In-Depth: Rep. Diana DeGette (D-CO) introduced this bill from the 115th Congress to ban the sale or manufacture of often kid-friendly flavors used in e-cigarettes:
“Tobacco use remains one of the greatest threats to our children’s health and we have to do more to protect them from the dangers of e-cigarettes. Most experts agree that the kid-friendly flavors that e-cigarette manufacturers are selling with these products are one of the leading causes of this spike in use among our high school and middle school students. To me, there is no legitimate reason to sell any product with names such as cotton candy or tutti fruitti, unless you are trying to market it to children. If we’re going to address the root cause of this problem, we have to start by banning the sale of these enticing kid-friendly nicotine flavors.”
Sen. Dick Durbin (D-IL), sponsor of the Senate version of this bill, adds:
“Ask any teacher, parent, or public health expert: E-cigarette use among America’s youth is officially an epidemic. These products have spread throughout our communities, and their popularity among children is due to one factor: flavors that are intentionally meant to appeal to kids, like cotton candy, kool-aid grape, gummy bear, and fruity hoops. I’m concerned that powerful e-cigarette companies are winning the war for our children’s health and well-being. If we don’t want the next generation of Americans to grow up with a lifelong addiction to nicotine – one that could very well kill them – then passing the SAFE Kids Act is absolutely critical.”
This bill’s proponents argue that it’s needed to protect children from the dangers of tobacco use, which is still the leading cause of preventable deaths in the U.S., killing over 480,000 people annually — more than AIDs, alcohol, car accidents, illegal drugs, murder, and suicides combined.
The Campaign for Tobacco-Free Kids is one of a number of organizations supporting this bill. Its president, Matthew L. Myers, says:
“Flavored tobacco products play a key role in causing kids to start and continue using tobacco, and flavors have fueled the skyrocketing e-cigarette epidemic that is addicting a new generation. Prohibiting tobacco products in kid-friendly flavors is one of the most important actions we can take to reverse the e-cigarette epidemic and continue driving down youth tobacco use.”
In an op-ed in The Hill, Dr. Thomas Ylioja, the clinical director of health initiatives at National Jewish Health, expressed his support for this bill:
“Tobacco companies have long known that flavors appeal to young people and encourage tobacco use. For nearly 90 percent of adults who smoke, tobacco use started when they were teens. Now, studies show that the vast majority of adolescents' first use of a vaping product is candy or fruit flavored — they mistakenly believe they are only inhaling flavored water vapor… In fact, the resurgent use of nicotine among teens and young adults has even been rightly called an ‘epidemic’ by the Food and Drug Administration and further proves the necessity of the legislation… The SAFE Kids Act will not only ensure that kid-friendly flavors of e-cigarettes are restricted, but also will give manufacturers a deadline to prove to the Food and Drug Administration that flavored products increase smoking cessation without increasing harm to the user and do not increase youth initiation. By regulating flavors used in vaping, we can begin to impact the use and sale of e-cigarettes to children. This legislation is the first step toward a comprehensive plan that will help limit youth access to e-cigarettes. We urge lawmakers to pass the bill. Together, we can work to protect our youth from the dangers of vaping and prevent future nicotine addiction.”
The Trump administration has expressed its concern about vaping’s effect on children. Scott Gottlieb, the FDA commissioner, has been an especially outspoken critic of the industry.
In a 2018 study, Dartmouth College’s Norris Cotton Cancer Center, in collaboration with Moores Cancer Center at UCSD, UCSF School of Nursing, and University of Pittsburgh School of Medicine, found that e-cigarettes do little to help smokers attempting to quit, but they do increase the odds of adolescents and young adults smoking. One of the researchers, Samir Soneji, PhD, Associate Professor at the Dartmouth Institute for Health Policy and Clinical Practice, said:
“Although the tobacco industry markets e-cigarettes as a tool to help adult smokers quit smoking, e-cigarette use actually only marginally increases the number of adult cigarette smokers who are able to successfully quit. On the other hand, e-cigarettes may facilitate cigarette smoking initiation and confer substantial harm to adolescents and young adults once they are introduced to nicotine.”
