The FDA’s announcement today that it has denied marketing applications for more flavored e-cigarettes is a significant step in the right direction. It is also important that FDA’s statement both recognizes the role of flavored e-cigarettes in attracting youth and makes clear that protecting our nation’s youth is a priority for the agency. However, the FDA will leave our kids at risk unless it acts quickly on the remaining applications, including for products like Juul that have driven the youth e-cigarette epidemic, and eliminates all flavored e-cigarettes, including menthol-flavored products that are widely used by kids. Every day these products remain on the market, our kids remain in jeopardy. To truly protect kids and end the youth e-cigarette epidemic, the FDA must act swiftly to clear the market of all flavored e-cigarettes, including menthol.
 
There is no public health justification for the FDA to allow the continued sale of any flavored e-cigarettes, including menthol-flavored products. There is overwhelming evidence that flavored e-cigarettes – including menthol products – appeal to kids and have fueled the youth e-cigarette epidemic, while there is a lack of evidence that flavored e-cigarettes are effective at helping smokers quit. Of the 3.6 million U.S. kids who use e-cigarettes, 83% report using flavored products and over 1 million use menthol e-cigarettes, according to the 2020 National Youth Tobacco Survey. The evidence shows that kids quickly migrated to menthol e-cigarettes after mint and other flavored cartridge products were taken off the market. If the FDA authorizes any menthol e-cigarettes, even more kids are likely to use them.
 
In contrast to the clear evidence that menthol and other flavored products fueled the youth e-cigarette epidemic, every major U.S. public health authority – including the U.S. Surgeon General, the U.S. Preventive Services Task Force, the CDC and even the FDA itself – has found that there is limited and inadequate evidence to conclude that e-cigarettes are effective at helping smokers quit. The 2020 Surgeon General’s Report on Smoking Cessation concluded, “there is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation.” The World Health Organization reached a similar conclusion in a July 2021 report, finding that “evidence on the use of ENDS [electronic nicotine delivery systems] as a cessation aid is inconclusive.” The evidence is even weaker that flavored e-cigarettes, including menthol-flavored products, are effective at helping smokers quit.
 
It would be particularly harmful for the FDA to authorize the continued sale of Juul’s menthol e-cigarettes given the fact that Juul was the main cause of the youth e-cigarette epidemic with its appealing flavors, massive doses of nicotine and slick, youth-oriented marketing campaigns. The Juul products pending before the FDA put kids doubly at risk. Not only do they come in menthol flavor attractive to kids, these products also have high nicotine levels – equivalent to a whole pack of cigarettes – that can rapidly addict kids. The FDA cannot allow these highly addictive, menthol-flavored Juul products to stay on the market. But Juul’s menthol e-cigarettes are not the only issue. Other menthol cigarettes such as blu and Reynolds American’s Vuse are also important.
 
Because of the delays and gaps in the FDA’s actions, it is critical that states and cities step up their efforts to eliminate ALL flavored e-cigarettes, as well as other flavored tobacco products. Youth e-cigarette use remains an enormous problem, with 3.6 million kids still using e-cigarettes, including nearly one in five high school students. The evidence is also clear that as long as any flavored e-cigarettes – including menthol-flavored products – are on the market, kids will shift to them and we will not end this public health crisis. States and cities must close the gaps left by the FDA and protect our kids from these dangerous and addictive products.

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