Prevention Matters

The U.S. Food and Drug Administration Tobacco Products Scientific Advisory Committee (TPSAC) recently concluded that the “removal of menthol cigarettes from the marketplace would benefit public health in the United States.”  This recommendation to the FDA is based on prevailing science surrounding menthol cigarettes.  Although menthol cigarettes do not contain more toxins, they increase the number of young people who try cigarettes and the number of children who become regular smokers, increasing overall youth smoking.  Menthol cigarettes have also been found to be more appealing to African-Americans and therefore contribute to higher smoking rates and decreased cessation among this population.

The TPSAC final report is set to go through a systematic review by experts from the FDA Center for Tobacco Products.  They are to take into account menthol cigarettes’ risks and benefits to the population, effects on overall smoking initiation and cessation rates, achievability, and consequential effects that may arise, such as demand for contraband.  The FDA intends to provide its first progress report on the review in about 90 days.

Partnership for Prevention supports the TPSAC’s recommendations and urges the FDA to take action to ban menthol to curb the uptake of smoking by youth and promote cessation among other high-risk groups.  The tobacco industry’s incessant marketing of menthol cigarettes to youth, African Americans and other communities are threats to the public’s health.  We are hopeful that the FDA will recognize the harmful impact of menthol cigarettes on the health of the nation and employ the committee’s advice.

Harmeet Singh
Tobacco Control Team

Partnership for Prevention is pleased to submit these comments to the U.S. Food and Drug Administration in regard to required textual warnings and accompanying graphics to be displayed on cigarette packages and in cigarette advertisements.

Partnership commends the FDA on the development of the new graphic health warnings. We urge the FDA to proceed with the implementation of the warnings without delay. The tobacco industry will inevitably work to impede and overturn the plans for the new health warnings on cigarette packages and advertisements, to take effect 15 months after issuance of this final rule. However, it is crucial that the FDA stay the course. According to the Centers for Disease Control and Prevention, an estimated 46 million people (aged 18 years and older) in the United States currently smoke cigarettes. Each day in the U.S., approximately 3,450 young people between 12 and 17 years of age smoke their first cigarette, and an estimated 850 youth become daily cigarette smokers. These statistics make it clear that more needs to be done to reduce the initiation of tobacco use and the prompt enforcement of this Family Smoking Prevention and Tobacco Control Act requirement will be a step in the right direction. These graphic health warnings will not only help young people to never start smoking, but also be beneficial in helping adults to quit.

Partnership for Prevention also strongly supports that 1-800-QUITNOW be required on all cigarette packages as a way to offer help to smokers who want to quit. A report released by the North American Quitline Consortium in 2010 showed that the total number of tobacco users accessing quitline services in FY 2009 was 515,000 (representing 1.2 percent of smokers), an increase of 129.7% over the FY 2005 level of 224,000. Quitlines are being used now more than ever so including the national access number on cigarette packages would be a simple and practical way to aid smokers who want to quit.

We thank you for the opportunity to comment on the cigarette warning labels and for your consideration of our views. Please contact David Zauche, Managing Senior Fellow & Senior Program Officer, at (202) 375-7807 or dzauche@prevent.org for further information or assistance.

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

FDA Proposes Graphic Warnings on Cigarette Packs

A series of gruesome pictures depicting emaciated lung cancer patients, a dead body in a morgue, a baby confined to a respirator (presumably the result of secondhand smoke) and other consequences of smoking that will appear on the outside of cigarette packages will hopefully shock people into quitting the habit or not starting in the first place, U.S. officials announced Wednesday, November 10.


WORST

Florida researcher looks for answers to alarming suicide rate among soldiers


American soldiers are killing themselves at the highest rate since the U.S. Military started keeping records and the trend is getting worse.

Military leaders say they are desperate to take action on the problem so the federal government is awarding a $17 million grant to Florida State and the Denver Veterans Affairs Medical Center for a suicide prevention program.

FSU's Professor Thomas Joiner is an internationally renowned expert on suicide who will help lead the military's effort to prevent suicides.