Using census counts, national health and tobacco use surveys, and published literature, Dr. Soneji’s team calculated the expected years of life gained or lost from e-cigarettes’ impact on smoking cessation among current smokers, and transition to long-term cigarette smoking among never-smokers. They found that “[e]-cigarettes could lead to more than 1.5 million years of life lost because their use could substantially increase the number of adolescents and young adults who eventually become cigarette smoker.”
In conclusion, Dr. Soneji argues for national, state, and local efforts to reduce e-cigarette use among youth and young adults, especially by reducing kid-friendly flavors’ availability:
“E-cigarettes will likely cause more public health harm than public health benefit unless ways can be found to substantially decrease the number of adolescents and young adults who vape and increase the number of smokers who use e-cigarettes to successfully quit smoking. We also need to close the regulatory gaps that make e-cigarettes appealing to adolescents and young adults by reducing the availability of kid-friendly flavors (e.g., fruit-flavored e-cigarettes) and issuing product standards that reduce the level of known toxins and carcinogens in e-juice.”
American Vaping Association president Gregory Conley expressed his organization’s opposition to this bill, saying it’d “constitute a de facto ban on over 95 percent of vaping products available on the market today,” effectively destroying the independent vaping industry. He added that this bill has “little regard” for adult smokers and small business owners in the e-cigarette industry.
Tony Abboud, executive director of Vapor Technology Association, an e-cigarette industry group, also expresses opposition to this bill:
“Our industry will aggressively oppose efforts to ban these life-changing products. We will continue to work with legislators and regulators on common sense regulation that protects the off-ramp for adult smokers these products provide.”
Mark Anton, executive director of the Smoke-Free Alternatives Trade Association, an e-cigarette industry group, has previously stated that his group shares the goal of preventing kids from using vapes, but doesn’t think flavors should be a target.
In the current Congress, this bill has one House cosponsor, Rep. Jamie Raskin (D-MD). There is also a Senate version, sponsored by Sen. Dick Durbin (D-IL) with the support of six bipartisan cosponsors, including five Democrats and one Republican.
Last Congress, this bill was introduced in the Senate by Sen. Durbin and six bipartisan cosponsors, including five Democrats and one Republican, and it didn’t receive a committee vote. There was no House version.
This bill has the support of the Campaign for Tobacco-Free Kids, the American Academy of Pediatrics, the American Cancer Society Cancer Action Network, the American Lung Association, the American Heart Association, the Lung Cancer Alliance, the National Association of Secondary School Principals, the Respiratory Health Association, and Children’s Hospital Colorado.
Of Note: The Centers for Disease Control (CDC) reports that although cigarette use by U.S. high schoolers has reached an all-time low (dropping from 28 percent in 2000 to eight percent in 2016), e-cigarette use has increased more than ten times from 2011 to 2015 (1.5 percent to 16 percent). In 2018, the U.S. saw a 78 percent increase in high-school use of e-cigarettes and a 48 percent increase in middle-school use of e-cigarettes. In 2018, over 3.5 million students in grades six through 12 used e-cigarettes, making vaping products the most common form of tobacco used by teens.
According to the Campaign for Tobacco-Free Kids, 82 percent of current youth e-cigarette users and 74 percent of current youth cigar smokers said they used these products “because they come in flavors I like.”
Additionally, although e-cigarette manufacturers claim that their flavorings are intended primarily to help adults quit traditional cigarettes, only three percent of adults use e-cigarettes, versus 12 percent of kids. In fact, according to a March 2018 study by researchers at the Geisel School of Medicine at Dartmouth College, for every one adult who quits smoking as a result of e-cigarettes, 81 more children have developed a regular smoking habit as a result of e-cigarettes.
The U.S. Surgeon General reports that much of teen vaping’s popularity can be attributed to the “appealing candy and fruit flavorings” accompanying such devices.
Summary by Lorelei Yang(Photo Credit: iStockphoto.com / llcsiren)