WASHINGTON — The federal government will act to ban thousands of flavors used in e-cigarettes, President Donald Trump said Wednesday, responding to a surge in underage vaping that has alarmed parents, politicians and health experts.
The surprise announcement could remake the multibillion-dollar vaping industry, which has been fueled by sales of flavored nicotine formulas such as “grape slushie” and “strawberry cotton candy.”
The Food and Drug Administration will develop guidelines to remove from the market all e-cigarette flavors except tobacco, Health and Human Services Secretary Alex Azar told reporters during an appearance with the president, first lady Melania Trump and the acting FDA Commissioner Ned Sharpless.
Trump said underage vaping has become such a problem that he wants parents to be aware of what’s happening.
“We can’t allow people to get sick and we can’t have our youth be so affected,” said Trump, father of a 13-year-old.
Melania Trump recently tweeted her concerns over the combination of children and vaping, and at the meeting, the president said, “I mean, she’s got a son — together — that is a beautiful, young man, and she feels very, very strongly about it.”
About 23 percent of 11th-graders in Iowa use e-cigarettes at least once a month, the 2018 Iowa Youth Survey found. About 2 percent of sixth-graders and 8 percent of eight-graders reported doing so. Almost as many Iowa girls as boys in those grades said they use the devices.
This comes despite laws that forbid e-cigarette and other tobacco sales to anyone under 18.
Iowa legislators earlier this year discussed a measure, Senate File 607, to raise the age to 21 but it did not gain traction. Critics including the American Cancer Society Action Network said the bill was not a real solution — that the devices should also be taxed like tobacco and regulated under Iowa’s Clean Indoor Air Act.
Trump’s first public comments on vaping come as health authorities investigate hundreds of breathing illnesses reported in people who have used e-cigarettes and other vaping devices. Nationwide, six deaths have been reported from the recent illnesses.
No single device, ingredient or additive has been identified, though many cases involve marijuana vaping.
Iowa health officials said Wednesday they have recorded eight confirmed cases of vaping-related respiratory illnesses — most of them associated with users modifying a store-bought vape product with illicit marijuana-derived oil or buying vaping products on the street.
“It has been a particularly challenging investigation,” Dr. Caitlin Pedati, medical director for the Iowa Department of Public Health, told the agency’s oversight board members, noting seven people who reported a range of mild to serious medical problems had admitted using illicit THC products not obtained through Iowa’s licensed dispensaries.
Reported symptoms of vaping users complaining of respiratory problems included cough, fatigue, dizziness, headache, vomiting and diarrhea, chest pain, and worsening difficulty breathing, sometimes requiring ventilation and intensive care, she said.
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“I can tell you that from a clinical and public health perspective, my recommendation is that nobody would ever be using these illicit THC or nicotine vaping products at all,” Pedati said during Wednesday Board of Health meeting.
The state’s medical director said youth should be discouraged from using vaping and e-cigarette products of any kind since the long-term health impacts of using them are unknown.
The FDA has had the authority to ban vaping flavors since 2016, but previously has resisted calls to take that step.
But parents, teachers and health advocates have increasingly called for a crackdown on flavors, arguing they are overwhelmingly to blame for a recent surge in underage vaping by teens, particularly with small, discrete devices such as Juul’s.
Anti-tobacco groups praised the announcement but said action must be “immediate.”
“It has taken far too long to stop Juul and other e-cigarettes companies from targeting our nation’s kids with sweet-flavored, nicotine-loaded products,” said a statement from Matthew Myers, of the Campaign for Tobacco-Free Kids.
More than 80 percent of underage teens who use e-cigarettes say they picked their product because it “comes in flavors that I like,” according to government surveys.
Juul and other manufacturers argue their products help adult smokers wean themselves off paper-and-tobacco cigarettes.
Last year, Juul said it supported efforts around the country to raise the legal age for purchasing the products to 21.
It announced a $30 million initiative that includes research and a panel of public health officials and experts — a panel that would be assembled by Iowa Attorney General Tom Miller.
“Juul has pledged to work with me and others to keep their products from kids,” Miller said in a statement at the time.
Representatives for Juul did not immediately respond to a request for comment Wednesday.
The Vapor Technology Association said in a statement the flavor ban would force smokers “to choose between smoking again ... or finding what they want and need on the black market.” The group represents vaping manufacturers, retailers and distributors.
The Associated Press and Rod Boshart of The Gazette Des Moines Bureau contributed.