FDA Announces Plans to Reduce Tobacco Use with Restrictions on Menthol, Flavors, and Access to Flavored E-Cigarettes
On Nov. 15 the Food and Drug Administration (FDA) formally announced plans to prohibit menthol flavoring in combustible cigarettes, prohibit flavors in cigars, and restrict the sale of some flavored electronic cigarettes to age-restricted in-person locations, with heightened age verification for online sales. The FDA plan comes as newly-released data shows an alarming spike in youth usage of electronic cigarettes significantly driven by the appeal of kid-friendly flavored products.
FDA is moving in the right direction, but details regarding how the agency will implement these newly-announced initiatives will be crucial. As we noted previously, you may remember, ACS CAN and other public health groups sued the agency when it issued Guidance in 2017 that halted implementation of key provisions of the "deeming" rule that governs electronic cigarettes. After the Nov. 15 announcement, FDA filed notice of the announcement with the court in an effort to assert a defense in the pending lawsuit which seeks concrete action by the FDA. We responded that the lawsuit is still necessary because the FDA continues to shirk its statutory obligations under the Tobacco Control Act.
Prior to the announcement, ACS CAN along with its tobacco control partners, sent a letter to the FDA outlining key actions the agency should take to address the youth e-cigarette use epidemic. Those actions include enforcing premarket review, prohibiting flavors in all products, restricting industry marketing, and preventing the sale of tobacco products to youth.
Court-Ordered "Corrective Statements" Appear on Cigarette Packages
The tobacco industry has finally been forced to disclose the truth about its deadly and addictive products directly on cigarette packages. On Nov. 21, major cigarette manufacturers began shipping court-ordered"corrective statements" affixed to cigarette packages that state in plain-language that all cigarettes cause cancer, emphysema and heart disease, and that tobacco companies intentionally designed cigarettes with enough nicotine to "create and sustain addiction."
There are five different corrective statements pertaining to five specific areas in which the industry defrauded the American people: 1) the adverse health effects of smoking; 2) the addictiveness of smoking and nicotine; 3) the lack of significant health benefit from smoking "low tar," "light," "ultra light," "mild" and "natural" cigarettes (products that have been deceptively marketed as less harmful than regular cigarettes); 4) the manipulation of cigarette design and composition to ensure optimum nicotine delivery; and 5) the adverse health effects of exposure to secondhand smoke.
These statements, which have already appeared in national newspapers, on TV and on tobacco company websites, are the result of a nearly two-decade court battle between the U.S. Department of Justice and the tobacco industry. The American Cancer Society, along with other public health groups, is an intervenor in the case of US v. Philip Morris et al, in which a federal court found tobacco companies guilty of racketeering due to their decades of lying to the American public about smoking and its deadly health effects. The statements represent the first time tobacco companies are compelled to use their cigarette packaging to directly communicate with consumers about the dangerous and addictive nature of their products.
The tobacco companies estimate the packages with corrective statements will hit retail establishments anywhere between two days and two weeks after shipment. The court ordered two weeks' worth of product be shipped three times per year for two years at roughly four-month intervals.
While we have seen meaningful progress in our fight against tobacco use, new evidence reveals that the tobacco industry continues to work to hook a new generation of users to its deadly products. After decades of deception and millions of lives lost, ACS CAN will continue to push for strong regulatory oversight of all tobacco products and access to evidence-based tobacco intervention and cessation strategies.
State & Local Activities
New Tobacco 21 Ordinances
- Hermantown, Minnesota became the 15th city in the state to raise its tobacco sales age to 21.
New Tobacco Taxes
- Voters passed an ACS CAN-supported tobacco tax ballot measure in Avon, Colorado with nearly 76% of votes cast. The tax on cigarettes will increase by $3.00 per pack. The tax on other tobacco products, including e-cigarettes, will increase by an additional 40% of the retail price starting Jan. 1.
Restrictions on Electronic Cigarettes & Flavored Tobacco Products
- Saratoga, California adopted an ordinance restricting the sale of flavored tobacco. While the ordinance does not include menthol cigarettes, two council members spoke in favor of restricting menthol, so there will be an effort to strengthen the ordinance in 2019.
- Marin County became the 27th local jurisdiction in California to restrict the sale of flavored tobacco products. The county's ordinance prohibits the sale of all flavored tobacco products, including menthol cigarettes, in the unincorporated parts of the county.
- Colorado Gov. John Hickenlooper issued an executive order aimed at curbing the youth e-cigarette use epidemic and addressing youth prevention for other types of tobacco products. The executive order takes several steps within existing state agency authority. The steps include:
- doubling the number of compliance checks of tobacco and e-cigarette retailers to ensure they are not selling to underage persons;
- extending the current prohibition on smoking in state buildings to e-cigarettes and vaping;
- extending prohibitions on smoking and vaping to the grounds of state buildings;
- issuing a health advisory on e-cigarettes and vaping; and
- investigating the association between vaping and other risky behavior like binge drinking and substance use and identify programs to prevent these behaviors.
ACCESS TO CARE
Majority of Voters Support Health Coverage at No Extra Cost for Patients with Pre-Existing Conditions
Results from a new nationwide poll released Nov. 27 show nearly seven in ten voters (68 percent) across party affiliations say people with pre-existing health conditions should have access to health coverage without paying more because of their health status and 80 percent agree that simply having health insurance is inadequate. Plans must cover necessary treatments when people have a medical condition and need care the most.
The poll, which was conducted just before and during the midterm elections, also found 82 percent "disagree" that insurance companies should be able to charge higher prices to sicker customers. Ninety percent said they would be "concerned" and 78 percent say they would be "very concerned" if care for pre-existing conditions was no longer required to be covered.
More than half of those surveyed indicated that they or an immediate family member have a pre-existing medical condition. The issue of pre-existing conditions protections has been the focus of many legislative efforts and a number of lawmakers have committed to addressing the issue in the upcoming session.
The poll found strong support for these protections across all demographics and political party affiliations. An overwhelming three-quarters of those who voted for a Democrat (75 percent) and a solid majority who voted for a Republican for Congress (59 percent) say coverage for pre-existing conditions means that people have coverage without paying more.
ACS CAN commissioned the questions as part of an omnibus poll fielded by Lake Research Partners and The Tarrance Group. The poll of 2,400 of likely voters was conducted November 4-6, 2018.
- The ACS CAN-supported ballot measure to expand Medicaid in Idaho passed with more than 60 percent of the vote and won a majority of votes in 35 out of Idaho's 44 counties.
- Utah voters supported a ballot measure to expand Medicaid expansion with more than 53 percent voting in favor. ACS CAN was part of the coalition that supported the measure.
- More than 53 percent of Nebraska voters favored an ACS CAN-supported ballot initiative to expand Medicaid coverage in the state.
HEALTHY EATING & ACTIVE LIVING ENVIRONMENTS
- ACS CAN was part of an Oregon coalition that helped defeat Measure 103, a preemptive tax exemption on groceries that would have prohibited local municipalities from taxing sugar-sweetened beverages. The measure was opposed by 57 percent of voters.