Joiner says there's a new trend of suicide in the military. The suicide rate among soldiers used to be lower than the general population. Joiner says now it's higher at an average of 12.5 suicides per 100,000 soldiers.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Wow….New graphic cigarette health warnings … FDA wants to know what you think.

At a press conference this morning (November 10, 2010) Health and Human Services Secretary Kathleen Sebelius helped unveil a “comprehensive tobacco control strategy that includes proposed new bolder health warnings on cigarettes and advertisements. In 2009 President Obama signed into law the “Family Smoking Prevention and Tobacco Control Act” (Public Law 111-31) which required that the Food and Drug Administration add “nine new larger and more noticeable textual warning statements and color graphic images depicting the negative health consequences of smoking.” The Notice of Proposed Rule Making includes 36 proposed images that are a remarkable and long overdue improvements over the warnings Congress required on cigarette packages and advertising ,back in 1984. The FDA is also conducting an extensive 18,000 person consumer test of the proposed graphic images to help identify the nine that will most effectively help current smokers quit and discourage potential new smokers from starting. The results of the FDA’s consumer research will also be released shortly and public comment will be solicited.

The current deadline for public comment on the proposed 36 images is January 9, 2011. The wording of the nine warnings was specified by the Congress when it enacted Public Law 111-31. These warnings include:

‘‘WARNING: Cigarettes are addictive."
‘‘WARNING: Tobacco smoke can harm your children."
‘‘WARNING: Cigarettes cause fatal lung disease."
‘‘WARNING: Cigarettes cause cancer."
‘‘WARNING: Cigarettes cause strokes and heart disease."
‘‘WARNING: Smoking during pregnancy can harm your baby."
‘‘WARNING: Smoking can kill you."
‘‘WARNING: Tobacco smoke causes fatal lung disease in nonsmokers."
‘‘WARNING: Quitting smoking now greatly reduces serious risks to your health."

The challenge for the FDA is to identify graphic images that best amplify the statutorily mandated wording of the cigarette warnings. Federal law also requires that the warnings and graphic images make up the top 50 percent of the front and back of cigarette packages.

FDA Commissioner Margaret Hamburg said it best: “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes. This is a concrete example of how FDA’s new responsibilities for tobacco product regulation can benefit the public’s health.

So….take a few minutes to check out the FDA’s proposed new labels.

If you have family and friends who smoke…show them the new labels… get their advice and then tell the FDA.

The FDA has given us all an opportunity to play an important role, individually and collectively, in fighting the nation’s leading cause of premature death and preventable illness. Stronger health warnings, especially if they are accompanied by the 1 800 QUIT NOW cessation number, can help more smokers get access to effective cessation medications and discourage thousands of young people from striking the first match of what can become a lifelong, life threatening addiction.

Lets get to work. Tell the FDA what you think.


E Ripley Forbes
Director, Government Affairs

On June 22, 2010 new restrictions on tobacco product sales and marketing under the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) finally went into effect. This act is specifically aimed at protecting children and youth from the dangers of using tobacco. These restrictions prohibit the sale of cigarettes and smokeless tobacco to people under the age of eighteen; prohibit the sale of cigarette packs with less than twenty cigarettes; prohibit the distribution of free samples of cigarettes and smokeless tobacco; and prohibit tobacco companies from sponsoring many events such as music concerts, athletic games, and other cultural or social gatherings. These are certainly great strides for tobacco control, but the U.S. Food and Drug Administration (FDA) and tobacco prevention advocates still have a ways to go in order to continue to prevent tobacco use among America’s youth.

One major task is educating both retailers and the public about these new restrictions. The FDA has wasted no time and is tackling this issue with their new website: Break the Chain of Tobacco Addiction. The website features various ways for retailers, organizations, and the general public to “spread the word” about the new regulations. The site has flyers and posters available for download with slogans such as “Don’t Let Minors Buy Tobacco. It’s the Law. Break the chain of tobacco addiction. Keep tobacco out of the hands of America’s youth. It’s the right thing to do” and “Break the Chain of Tobacco Addiction: I follow the law. I don’t sell tobacco to minors.”

