Reps. Pallone and Shalala Introduce Comprehensive Legislation to Reverse E-Cigarette Epidemic and Drive Down Youth Tobacco Use

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
April 16, 2019

WASHINGTON, D.C. – The Campaign for Tobacco-Free Kids strongly supports the Reversing the Youth Tobacco Epidemic Act of 2019 being introduced by House Energy and Commerce Chairman Frank Pallone (D-NJ) and Rep. Donna Shalala (D-FL). This legislation provides the comprehensive strategy we need to reverse the youth e-cigarette epidemic that is sweeping across our country and to continue driving down youth tobacco use. We applaud Chairman Pallone and Rep. Shalala for their leadership in introducing this legislation.

The bill's prohibition on flavored tobacco products that appeal to kids, including flavored e-cigarettes, flavored cigars and menthol cigarettes, is especially critical to stop tobacco companies from continuing to target and addict kids with enticing flavors. Flavored e-cigarettes have driven the youth epidemic. In addition, flavored cigars have proliferated in recent years and become popular with kids, and more than half of youth smokers – including seven out of ten African-American youth smokers – smoke menthol cigarettes. Prohibiting flavored tobacco products is one of the most important steps we can take to reverse the youth e-cigarette epidemic and continue reducing youth tobacco use.

In addition to prohibiting flavored tobacco products, this bill includes other strong provisions that can accelerate progress in reducing tobacco use and save lives. These provisions:

  • Prohibit the sale of tobacco products to anyone under 21 nationwide.
  • Prohibit online sales of tobacco products.
  • Extend advertising restrictions that currently apply to cigarettes and smokeless tobacco to other tobacco products, including e-cigarettes. These include prohibitions on brand-name sponsorships of sports, music or other events and distribution of non-tobacco items (such as shirts and hats) with tobacco brand names.
  • Require the FDA to issue a final rule to implement graphic health warnings on cigarette packs and advertising, as required by the 2009 Tobacco Control Act.

Flavored Tobacco Products

The bill’s prohibition of flavored tobacco products is strongly supported by scientific evidence. There is conclusive evidence that flavors play a critical role in youth initiation and continued use of tobacco products. Flavors improve the taste and mask the harshness of tobacco products, making it easier for kids to try the product and ultimately become addicted. The vast majority of youth tobacco users report starting with a flavored product and that they use tobacco products “because they come in flavors I like.” E-cigarettes are sold in more than 15,000 flavors, and flavored cigars make up more than half of the U.S. cigar market. These products come in flavors like gummy bear, cotton candy, cherry dynamite and mango that clearly appeal to kids.

Flavored products, especially Juul, have driven the skyrocketing youth e-cigarette epidemic, which is addicting a new generation of kids and threatening the enormous, decades-long progress our nation has made in reducing youth tobacco use. In 2018 alone, e-cigarette use increased by an alarming 78 percent among high school students and 48 percent among middle school students, according to the 2018 National Youth Tobacco Survey (NYTS). More than 3.6 million middle and high school students were e-cigarette users in 2018 – an increase of 1.5 million in just one year.

Flavored cigars are also popular among youth. Cigars are especially popular among high school boys, who smoke cigars at about the same rate as cigarettes, and among African-American high school students, who smoke cigars at nearly three times the rate of cigarettes, according to the 2018 NYTS. Bloomberg News recently documented how tobacco companies have targeted African-American teens with candy- and fruit-flavored cigars.

There is also more than enough evidence to ban the sale of menthol cigarettes. Menthol cools and numbs the throat and reduces the harshness of tobacco smoke, making menthol cigarettes more appealing for kids who are starting to smoking. Over half of youth smokers ages 12-17 – and seven in ten African-American youth smokers – use menthol cigarettes. A comprehensive FDA scientific analysis, issued in 2013, concluded that menthol cigarettes 1) increase smoking initiation and progression to regular smoking among youth and young adults; 2) increase nicotine dependence (addiction); and 3) reduce success in quitting smoking.

For decades, the tobacco industry has engaged in targeted marketing of menthol cigarettes to African Americans and to youth. The marketing and availability of menthol cigarettes is a likely contributor to the higher rates of tobacco-caused death and disease experienced by African Americans.

This evidence led the FDA, in November 2018, to announce that it would seek to ban menthol in combustible tobacco products, including cigarettes and cigars. But the FDA has yet to propose a rule to do so, underscoring the need for Congress to act. At the time of the November 2018 announcement, then FDA Commissioner Scott Gottlieb stated, “I believe these menthol-flavored products represent one of the most common and pernicious routes by which kids initiate on combustible cigarettes. The menthol serves to mask some of the unattractive features of smoking that might otherwise discourage a child from smoking. Moreover, I believe that menthol products disproportionately and adversely affect underserved communities. And as a matter of public health, they exacerbate troubling disparities in health related to race and socioeconomic status.”