FDA wants e-cigarette makers to extinguish use by kids

JUDY WOODRUFF: The U.S. Food and Drug Administration
today issued its toughest crackdown yet on the makers of electronic cigarettes. These vaping devices have become increasingly
popular with young people. And, as William Brangham reports, the FDA
told manufacturers they have two months to prove they can keep their e-cigarettes out
of the hands of minors. WILLIAM BRANGHAM: In announcing its action
today, the FDA said the use of e-cigarettes among young people had hit — quote — “an
epidemic proportion.” It’s illegal for anyone under 18 to buy any
tobacco or nicotine products, including these e-cigarettes. In a moment, I will talk with the head of
the FDA, Dr. Scott Gottlieb. But, first, to give you a sense of what these
e-cigarettes are and how kids are using them, here’s an excerpt from a report special correspondent
Kavitha Cardoza of Education Week did two months ago at a high school in Connecticut. KAVITHA CARDOZA: Fran Thompson, the principal
of Jonathan Law High School, opens what he calls his vaping drawer. FRAN THOMPSON, Principal, Jonathan Law High
School: These are some of the items that we have confiscated this week. KAVITHA CARDOZA: The items are all e-cigarettes. The most popular brand by far is called Juul. FRANCIS THOMPSON: This is a Juul. I know it looks like a flash drive, right? So, the liquid goes in here. KAVITHA CARDOZA: Basically, they’re devices
that heat up a liquid, often nicotine, and you inhale the vapor. FRANCIS THOMPSON: And then they smoke it,
they vape it. KAVITHA CARDOZA: Kids can hide them anywhere. ZANE BERKS, Student: Their socks, their backpacks,
their pockets, their wallets, their bras, back pockets, everywhere. EMMA HUDD, Student: Anywhere, yes, because
they’re so small. KAVITHA CARDOZA: Students Zane Berks and Emma
Hudd say that’s part of a Juul’s popularity. EMMA HUDD: It’s a lot easier than smoking
a cigarette or drinking. People do it in class all the time. And kids like that it’s sneaky and that they’re
getting away with it, because it gives you that, like, rebellion. FRANCIS THOMPSON: Are you really writing about
Christopher Columbus? I have athletes doing it. I have honors kids doing it. There’s absolutely no stereotype in terms
of the spectrum of who would be doing this. KAVITHA CARDOZA: That makes this school in
Milford, Connecticut, typical. Juuling, as it’s called, has spiked all over
the country among youth. But, unlike alcohol or cigarettes, often,
parents aren’t even sure what it is. Parent Liz Goodwin has two teenagers in this
school. She found nicotine liquid pods in their pockets
while she was doing laundry. LIZ GOODWIN, Mother: When I found the pods,
I Googled it and looked for it, and I couldn’t find anything. I just had a photo of it and tried to describe
it, and what is this? And then I saw the amount of nicotine. It’s the equivalent of one pack of cigarettes. I also understood some of my adult friends
used e-cigarettes as a way to get off of smoking, so I didn’t know how dangerous it was. FRANCIS THOMPSON: I will show you what was
going on. KAVITHA CARDOZA: Principal Thompson says his
aha moment was in the bathroom. FRANCIS THOMPSON: So, your typical high school
bathroom, right? KAVITHA CARDOZA: Brings back memories. FRANCIS THOMPSON: Just like watching “Grease,”
right?” But what was happening was you might have
five or six kids hanging out in here with the door closed and vaping. KAVITHA CARDOZA: Suchitra Krishnan-Sarin Runs
the Yale Tobacco Centers of Regulatory Science at Yale University. She says the flavors are a big part of e-cigarettes’
popularity. They sound playful and harmless, mango, mint,
cotton candy, blueberry pie. SUCHITRA KRISHNAN-SARIN, Yale University:
These products come in over 7,000 different flavors. And they can also mix and match to create
their own, which, again, introduces a sense of novelty. KAVITHA CARDOZA: But the vapors inhaled has
been found to contain lead, zinc, chromium and nickel. And Krishnan-Sarin says nicotine, the main
liquid in these devices, is extremely addictive and can cause memory and attention loss, especially
in the developing teenage brain. WILLIAM BRANGHAM: That was from a report by
special correspondent Kavitha Cardoza. In its warning today, the FDA told the four
main manufacturers of e-cigarettes that if they can’t prove within 60 days that they
can keep these devices out of the hands of kids, the FDA would consider taking them off
the market totally. The FDA also sent over 1,000 warning letters
to retailers that sell them, places like drugstores and gas stations. For more on today’s action by the Food and
Drug Administration, I’m joined by the head of that agency, FDA Commissioner Dr. Scott
Gottlieb. Commissioner, thank you very much for being
here. Could you just explain to me? This clearly seems like an escalation on the
FDA’s part today. Why today? Why now? DR. SCOTT GOTTLIEB, FDA Commissioner: Well, what
we have access to right now is data that demonstrates to us that there’s nothing short of an epidemic
of use among teenagers. We knew use was rising among high school teenagers,
among young people, kids. But we now have access to some preliminary
— preliminary data that we will make public pretty soon that shows that this is nothing
short of an epidemic of use. And we feel we need to step in with dramatic
action to try to curtail that use. Unfortunately, we do see these e-cigarettes
as a viable alternative for adult smokers to migrate off of combustible tobacco on to
products that might not have all the risks associated with them of smoking. But, unfortunately, in order to close the
on-ramp for kids, we’re now going to have to take some actions that we think are going