The FDA is also using their website to help people “Stay Informed” – visitors to the website can sign up for e-mail updates, an RSS feed, or become a follower on Twitter. There are also various links to information and materials to help people “Learn More” and there are a variety of “Guidances” for the help the tobacco industry comply with these new regulations. The FDA is encouraging organizations to feature its widget that scrolls content from the FDA’s website and the “Break the Chain” badge on their own sites.

To help spread the word about these important new regulations, visit the “Break the Chain” website at http://www.fda.gov/TobaccoProducts/ResourcesforYou/BreakTheChain/default.htm.


Katie Burggraf
Tobacco Control Team
Partnership for Prevention

A new study by the Fred Hutchinson Cancer Research Center in Seattle showing that postmenopausal women who take fish oil supplements may reduce their breast cancer risk was named the “Best Prevention Idea of the Week,” while the recent news from the U.S. Food and Drug Administration that about 40 million doses of swine flu vaccine worth about $260 million will be destroyed because it's past the expiration date was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Study Finds Fish Oil Supplements Linked to Lower Risk of Breast Cancer

Postmenopausal women who take fish oil supplements may reduce their breast cancer risk, a new study suggests.

The study focused on the potential health benefits of 15 different so-called "specialty" supplements to see if they affect breast cancer risk, said study senior author Emily White, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle.

Fish oil supplements, made from fatty fish such as salmon, contain high levels of omega-3 fatty acids.

In the study, White and her colleagues asked more than 35,000 Washington state women who were between the ages of 50 and 76 and all past menopause to answer questions about their use of "non-vitamin, non-mineral supplements." All were participants in the Vitamins and Lifestyle (VITAL) cohort study, and none had a history of breast cancer.

After six years of follow up, 880 cases of breast cancer were identified.

WORST

40 Million Expired Swine Flu Vaccine Doses to Be Destroyed


About 40 million doses of swine flu vaccine worth about $260 million will be destroyed because it's past the expiration date, says the U.S. Food and Drug Administration.

The amount of the outdated vaccine, which will be incinerated, is more than twice the usual surplus and likely sets a record, according to the Associated Press.

One government estimate suggests that about 30 million more swine flu vaccine doses could expire and have to be destroyed. If that's the case, it means that more than 43 percent of the total supply of swine flu vaccine for the U.S. public will have gone to waste, the AP reported.

A year ago today, June 22, 2009, President Obama signed the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act), which places the regulation of tobacco products under the authority of the Food and Drug Administration (FDA).

Under the provisions of this Act, the FDA established the Center for Tobacco Products whose main goals include preventing the initiation of tobacco use among America’s children and adolescents; aiding adults with tobacco cessation; supplying the public with necessary information on the ingredients of tobacco products and the potential harms of using tobacco products; and using the regulation of tobacco products to protect the public from the health burden of tobacco, which is currently the leading cause of preventable disease in the United States.

So what happens today, June 22, 2010?

Today, new restrictions on tobacco product sales and marketing go into effect. These include the banning of descriptors such as “light,” “mild,” and “low” in cigarette and smokeless tobacco labeling and advertisements; larger and more graphic warning labels on smokeless tobacco products and advertisements; and the implementation of the 1996 Rule on Youth Access and Marketing. This rule aims to prevent the use of tobacco related products among America’s youth through regulations that prohibit the sale of cigarettes and smokeless tobacco to minors under federal law; ban tobacco related sponsorships of athletic, social, and other cultural events; and prohibit the sale of cigarette packages with less than twenty cigarettes.

And what should we look for in the future?

In the future the FDA is looking to develop tobacco product standards, regulate the introduction of new tobacco products, and place larger and more graphic warning labels on cigarette packaging and advertisements. Until then, the FDA urges states and localities to continue implementing tobacco taxes, smoke-free laws, funding for tobacco prevention and cessation, and coverage for smoking cessation services – all of which have proven to be effective in controlling the use of tobacco.

As Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation explains, “Tobacco use is a contributing factor to dozens of diseases and conditions that impact American and accounts for $96 billion each year in health care costs. This groundbreaking legislation is a big investment in prevention that will help all Americans lead healthier lives.”

Read more about the Tobacco Control Act’s One Year Anniversary by clicking here.

