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Lung Group Blasts Sluggish Gov’t Response to E-Cigs

The American Lung Association is once again giving an “F” grade to federal health officials for their “disturbing failure” to protect the nation’s youth from electronic cigarettes and other tobacco products.

In its 17th annual “State of Tobacco Control” report released Wednesday, the group was highly critical of the FDA for recent actions aimed at reducing access to tobacco use among middle- and high-school students and young adults.

Last year, the FDA announced its intention to pursue several measures to address what FDA Commissioner Scott Gottlieb termed the “epidemic” rise of e-cigarette use among youth.

But the American Lung Association (ALA) report charged that the proposed actions “amounted to half measures that are unlikely to have a meaningful impact in reducing youth e-cigarette use.”

The FDA also announced, but has not acted on, plans to ban the sale of menthol cigarettes and all flavored cigars. No timetable has been given for this action, and ALA President and CEO Harold P. Wimmer said that, although the move would be “historic,” the failure to act resulted in the “F” grade for the agency.

“All states and the federal government can do more to reduce tobacco use: the FDA in particular has been asleep at the switch for far too long,” Wimmer said in a press statement.

“Their failure to act for years set the stage for e-cigarette use among youth to finally explode into an epidemic. We call on the FDA and Commissioner Gottlieb to make 2019 the year it takes decisive action on youth e-cigarette use and removes menthol cigarettes and flavored cigars from the marketplace.”

The 2019 report noted that a “clear consequence” of FDA’s inaction has been the unprecedented rise in e-cigarette use among youth, with 20.8% of high school students reporting current e-cigarette use in 2018 in one nationally representative survey. That represents a nearly 12-point rise from the previous year.

“This increase in teen e-cigarette use is pretty staggering, and it is a direct result of the previous administration and the current administration not being aggressive enough in exercising the authority the FDA has,” ALA national policy director Thomas Carr told MedPage Today. “We hope 2019 will be different, and that we will see substantive action from the FDA.”

In the annual report, the ALA called on federal officials to take immediate steps aimed at reducing tobacco use, including:

  • Revisit the decision to delay pre-market review of most e-cigarettes now on the market and other newly deemed tobacco products that has prevented meaningful regulation of the products
  • Move forward with graphic warning labels on combustible cigarettes
  • Ban all flavored tobacco products, including menthol cigarettes and e-cigarettes

The annual “State of Tobacco Control” report also grades states on their efforts to enact policies to reduce tobacco use among youth and adults, and most received a failing grade, too.

Carr noted that 2018 marked the 20th anniversary of the 1998 tobacco Master Settlement Agreement (MSA) under which 46 states, the District of Columbia, and several U.S. territories reached a legal settlement that requires tobacco makers to make annual payments to the states in perpetuity, as reimbursement for tobacco-caused healthcare costs.

While the original intent was that states would spend the settlement money on tobacco prevention and smoking cessation programs, most have used little of it for this purpose. The 2019 ALA report gave 43 states and the District of Columbia “F” grades for failing to spend even half of the CDC-recommended levels on tobacco related programs.

The ALA report called on all states to:

  • Increase funding for tobacco control programs and focus these programs on at-risk populations
  • Expand comprehensive smoking cessation coverage in all Medicaid programs
  • Pass comprehensive smoke-free laws

Twenty-two states do not have comprehensive smokefree laws. While many workplaces, bars, and other public places in these states are smokefree, others are not.

Carr said the lack of action by federal and state officials has emboldened the tobacco industry to attempt to delay or weaken tobacco control policies through lobbying efforts.

He noted that the industry recently spent $22 million to oppose tobacco tax ballot measures in Montana and South Dakota. Voters in both states failed to approve the measures in the November elections.

“That is a lot of money for those states,” he said.