Pleas and Anger in Public Comments on Youth E-Cig Use

    Throughout 2018, the US Food and Drug Administration (FDA) has tried to stymie rising rates of youth vaping. As part its latest effort, the federal agency says it’ll be exploring drugs, specifically tailored at stopping teen use of e-cigarettes. The public is responding with both criticisms and affirmations in the lead up to a public hearing in January.

    Following its launch of the “The Real Cost” Youth E-Cigarette Prevention Campaign in April 2018, the FDA says it’s looking to expand the Youth Tobacco Prevention Plan by developing “drug therapies, as part of multimodal treatment strategies,” which could involve “behavioral interventions” as well as nicotine replacement therapy (NRT).

    “FDA is not aware of any research examining either drug or behavioral interventions for the cessation of youth or adult e-cigarette use,” the agency states. It does reference that “multiple drugs for smoking cessation are approved for the adult population, including a variety of prescription and over-the-counter nicotine replacement therapy (NRT) products, as well as the prescription drugs varenicline and bupropion hydrochloride sustained release.”

    After rescheduling the original December 5 date because of former President George H.W. Bush’s death, the FDA has set a public hearing for January 18, 2019 to engage the perspectives of “public health stakeholders (including adolescents) regarding approaches to eliminate youth e-cigarette and other tobacco product use, including exploring whether there is a need for drug therapies to support youth e-cigarette cessation, and if so, how FDA can support the development of such therapies.”

    Over 70 comments were received in anticipation of the December hearing. Some endorsed potential drug therapies. Others questioned whether putting teenagers on another potentially addictive substance was necessary. But most seized the opportunity to give their two cents on tobacco policy more broadly. Comments, like Anonymous’s: “Just make cigarettes illegal,” echo common prohibitory declarations. Others identify the “children enticing flavor,” as commenter Jed dubbed them, to be the thing that needs to go.

    But many commenters plugged harm reduction perspectives on e-cigarettes.

    “In your zeal to eliminate nicotine use among children,” writes Katie Everett-Ferry from Pennsylvania, “please don’t forget about us adults who should have the liberty to easily purchase online the various flavored juices that are helping us in our quest to lessen our nicotine use and ultimately quit.”

    Like Everett-Ferry, other commenters identified the effectiveness of vaping as a tool to stop smoking comparably more harmful combustible cigarettes.

    “I began smoking at the age of 14. I quickly became addicted and ended as a 2-2 1/2 pack a day smoker until I was 53 years old and diagnosed with severe COPD,” shared Janet from New Jersey. “It wasn’t until the advent of nicotine patches and electronic cigarettes that I was finally able to do so. The electronic cigarette has saved my life. I haven’t had a real cigarette in 7 years and don’t intend to return.”

    These commenters recognize the “FDA’s wish to keep tobacco and nicotine products out of the hands of children”—which they support. Yet Janet, like others, is urging the FDA to avoid letting anti-nicotine policies, particularly as they concern bans on flavors, impede adults’ access to the products.

    “I never thought I would be able to quit smoking cigarettes, but with the help of better flavored products containing nicotine I was able to,” writes Melissa Knoll from Virginia.

    Juul pulled most of their flavors, especially sweet ones, from brick-and-mortar shops back in November. And the drive to prohibit flavored nicotine products is taking aim at cigarettes, as well. Around the same time that Juul intervened in the supply of flavored pods, FDA Commissioner Scott Gottlieb announced that his agency would seek a ban on menthol cigarettes and flavored cigars too.

    But not all of the commenting adults agree with vaping bans, even for teens. A number argue that the state should not legally obstruct teen e-cigarette use, but rather leave it up to parents. Some parents approve of their child’s vaping if it means that they will quit cigarettes.

    Tawni Trevino of VaperTec, a small vape shop in Boise, Idaho, attests to this. “At our shop, we have had parents who have stated that they were purchasing for their kids so they would/could stop smoking, at which point we said we could not sell to them now because we knew it was for a minor and this has happened on multiple occasions. We have had parents yell (and I do mean yell) at us and say, ‘So you aren’t willing to help my 16 year old daughter quit smoking?'”

    The comment submission form can be found on the FDA’s website.

    Image via darnewsonline

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