the illnesses to any specific e-cigarette product or ingredient, although health officials have expressed suspicions about the effects of inhaling vitamin E acetate, which is contained in some vaping products.
The FDA has urged consumers to avoid inhaling vitamin E acetate, buying vaping products on the street, using marijuana-derived oil with the products or modifying a store-bought vape product.
While e-cigarettes are marketed as tools to help smokers quit, health officials believe companies are targeting a new generation of nicotine users.
Azar said recent data showed a surge in adolescent usage of e-cigarettes and that youth were drawn to flavors including mint and menthol. About 8 million adults use such cigarettes and 5 million children were doing so as well.
"This is exceptionally harmful to our children," he said. "An entire generation of children risk becoming addicted to nicotine because of the attractiveness ... and availability of these vaping products."
HHS said preliminary data show more than a quarter of US high school students used e-cigarettes in the past 30 days. That's up from 20.8 percent last year and 11.7 percent in 2017.