Kathryn Burggraf
Tobacco Control Intern
Partnership for Prevention

According to a survey administered by the Virginia Foundation for Healthy Youth, one out of three teenagers younger than 18 mistakenly identified a new type of smokeless tobacco product as candy or gum. The survey of about 1,400 Virginia residents, including 728 younger than 18, asked them to identify package images for several types of new, smokeless tobacco products, as well as package images of mints and gums. About 39 percent of the respondents younger than 18 identified Camel Orbs, an oral tobacco product that dissolves in the month and delivers nicotine to the user, as mints or gum. Of the teenagers younger than 18 surveyed who do not currently use tobacco, 27 percent said they would try Camel Orbs based on packaging alone.

Another product identified in the survey was Stonewall, a type of smokeless, pellet tobacco sold by Star Scientific Inc. About 35 percent of the survey respondents 18 or younger perceived Stonewall to be candy, mints or gum. Twenty-three percent said they would try Stonewall because of the packaging.

The survey results suggest that packaging of the products alone may appeal to youth, said Danny Saggese, director of marketing for the Virginia Foundation for Healthy Youth."It poses a significant risk to youth and raises the possibility of them not only using these products, but using them in places where smoking is now prohibited, and potentially becoming nicotine addicts," he said.

In March 2010, the U.S. Food and Drug Administration issued a rule restricting access and marketing of cigarettes and smokeless tobacco products to youth. The rule becomes effective June 22, 2010 and will require smokeless tobacco products to have warning labels that cover one-third of the front and back of the packages. However, many tobacco prevention groups and government officials believe the FDA should ban smokeless tobacco products altogether. In an April 18th New York Times interview, U.S. Senator Jeff Merkley of Oregon called the products “tobacco candy,” noting that “everything about them is designed for kids.”

Brandi Robinson
Program Associate
Partnership for Prevention

In a page one story in yesterday’s Washington Post entitled, “FDA plans to limit amount of salt allowed in processed foods for health reason," reporter Lyndsey Layton writes:

“The Food and Drug Administration is planning an unprecedented effort to gradually reduce the salt consumed each day by Americans, saying that less sodium in everything from soup to nuts would prevent thousands of deaths from hypertension and heart disease. The initiative, to be launched this year, would eventually lead to the first legal limits on the amount of salt allowed in food products.

The FDA’s involvement is welcome news. For years public health authorities have cautioned Americans to reduce sodium consumption in order to reduce the risk of heart disease and stroke; the nation’s first and third leading causes of death. In fact, according to the Centers for Disease Control and Prevention, 69% of adults in the United States are at “especially high risk for health problems from consuming too much sodium.” You are considered high risk if you are over 40 years of age, African American or have high blood pressure.

But following advice to reduce sodium consumption is tough work. 77 percent of sodium in our diets come from processed and restaurant foods. According to the WPost story the FDA is planning to “analyze the salt in spaghetti sauces, breads and thousands of other products” and (work) “with food manufacturers” to set limits for salt that would be “designed to gradually ratchet down sodium consumption. The changes would be calibrated so that consumers barely notice the modification.” (emphasis added)

A few hours after publication of the story, the Institute of Medicine lifted a media embargo and went public with their much anticipated report “Strategies to Reduce Sodium Intake in the United States.” The report confirms that despite multiple “voluntary efforts to reduce sodium consumption in the United States during the past 40 years, they have not succeeded.”

Much is at stake. According to the IOM, “population-wide reductions in sodium could prevent more than 100,000 deaths annually.”

The heart of the IOM recommendation is a regulatory strategy similar to the approach the Washington Post indicated the FDA was considering. They recommend “the FDA set mandatory national standards for the sodium content in foods – not banning outright the addition of salt to foods but beginning the process of reducing excess sodium in processed foods and menu items to a safer level.” The report emphasized: “It is important that the reduction in sodium content … be carried out gradually, with small reductions instituted regularly as part of a carefully monitored process.”

And good news for food gourmands. The report notes “evidence shows that a decrease in sodium can be accomplished successfully without affecting consumer enjoyment of food products IF IT IS DONE (emphasis added) in a stepwise process that systematically and gradually lowers sodium levels across the food supply.”

