AAP leaders continue to call for a federal ban on menthol-flavored tobacco products after the U.S. Food and Drug Administration (FDA) announced it has authorized the marketing of four non-tobacco-flavored e-cigarette products.
The AAP joined other health organizations and anti-tobacco groups in denouncing the decision, citing the harmful effects of such products.
“We are disappointed in the FDA’s decision given our experience as pediatricians caring for children and adolescents, and all the evidence showing the harmful health effects these products have on people of all ages, particularly children,” said AAP President Benjamin D. Hoffman, M.D., FAAP. “The marketing of flavored e-cigarettes has had disastrous consequences for the long-term health of children and young adults. The AAP strongly opposes this decision by the FDA as these products are designed and marketed to addict children, particularly children of color. We hope the FDA will reverse this deeply unwise decision.”
In its announcement, the FDA noted that these are the first non-tobacco-flavored e-cigarette products it has authorized.
“While this action permits these specific tobacco products to be legally marketed in the U.S., it does not mean these tobacco products are safe nor are they 'FDA approved,'” according to the announcement. “All tobacco products are harmful and potentially addictive. Those who do not use tobacco products shouldn’t start.”
The FDA said it will monitor how these products are marketed, and it may suspend or withdraw authorization if there is a notable increase in use of the products among youths or former smokers.
In 2009, Congress banned flavored cigarettes but made an exception for menthol. For years, the Academy has been advocating for the removal of these products from the market.
In 2022, the FDA proposed banning menthol cigarettes and all cigar flavors other than tobacco. The proposal did not include menthol e-cigarettes. Last year, the AAP called on the Biden administration to move forward with a federal ban on menthol cigarettes and flavored cigars amid reports that the proposed new rules had been delayed.
Menthol gives cigarettes a minty taste and cooling effect that can attract youths and young adults. While fewer people smoke cigarettes now than in recent decades, use of menthol cigarettes has increased, according to the Centers for Disease Control and Prevention (CDC).
Certain population groups are more likely to smoke menthol cigarettes than other groups, due in part to aggressive tobacco industry targeted marketing. According to the CDC, non-Hispanic Black or African American people who smoke cigarettes, regardless of age, are much more likely to smoke menthol cigarettes than people of other races or ethnicities who smoke cigarettes. Between 1980 and 2018, an estimated 1.5 million Black Americans began smoking menthol cigarettes, and 157,000 Black smokers died prematurely because of menthol cigarettes.
In 2020, 51% of Hispanic adults ages 18 or older who currently smoked cigarettes used menthol cigarettes, compared to 34% of non-Hispanic white adults, according to the CDC. Young adults with serious mental health conditions and people with lower levels of income also are more likely to use menthol tobacco products.
The AAP policy statement Protecting Children and Adolescents from Tobacco and Nicotine recommends the FDA regulate all tobacco and nicotine products to protect public health, which includes prohibiting all flavor ingredients, including menthol, in all tobacco and nicotine products. The AAP also recommends adequate funding for tobacco use prevention, screening and treatment specifically for pediatric populations.
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