The AAP is applauding a Supreme Court ruling Wednesday that supports the Food and Drug Administration’s (FDA’s) refusal to authorize the sale of certain flavored e-cigarettes.
Justices unanimously ruled that the FDA did not violate federal law when it denied an application from flavored nicotine liquid manufacturers Triton Distribution and Vapetasia. The e-cigarette manufacturers had alleged the FDA changed the requirements for authorization of flavored e-cigarettes without adequate notice, a contention the FDA denied.
“It’s great news because it really does underscore the importance of what the FDA has done,” said Rachel Boykan, M.D., FAAP, chair of the AAP Section on Nicotine and Tobacco Prevention and Treatment. “This is based on research and data. The flavors, the ones that are most popular, are very highly, highly concentrated nicotine. Nicotine, of course, is incredibly addictive. We want to prevent kids from starting.”
The Academy joined other health organizations in an amicus brief supporting the FDA’s decision. The organizations wrote that the FDA acted within the law to reject authorization of these products because significant evidence shows flavored products are harmful to youth.
“The tobacco industry has long known that flavors are important to its ability to successfully market its products to young people,” the organizations said in the brief. They also noted that “e-cigarettes that can be used to consume (manufacturers’) e-liquids frequently come in sleek, colorful designs that appeal to youth.”
Last year, half a million fewer U.S. youths reported using e-cigarettes than in 2023, according to the annual National Youth Tobacco Survey (NYTS).
Despite the decline, approximately 1.63 million youths reported using e-cigarettes in 2024. The vast majority of youths used flavored products (87.6%), with fruit, candy and mint being the most common flavors, according to the NYTS.
“While fewer kids are using (e-cigarette products), a larger percentage of them are using them almost daily,” Dr. Boykan said. “That’s the nicotine, and the flavors are literally what hooks them.”
The AAP has long advocated for legislation to safeguard children from purchasing and using e-cigarettes. The Academy has supported a ban on flavored tobacco. In 2023, it released a policy statement, clinical report and technical report, each titled Protecting Children and Adolescents from Tobacco and Nicotine.
While the win at the Supreme Court should be celebrated, it comes one day after the FDA’s top tobacco regulator, Brian King, Ph.D., M.P.H., was removed suddenly from his post and dozens of staff responsible for keeping unauthorized e-cigarette products off the market were dismissed. In the end, Dr. Boykan said, work remains to keep unsafe products away from children and young adults.
“We need to continue to advocate for flavor restrictions,” Dr. Boykan said. “Not all of these products are off the market. There’s still plenty of them that are there illegally and also legally, like menthol. I think, whether or not the FDA will be able to continue to do this work, most of the work is often initiated at the local level. We need to continue to advocate for these things because that will make a difference.”
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