The American Association for Cancer Research (AACR) applauds the administration, including the Department of Health and Human Services and the U.S. Food and Drug Administration (FDA), for announcing enforcement action that will remove from the market “unauthorized, non-tobacco-flavored e-cigarette products” until manufacturers submit a pre-market tobacco product application to the FDA.
The AACR has worked for decades to develop and support policies that reduce tobacco use and thereby prevent cancer. However, despite significant progress in lowering the national smoking rate, tobacco use continues to be the leading cause of preventable death and disease in the United States. The rise in the use of tobacco products such as e-cigarettes, particularly by youth and young adults, has reached epidemic proportions and threatens to reverse years of progress in reducing overall tobacco use.
New preliminary data from the U.S. government’s 2019 National Youth Tobacco Survey demonstrate that 27.5 percent of high school students were current users of e-cigarettes in 2019, up from 20.8 percent in 2018. This worrisome trend comes despite efforts by the FDA to enforce restrictions on the sale and marketing of e-cigarettes to youth and young adults. Clearly these efforts have been inadequate, and more must be done to address this national public health threat. According to the survey, almost two-thirds of high school e-cigarette users vape fruit-flavored or menthol/mint-flavored e-cigarettes.
“The administration’s planned enforcement action on the manufacturers of flavored e-cigarettes is a welcome step toward addressing the crisis of e-cigarette use by young people,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR.
Furthermore, there is an ongoing outbreak of severe lung disease across the country among both young and adult users of e-cigarettes, leading to seven deaths to date. The FDA, the Centers for Disease Control and Prevention (CDC), and state health departments continue to investigate these cases in order to identify the e-cigarette component(s) responsible for severe illness and deaths.
“The AACR is very concerned that the lack of adequate research on and regulation of e-cigarettes has led to the severe illness, hospitalizations, and deaths of our citizens,” said Roy S. Herbst, MD, PhD, chief of medical oncology at Yale Comprehensive Cancer Center and chair of the AACR’s Subcommittee on Tobacco Products and Cancer.
As part of its commitment to tobacco control policies, the AACR hosted a congressional briefing in June 2019 on the emerging public health crisis of e-cigarettes. The briefing updated policymakers and the public on the latest e-cigarette usage trends, the science regarding the harm from these products, and the regulatory efforts to curb use by youth and young adults. Further research is needed to fully understand the short- and long-term harms of e-cigarette use, especially among youth, young adults, and adult non-smokers. Currently, there is no definitive evidence of potential benefits of their use to current smokers.
The AACR urgently calls for additional steps by the administration and Congress, including:
- Prohibiting the sale of tobacco products to individuals under the age of 21;
- Restricting online sale of all tobacco products, particularly to underage purchasers;
- Strongly supporting the actions that the Center for Tobacco Products at the FDA is taking to regulate the manufacturing, distribution, and marketing of tobacco products; and,
- Increasing funding for the CDC and National Institutes of Health (NIH) for research on tobacco products, including the prevention of tobacco use as well as effective cessation efforts.
“The AACR has the responsibility to take a strong stand against the marketing and use of e-cigarettes, especially among youth and young adults,” said AACR President Elaine R. Mardis, PhD, co-executive director of the Institute for Genomic Medicine at Nationwide Children's Hospital. “We will continue to help shape the policies that prevent cancer and safeguard public health. Thus we are eager to work with the administration and Congress at this critical time to restrict the use of these products while championing important research initiatives to identify adverse health effects.”