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Will FDA’s latest restrictions reduce underage vaping and smoking?

The Food and Drug Administration moved to ban sales of menthol cigarettes and flavored cigars while announcing new guidelines for retailers selling flavored e-cigarettes in order to curb the rise in underage smoking and vaping. The ban is the biggest tobacco measure taken by the FDA in nearly a decade. Amna Nawaz interviews FDA commissioner Dr. Scott Gottlieb about the moves.

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  • Judy Woodruff:

    The U.S. Food and Drug Administration is taking new steps to try curbing the rise in underage smoking and vaping. The agency announced new guidelines for retailers selling flavored e-cigarettes, stopping short of an outright ban.

    But, as Amna Nawaz reports, the agency did move to ban sales of menthol cigarettes and flavored cigars, something tobacco companies have long opposed.

  • Amna Nawaz:

    The move to ban menthol cigarettes is the biggest tobacco measure taken by the FDA in nearly a decade, although it may take more than a year before it can be fully implemented.

    The new rules on many flavored e-cigarettes, however, kick in much sooner, just three months from now. The FDA will limit sales at convenience stores and elsewhere to age-restricted areas that are supposed to be closed off to kids under the age of 18.

    E-cigs and vaping have grown by huge numbers. More than one out of five high schoolers in the U.S. used an e-cigarette during the past year, more than three million in all.

    Dr. Scott Gottlieb is the FDA commissioner, and he joins me now.

    Dr. Gottlieb, thank you for making the time.

    I want to ask you about the new rules today. A lot of people expected an outright ban when it comes to the flavored e-cigarettes. You stopped short of that. Why?

  • Dr. Scott Gottlieb:

    Well, I don't think the policy we now say was different than What people expected.

    There was some reporting last week about what we might do, and that reporting was consistent with what we ultimately announced today. What we're doing is, we're putting in place significantly enhanced age-verification requirements in retail establishments for retail outlets that want to sell the fruity-flavored e-cigarette products, because we know those are being used by a lot of kids.

    And we have to address this really sharply increasing rate of youth use that we're seeing in the marketplace. And so a lot of those products are now going to be sold in adult-only vaping stores and other adult-only establishments that can age-restrict people who come in.

    If a convenience store still wants to try to sell those products, they're going to have to put in place measures like having a separate room where they can effectively restrict access to the room, card people before they go in the room.

    So there's that opportunity. But I think what you're going to see happen is, most of the sales of those products are probably going to going to migrate to establishments that already do put in place age verification requirements as a result of the measures that we're intending to take.

  • Amna Nawaz:

    On the age verification front, though, that will stop who's able to purchase the products, but not necessarily who uses them, right?

    And we already know that a lot of younger kids often get the product from people who are legally purchasing them over the age of 18. So how do you enforce something like that?

  • Dr. Scott Gottlieb:

    Well, that's right.

    I mean, there's no — there's no magic bullet here. There's no one solution that's going to affect this. We're taking a range of steps to try to put downward pressure on the rate of the youth use.

    And we really need to see these are trends reverse. It's not enough to just slow the trajectory of the youth use. We need to see these trends start to reverse. And so we took initial steps today to try to do that. We think the measures we took are robust. They're going to have an impact on the market.

    But if we don't start to see these youth use rates come down and come down sharply, we're going to be back here taking additional steps. And we now have in place monitoring, we have in place enforcement activities. We're going to be going into these retail establishments to see if the products are still being sold to kids at the same levels that we have seen in the past.

    But if we don't see a change in the marketplace, we're going to have to take additional steps.

  • Amna Nawaz:

    You mentioned that there will be a change in the marketplace you would like to see.

    We're going to probably see a big one when it comes to the menthol ban, a significant dent, based on that action you took today. And you said something earlier on a media call that you hosted briefing people about the decisions today, citing some of your clinical experience working in some African-American communities.

    And we know that there is disproportionate use of these menthol cigarettes in communities of color in America. I'm curious if you could tell me a little bit more about that. What did you see was the effect and what do you hope will be the effect of this band?

