Leading medical organizations urged Congress and the Trump administration to increase the regulation of vaping products on Wednesday.
The American Medical Association, the American Academy of Pediatrics and the American College of Physicians want more e-cigarette regulation because they're worried about the short- and long-term health consequences of vaping, especially for children. They asked Congress and the administration to ban flavored vaping products, including mint and menthol flavors, and raise the national age to buy tobacco and e-cigarettes to 21.
The group also wants stricter regulation of marketing practices that target children, and to tax e-cigarettes like tobacco products.
"We need swift and decisive action," said Dr. Sara Goza, president-elect of the American Academy of Pediatrics. "Every day we wait, more and more children will be put at risk."
A recent spate of vaping-related lung injuries has led to widespread public concern over the use of e-cigarettes, especially among kids.
Flavored vaping products, which include fruit and candy flavors, are particularly worrying for health professionals and regulators because they're more appealing to children than tobacco-flavored products. Many health professionals and public officials want to put a stop to the sale of flavored e-cigarettes to cut down on the number of children who take up vaping, a proposal supported by the president.
Kids might be less likely to start vaping if they don't think e-cigarettes taste good. Skeptics, including leading health professionals, believe that vaping companies knew that so they developed flavors that children would like.
"We need to be intellectually honest about the impact of developing products that have flavors that are particularly attractive to children," Dr. Patrice Harris, president of the American Medical Association.
The group called for the ban to include mint and menthol-flavored products because they're worried that kids will increase their use of those flavors when other flavors are banned. Mint and menthol e-cigarettes are already popular among teens.
E-cigarette companies are fighting the ban.
The Food and Drug Administration announced last month that it would enforce premarket authorization for non-tobacco flavored e-cigarettes to drive unauthorized flavored products off the market. During Wednesday's press conference, the medical organizations asked the Trump administration to "speed up" the process.
Legislation introduced by Sen. Dick Durbin (D-Ill.) in 2018 called the Stopping Appealing Flavors in E-Cigarettes for Kids (SAFE Kids) Act would limit e-cigarette flavorings and ban cigar flavorings. Rep. Diana DeGette (D-Colo.) introduced the SAFE Kids Act to the U.S. House of Representatives in March.
Most vaping-relating lung injuries are linked to the use of black-market e-cigarettes, which often contain THC. But there isn't enough scientific evidence to establish a causal linkage between lung injuries and e-cigarette use. There's also no evidence on the second-hand effects of vaping. The AMA, AAP and ACP want the government to aggressively regulate e-cigarettes because they're concerned about the unknown risks associated with vaping.
They're also concerned about the known effects of nicotine, which e-cigarettes contain in high amounts. Nicotine can impair the cognitive development of adolescents and make them more likely to develop other addictions or more severe addiction. The group argued that alone should be grounds for more regulation.
"Young people are experimenting with e-cigarettes, which could result in another generation at risk of nicotine dependence," said Harris.
The healthcare leaders were dubious about any proposal to cap the amount of nicotine that e-cigarettes can contain because of the known harms of nicotine.
"A lower amount of poison is still poison," said Dr. Jacqueline Fincher, president-elect of the American College of Physicians.
The group also said that the FDA has the powers it needs to regulate black-market products effectively and that the existence of black-market products shouldn't "stop us from doing the right thing." While unauthorized THC products have been associated with the unknown lung illness sweeping the country, kids start using conventional e-cigarettes before they move onto products containing THC.
"We need to make sure we're not getting these children addicted (to nicotine) in the first place," Goza said.
Vaping companies claim that they intend their products to be used by adults to help them quit smoking, but the FDA doesn't approve e-cigarettes for smoking cessation. There's also little evidence that vaping helps people stop smoking.
"As physicians, we start and end with the science," Harris said. "There is no data that these products help with smoking cessation."
Goza and Fincher are set to meet with administration officials on Wednesday to discuss the harmful effects of vaping.
