Better Options

In the struggle against underage vaping, restricting access to flavored e-cigarettes should be the last resort.

By Chris Howard

Put yourself in the shoes of a smoker who is trying to quit. You’ve tried various quit-smoking products, such as nicotine patches, gums and prescription medications. None have worked. Your friend tells you how vaping with flavors works, so you decide to give e-cigarettes a try.

You stop at a convenience store, seeking a vapor product that meets your needs. Surprisingly, the flavors that seemed so appealing are nowhere to be found. You never liked menthol, and tobacco reminds you of the cigarettes you hope to avoid. Like many smokers, you’re anxious about leaving cigarettes behind and your ability to quit. This latest obstacle makes quitting seem impossible (again). What happens next? You buy another pack of cigarettes and promise to try again another day.

The reality is that smokers don’t get to count on “another day.” Each cigarette increases the smoker’s risk of developing a smoking-related illness that will inevitably lead to a lower quality of life or worse—premature death.

The vapor industry shares the U.S. Food and Drug Administration’s (FDA) goal of ensuring e-cigarettes are used only by adults. That said, the FDA should consider a variety of more reasonable options to curb youth access without jeopardizing e-cigarettes’ harm reduction potential.

Codify marketing standards: Many adult-oriented industries employ voluntary codes of conduct to govern marketing practices. The FDA should seek consensus standards prohibiting marketing practices directed at youth. The Vapor Technology Association (VTA), which advances the interests of 800-plus manufacturers, wholesalers, small-business owners and entrepreneurs of the vapor industry, has already enacted such standards (see https://bit.ly/2Ozbfyn), which are mandatory for membership. Most, if not all, vapor companies would likely embrace objective, FDA-accepted parameters as reasonable ways to reduce youth e-cigarette access.

Revamp enforcement scheme: Undoubtedly, the FDA is resource-constrained and overwhelmed by age-verification requirements for vapor products. That said, even if the FDA could act on every violation, the current scheme allows a retailer to sell tobacco products to a minor five times within a 36-month period before the FDA can stop them from selling tobacco for 30 days. Revamping the current enforcement policy to provide for stricter and more consistent penalties would enable the FDA to use agency resources more effectively and deter bad actors from breaking the law.

Enhance restrictions for online purchases: Some online retailers are already implementing two-factor authentication and other measures to curb youth access to vapor products—measures rightly considered by the FDA. Such online purchase restrictions should continue to be developed, strengthened and exercised in order to eliminate youth access to vapor products.

Work with schools: Nearly every anecdotal news report involves a teenage student’s exposure to e-cigarettes. Given that schools are also seeking tools to combat this issue, the FDA should work more closely with school districts to provide resources and training that helps teachers identify the signs of youth e-cigarette use and how to stop it. The FDA’s current “The Real Cost” campaign is the right approach to assist teachers and educate youth, but unfortunately the messaging is riddled with inaccuracies about health effects that could deter smokers of combustible cigarettes from switching to vapor products.

Analyze the impact of higher minimum purchase age: Some states have increased the minimum purchase age for e-cigarettes to 21. The FDA should analyze purchase and use patterns in these states to assess any reduction in straw sales and youth usage rates resulting from increased purchase age requirements.

The decisions the FDA makes affect millions of adults who rely on vapor products for harm reduction. Restricting the availability of flavors is a radical measure that places unnecessary obstacles for adults obtaining products of their choice. In many ways, the proposed restrictions may actually help combustible cigarettes.

For these reasons, the FDA’s proposed flavor ban should be a last resort.