The spread of a mysterious, deadly lung illness linked to vaping is reinvigorating critics of e-cigarettes who want the government to take a much tougher stance on the devices by enacting an outright ban or limiting flavors.
Public health groups and lawmakers are pressuring the Food and Drug Administration to keep e-cigarettes out of reach following the outbreak, which has killed six people and infected as many as 450 more.
Democratic Minority Whip Dick Durbin called on Dr. Ned Sharpless, the acting head of the Food and Drug Administration, to resign if he does not ban e-cigarettes until they undergo a rigorous safety review. “Get rid of them!” said Democratic Rep. Rosa DeLauro of Connecticut, who wants the Trump administration to immediately take all vaping devices off the market.
Even though authorities haven’t confirmed the cause of the illness, public health groups are renewing calls for the FDA to ban flavored e-cigarettes, which range from mint to mango and cotton candy, and which critics charge entice children into vaping.
Michigan is already moving to ban flavors, and other states could follow suit. Bloomberg Philanthropies is contributing $160 million to initiatives to get stiffer regulations at the federal, state, and local levels. House Democrats have called in health officials for a hearing on Sept. 25 about the illnesses, which cause shortness of breath, chest pain, and vomiting, and may seek to gain consensus around a bill to impose restrictions.
Meanwhile, government agencies have released conflicting guidance about vaping.
The Centers for Disease Control and Prevention has urged people not to use e-cigarettes at all, even though officials say they can’t pinpoint the exact cause for the illness and that it could be related to marijuana, nicotine, a combination, or even another unknown substance that has been mixed in. The FDA, however, has told people not to vape THC, the ingredient that causes the high in marijuana. Some samples scientists examined related to the illness had vitamin E acetate added to marijuana, which could be a possible culprit.
Defenders of the products say regulators shouldn’t be so quick to go after e-cigarette flavors and that Congress should instead zone in on dealing with THC, which is largely unregulated. They worry people will turn to regular cigarettes if they don’t have the option of using a device that tastes nothing like tobacco.
“We have been stating for weeks now that it is absolutely essential our public health officials speak with clarity on the issue and speak about the facts, and not provide blanket warnings that are wrongly designed to scare people,” said Tony Abboud, executive director of the Vapor Technology Association.
While there are 480,000 deaths a year from regular cigarettes, which are readily available at convenience stores and gas stations, smoking rates in the U.S. have reached a historic low. At the same time, government data show more than 3.6 million teens reported vaping during the past month, an increase of 1.5 million from the year before, according to government data from 2018. Health officials in the Trump administration have said they are concerned about the long-term effects of nicotine and worry that teens would later take up smoking regular cigarettes.
E-cigarette regulation already has been through numerous twists and turns since Congress gave the FDA the power to regulate cigarettes in 2009. Because of a court order, e-cigarette manufacturers have until May 2020 to submit applications to the FDA with scientific evidence showing that marketing their product would be better for public health. Part of this will require them to show that their product will help people switch from smoking to vaping, and would not cause nonsmokers to take up vaping.
From there, the FDA has one year to approve the devices while they’re still allowed to remain on the market. Vaping manufacturers have filed for an injunction, with smaller manufacturers saying the timeline is impossible and that they don’t have clear guidance about what regulators need. The FDA under President Trump had been prepared to give companies a deadline of 2022, but when teen vaping rose, the agency moved up the date by a year. The court-imposed deadline is even shorter, at just nine months away.
“This is a ticking clock which will lead to the closure of thousands of businesses and the loss of tens of thousands of jobs,” said Abboud from the Vapor Technology Association. “But most importantly it will lead to the return to either smoking cigarettes or people moving toward black market products.”
Regulations could get even tougher before the application deadline. The Trump administration is considering a proposal that would obligate retailers to sell flavored e-cigarettes in parts of their stores that are off-limits to minors. The idea would effectively ban the products in some places given that not all stores will be able to meet the building requirements.
Another regulation would require nicotine “pods” that are used in e-cigarettes to only be sold on certain websites and vape shops that check to see whether a buyer is 18 or older and that limit how many products a customer can buy.
The agency could go further, and Sharpless has warned it will do so if it doesn’t see reductions in teen vaping. The agency ran TV ads this summer warning kids about the dangers of e-cigarettes and has sent warning letters to manufacturers, including one to Juul this week for allegedly illegally marketing its products as a safer alternative to cigarettes without receiving federal approval.
But members of Congress have charged that the FDA is shirking its responsibilities. Democratic Sen. Richard Blumenthal of Connecticut called for the Consumer Product Safety Commission to launch an investigation. He told the Washington Examiner that the FDA regulations on e-cigarettes overall “has been way too laggard” and said the agency could put a stop to the spate of illnesses.
“Right now what we have is a black hole,” he said. “The FDA has failed … I think we need to figure out how we can better scrutinize and oversee an industry that is really out of control.”
Democratic Rep. Raja Krishnamoorthi of Illinois, who oversees a subcommittee charged with consumer policy, said Congress and regulators will “all need to do a lot more.”
“We really don’t know the harm that vaping causes,” he said. “We know it does cause harm, and we have to do everything we can to protect kids right now.”
The vaping industry has few allies in Congress, though Republican Sen. Ron Johnson of Wisconsin has accused the FDA of overstepping in the past, given that e-cigarettes could help people quit smoking. He told the Washington Examiner he thought the agency was appropriately addressing the latest outbreak, which he called “worrisome,” and drew attention to reports about the THC link.
“I think the FDA is doing an awful lot right now,” he said. “They are looking into this.”
Republicans aren’t united in opposing e-cigarette regulations. Sen. Mike Braun of Indiana said that both smoking and vaping ought to “be gone completely” by whichever methods the government can use.
“That idea that it’s better than smoking I think is now completely going to have to be re-thought,” he said.
