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American Academy of Pediatrics Welcomes New FDA Proposed Rule on E-Cigarettes and Tobacco, Urges Stronger Action to Protect Children and Prevent Child Poisonings


Washington, DC—The American Academy of Pediatrics (AAP) welcomes a long-awaited proposed rule released today by the Food and Drug Administration (FDA) allowing the agency to regulate e-cigarettes and other tobacco products, but urges additional, immediate action to protect young people effectively from addiction and from the poisoning risks these products pose.

The proposed rule gives FDA new authority to oversee e-cigarettes and expands its existing authority over cigars, hookahs, and other tobacco products. In addition, the regulation:

  • requires manufacturers to register and disclose their products’ ingredients with FDA
  • prevents tobacco companies from making health claims about e-cigarettes and other products without FDA review
  • establishes 18 as the nationwide minimum age to legally purchase e-cigarettes and all other types of tobacco products
  • bans free samples and vending machine sales of e-cigarettes and all other tobacco products in areas accessible by children under age 18, such as shopping malls; and
  • requires warning labels for e-cigarettes and cigars
Notably absent from the proposed rule is any requirement for the manufacturers of e-cigarettes to provide child-proof packaging for its liquid nicotine refills, which have become an increasing threat to child health and safety. Recent findings from the Centers for Disease Control and Prevention show that calls to poison control centers related to e-cigarette exposure increased from one per month four years ago to 215 per month as of February 2014.
“As pediatricians, we do everything in our power to keep our young patients safe from poisonous products, like household cleaners and prescription medications. These products are required to have child-proof packaging; poisonous liquid nicotine should be no different,” said AAP President James M. Perrin, MD, FAAP. “FDA missed an opportunity to protect children by failing to require safer packaging for liquid nicotine in its proposed rule. Children are being poisoned at an alarming rate, making the consequences of FDA’s omission all the more troubling and wide-reaching.”
While the Family Smoking Prevention and Tobacco Control Act of 2009 allowed the FDA to immediately regulate cigarettes and smokeless tobacco products, it required the agency to initiate rule-making in order to expand its reach to all tobacco products, which it did today. However, the regulation does not address the sale of flavored e-cigarettes and cigars, including candy and fruit flavors like cotton candy, grape, gummy bear and strawberry, and also does not prevent online sales or marketing practices that target children. The AAP stands in strong opposition to these practices and urges FDA to prohibit them in the rulemaking process.
“Lifelong nicotine addiction most often starts in childhood, making tobacco a major threat to children's health, regardless of the form it takes,” said Dr. Perrin. “Pediatricians call on FDA to quickly address toxic liquid nicotine and prevent marketing practices that target children, like candy flavors. Today’s proposed rule is a step in the right direction, but does not go far enough. It could take several years for the rule to take full effect, further jeopardizing the health of children. The evidence is clear that we need to move forward now with immediate action. With 1 in 10 youths already using e-cigarettes, we cannot afford to wait another day.”
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The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.