The Trump Administration on Wednesday asked the Food and Drug Administration to ban flavored e-cigarettes from the market after an increase in mysterious lung infections.
The Alabama Department of Public Health is reportedly investigating five cases of lung disease associated with vaping, though it's unknown if any of those cases originated in Limestone County. A spokesperson with Athens-Limestone Hospital said she was not aware of any vaping-related illnesses treated at the hospital.
In a statement, the state health department asked health care providers to document any respiratory illnesses reported by those who use electronic cigarettes.
The Centers for Disease Control and Prevention is also investigating a cluster of severe pulmonary disease among people who vape, with more than 450 cases reported to date in 33 states. Health department officials in Kansas reported a 50-year-old woman died this week from a lung disease linked to vaping, but it was not known which vape products the woman had used. Five e-cigarette-related deaths have been confirmed in California, Illinois, Indiana, Minnesota and Oregon.
A physician at the UAB Hospital in Birmingham explained while there are some who claim e-cigarette use may aid smoking cessation, the CDC recommends those not already using tobacco products refrain from vaping.
“… The usage of electronic cigarettes by children, teens, young adults and those who are pregnant is to be avoided. Studies have shown nicotine to be harmful to the developing fetus and to cause harm to the developing adolescent brain,” said Cody Gibson, a researcher and lab manager with UAB's School of Medicine. “One must also be aware that electronic cigarette liquids may contain a number of harmful chemicals and carcinogens, in addition to nicotine."
Law firm Beasley Allen, which filed suit against San Francisco-based e-cigarette maker Juul Labs in July, commended the FDA for investigating what it referred to as Juul's “deceptive marketing of its vaping devices and products that specifically targeted children and youth.” As part of the lawsuit, Beasley Allen is representing a Limestone County father who claims his son suffered “a permanent brain injury” because of his addiction to nicotine and use of the Juul e-cigarette.
“Juul Labs was over the line and everything they did, from designing the product, manipulating the nicotine and marketing, was targeted at addicting young people to nicotine,” said attorney Joseph VanZandt. “Juul’s actions have intentionally reversed decades of progress in reducing youth tobacco use. Juul has sparked a new nicotine addiction epidemic that has helped it build a $38 billion empire.”
The FDA has the authority to ban vaping flavors but has previously resisted calls to take that step. Agency officials instead said they were studying if flavors could help smokers quit traditional cigarettes.
But parents, politicians 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 U.S. teens, particularly with small, discreet devices such as Juul's.
Anti-tobacco groups applauded the announcement but said restrictions 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 Matthew Myers, of the Campaign for Tobacco-Free Kids, in a statement.
A ban on flavors would be a huge blow to companies like Juul, which has grown into a multibillion-dollar business by selling mint, fruit and dessert flavored-nicotine products.
Juul and other manufacturers argue their products are intended to help adult smokers wean themselves off traditional paper-and-tobacco cigarettes. But there is little evidence that e-cigarettes are effective for helping smokers quit.
Representatives for Juul did not immediately respond to a request for comment Wednesday.
A 2009 law banned all flavors from traditional cigarettes except menthol. But that law did not apply to e-cigarettes, which were then a tiny segment of the tobacco market.
"We simply have to remove these attractive flavored products from the marketplace until they can secure FDA approval, if they can," said Health and Human Services Secretary Alex Azar.
Azar said flavored products could apply for FDA permission to reenter the market. But under agency standards, only products that represent a net benefit to the nation's public health can win FDA clearance.
Azar said the administration would allow tobacco-flavored e-cigarettes to remain available as an option for adult smokers. But he said if children begin using those products, "we will take enforcement action there also."
Significantly, the Trump proposal is expected to bar menthol and mint vaping flavors. FDA officials have previously exempted those products from any sales restrictions because they were thought to be useful to adult smokers. Anti-vaping advocates criticized that decision, pointing to survey data showing roughly half of teens who vape use mint and menthol.
More than 80% of underage teens who use e-cigarettes say they picked their product because it "comes in flavors that I like," according to government surveys.
A few local governments, including San Francisco, have passed bans on flavored tobacco. And this month Michigan moved to become the first state to ban flavored electronic cigarettes. But other proposed flavor bans have stalled in state legislatures this year.
E-cigarettes have been on the U.S. market for more than a decade. FDA officials have repeatedly delayed enforcing regulations on them, responding to industry complaints that it would wipe out thousands of small vaping companies.
Most experts agree the aerosol from e-cigarettes is less harmful than cigarette smoke since it doesn't contain most of the cancer-causing byproducts of burning tobacco. E-cigarettes generally heat liquid containing nicotine. But there is virtually no research on the long-term effects of vaping.
— The Associated Press contributed to this report.