  • Dr. Scott Gottlieb:

    Well, look, I took care of hospitalized patients. I worked in an inpatient setting in urban environments. And a lot of the disease that I took care of was the consequence of smoking-related illness, a lot of the disease and the death of that I saw.

    So, I saw the consequences of smoking firsthand. And I'm a cancer survivor myself, so I know how grueling a cancer diagnosis can be. And that has impacted how I think about this issue. But I also have a mandate as a public health official and I have a legal mandate under the law to try to affect these.

    The menthol in particular does disproportionately affect certain communities. It is true, if you look at youth use of cigarettes, seven out of 10 African-American kids who use traditional cigarettes use a mentholated cigarette.

    And for kids between the age of 12 and 17 overall, all kids, 54 percent use mentholated cigarettes. We know that the flavors in the cigarettes, menthol in particular, is something that attracts kids to cigarettes and makes it easier for them to smoke.

    The menthol actually masks some of the distasteful effects of smoking.

  • Amna Nawaz:

    Dr. Gottlieb, I have to ask you about another concern that's been raised. It was raised during your confirmation process as well. And that was that you were financially invested in a chain of vaping lounges.

    Soon after your confirmation, you gave that e-cigarette industry five more years to come into compliance with regulations. And then, as I mentioned earlier, a lot of people thought there would be an outright ban on one of those products that you stopped short of.

    So the question is, is any of that, your financial investment in that industry, is that influencing your decisions? Are you taking it easy on the industry?

  • Dr. Scott Gottlieb:

    Well, I don't think we ever said that was going to be an outright ban on the e-cigarettes.

    What we said all along is that we felt that the e-cigarettes offer an opportunity for adults, but we need to take measures to try to restrict access to the kids. And we took pretty robust steps today. So I don't — I don't know where you're getting that statement from that we said there was going to be an outright ban. The agency never said that.

    And I would know because I speak on behalf of the agency. We did extend the compliance dates on the e-cigarettes when I initially came aboard, again, to try to give them time to come in with applications to the agency, to try to demonstrate what they need to demonstrate to remain on the market, because we do — we do recognize that there may be an opportunity for adults using these products.

    But the same time we did that, we sought to regulate nicotine and the combustible products, traditional cigarettes to render them minimally or nonaddictive. And so what we're trying to do is make the traditional cigarettes less attractive for adult smokers and try to migrate adult smokers hopefully off of nicotine altogether, and for those who still want to get access to nicotine through an inhaled route, perhaps through an e-cigarette, which I think most people recognize represents the potential for a modified risk alternative to traditional smoking, to traditional cigarettes.

    So there is a potential public health opportunity here. That's why I have been interested in e-cigarettes for a long time as a potential public health opportunity. But I have said all along, and I said at my confirmation hearing, that opportunity can't come at the expense of addicting a generation of kids on these products.

    And that's what we're seeing right now. We're seeing a generation of kids become addicted to nicotine through e-cigarettes. And we're going to step in, and we're going to stop it.

  • Amna Nawaz:

    Just to clarify, sir,are you still financially invested in those same vaping lounges and the industry?

  • Dr. Scott Gottlieb:

    Oh, of course not. I was divested before I came aboard FDA.

  • Amna Nawaz:

    Understood.

    Now, you mentioned there's going to be additional monitoring on all these rules and regulations moving forward. How quickly do you think you will be able to tell if they're working or not?

  • Dr. Scott Gottlieb:

    I think fairly quickly.

    The additional enforcement is in place right now. We have considerable resources behind looking at retail establishments to see if the sales are still going on. And we have our own surveys in the marketplace right now.

    So I think we're going to get a snapshot of what's happening pretty quickly. Things aren't going to change overnight. These trends got under way over the course of a long period of time. So it's going to take some time to reverse these trends. But I think we're going to get a pretty quick snapshot of whether or not we're having the impact that we intend to.

  • Amna Nawaz:

    FDA Commissioner Dr. Scott Gottlieb, thank you for your time.

  • Dr. Scott Gottlieb:

    Thanks a lot.

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