to narrow the off-ramp for adults. And that’s a trade-off that we have to make
based on what we’re seeing in the market right now. WILLIAM BRANGHAM: So you mentioned this, an
epidemic level of use among kids. As a physician and as the head of the FDA,
can you just sketch out for me, what do you see as the main health problems with kids
using these products? Dr. SCOTT GOTTLIEB: Well, there’s multiple
problems. First of all, we know that nicotine has direct
effects on the developing brain. So, nicotine in a child is not — not harmless. It’s not a benign substance. But, also, if we see the trend and use that
we’re seeing right now, that’s creating a massive pool of young people who are becoming
habituated on and addicted to nicotine, and some component of those young people are going
to migrate on to combustible tobacco products. So if you believe, as we do, that no child
should be using any tobacco product — and we certainly don’t want to see a new generation
of young people and kids become addicted to nicotine and start smoking — this pool of
users of e-cigarettes — and it’s a pool that’s growing very sharply, based on the data that
we have — represents risk for the future that some component of these kids are going
to migrate onto cigarettes and ultimately become long-term smokers, with all the health
effects that come from that. WILLIAM BRANGHAM: So you have told the manufacturers,
you guys have 60 days to prove to us that you can keep these out of kids’ hands. Let’s say the manufacturers fail to meet that
test. What happens then? DR. SCOTT GOTTLIEB: Well, what we said today is
we’re actively looking at removing from the market the flavored products. We believe that one of the — one of the aspects
of these products that makes them appealing to kids are the flavors. And some of those flavors come in fruity flavors
and other kinds of flavors that we think are increasing the appeal of these products to
kids. And so, right now, those products remain on
the market because the agency allows them to remain on the market under what we call
an exercise of enforcement discretion. We haven’t required the manufacturers to file
applications to prove that those flavors actually have a net public health benefit. But we have the ability to do that. We have the legal authority to do that. So what we would do is tell the manufacturers
that the flavors need to come off the market, and if they want to reintroduce the flavored
products onto the market, they will have to file successful applications with the FDA
that demonstrate that the existence of flavors provide a net public health benefit, that
the benefits of flavors in terms of helping adult smokers quit combustible tobacco outweigh
the risk that it’s going to also appeal to young people and get a — get a kid hooked
on an e-cigarette. WILLIAM BRANGHAM: So the FDA wouldn’t be necessarily
taking these products completely. You would be taking specifically the ones
that have fruity flavors, candy flavors, dessert flavors, that it seems to me you’re arguing
those appeal particularly to kids? DR. SCOTT GOTTLIEB: Well, the bottom line is all
options are on the table. And if the trends in use that we’re seeing
right now continue, we’re going to have to take even more dramatic actions. We think right now we can step into this market
with a combination of enforcement actions against the places that we know kids are getting
access to these products, which includes retail establishments that are selling them without
putting proper restrictions in place or without carding minors, as well as the online sites,
where we think that there are a straw purchases being made, where — where someone’s going
online, buying a lot of these products, and then reselling them to kids. But the other action we would take immediately
is look at removing these flavored products in the market. If we don’t think that those actions are sufficient
to try to curtail the scope of use that we’re now seeing among kids, we’re willing to step
into the market and take even more dramatic action. Now, I will say we do think the e-cigarettes
offer a viable alternative for adult smokers. So we don’t want to — we don’t want to extinguish
this opportunity entirely, because we do see some potential benefit from having these products
on the market as a way for adult smokers to get access to nicotine, without all the harmful
effects of combusting tobacco. But it’s going to have to come, I think, going
forward with some additional limitations on the availability and the types of products
being marketed in order to stem what we’re seeing as an epidemic of use among kids. WILLIAM BRANGHAM: JUUL Labs, which is one
of the main manufacturers of these e-cigarettes, several months ago, they said, we’re going
to put $30 million into a campaign to keep these-cigarettes out of kids’ hands. They said that they supported the idea of
raising the national age to 21 for these products. They put out a conciliatory statement supporting
what you did today. But, clearly, you don’t think the manufacturers
have done enough thus far. DR. SCOTT GOTTLIEB: Well, look, I’m measuring
what the manufacturers are doing and, frankly, what we’re doing based on the results, based
on the data that we’re seeing. And the data that we’re seeing is showing
that the proportion of teenagers and high school students using these products is growing
at a very fast clip. Ultimately, that’s going to be the measure
that I judge the manufacturers and I judge our own success by. That’s what I’m looking at. WILLIAM BRANGHAM: All right, Dr. Scott Gottlieb,
commissioner of the FDA, thanks very much. DR. SCOTT GOTTLIEB: Thank you.