On Thursday, April 22,  Partnership will host a briefing (“Reducing Sodium Consumption: Is it time?") on Capitol Hill with the Congressional Prevention Caucus to hear more about the adverse health effects of excessive sodium in the diet. Caucus Co-Chair, Representative Jim Moran (D. VA) will open the briefing which will be moderated by Partnership’s President Rob Gould. The briefing will include presentations by:

• Darwin Labarthe, MD, MPH, PhD, Director, Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention
• Thomas Farley, MD, MPH, Commissioner, New York City Department of Health and Mental Hygiene
• Mark Broadhurst, Director, Corporate Affairs and State Public Policy, Mars Food US
• Suzanne Hughes, RN, MSN, Preventive Cardiovascular Nurses Association

Briefings of the Congressional Prevention Caucus are open to the public. If you are able to attend this event, please email Partnership for Prevention at meetings@prevent.org

E Ripley Forbes
Director, Government Affairs
Partnership for Prevention

The newly-established FDA tobacco advisory panel has the opportunity to take a bold step and ban menthol cigarettes. Menthol cigarettes are popular with young smokers -- 62 percent of middle-school smokers begin with menthol cigarettes. And, about 75 percent of African American smokers use menthol brands. These two groups are heavily targeted by tobacco companies, which says menthol cigarettes are no more dangerous than other cigarettes. But, Congress and the FDA had no problem banning other favors like chocolate and clove. What’s the big deal here? How about $18 billion dollars a year? The tobacco industry won’t give up on menthol without a strong fight. Health advocates need to continue to make the case for a ban.

Read the Washington Post article on menthol - "FDA panel mulls putting limits on menthol cigarettes".

Diane Canova
Vice President, Policy and Programs

Starting in June, new federal tobacco laws require cigarette companies to stop using words like “light” or “mild” on packages to imply that those cigarettes are safer than others. At the same time, however, they are adopting lighter colors for the packages of such products. Critics say such moves make those same distinctions: light colors for light cigarettes.


Marlboro Lights, the nation’s best-selling brand, will be renamed Marlboro Gold and Marlboro Ultra Lights will change to Marlboro Silver. Meanwhile, R.J. Reynolds has already changed Salem Ultra Lights, which are sold in a silver box, to Silver Box.

“They’re circumventing the law,” said Gregory N. Connolly, a professor at the Harvard School of Public Health, tells The New York Times. “They’re using color coding to perpetuate one of the biggest public health myths into the next century.”

The New York Times reports that tobacco manufacturer Altria apparently hopes to navigate around indoor smoking ban laws by persuading the Food and Drug and Administration to let them market smokeless tobacco as far less harmful than cigarettes. 

"While public health doctors agree that the smokeless products are far less hazardous to individuals than cigarettes, they still have concerns because all tobacco products contain nicotine and carcinogens," write the Times' Duff Wilson and Julie Creswell.. "They also contend that promoting smokeless products — some in tiny packages in the shape of cigarette packs — would attract new, perhaps younger customers and maintain the addiction for smokers who might otherwise quit. They note that Altria is adding flavorings to its smokeless products that have long been used in candy.Furthermore, critics say, "

E-cigarette merchants are wasting no time in taking advantage of a recent federal court ruling that says e-cigarettes are exempt from regulation by the Food and Drug Administration.
"Smoke Wherever You Want, Whenever You Want!" proclaims a website named "getsmartsmoker.com" that is the object of new mass e-mail marketing campaign. "Smokers can finally regain the freedom to smoke anywhere: bars, restaurants, planes, anywhere smoking has been banned."  Funny that the merchant would publish a quote about the smoking hazards of a product that they claim has none.

The ad also includes a quote from action movie hero/Calif. Gov./Arnold Schwarzenegger in which  he says that, while children under 18 should not be allowed access to e-cigs, "If adults want to purchase and consume these products with an understanding of the associated health risks, they should be able to do." It also includes a form that allows you to order a free (plus $9.95 shipping and handling) trial e-cigarette.

U.S. District Judge Richard Leon today ruled that the U.S. Food and Drug Administration may not regulate electronic cigarettes as drugs or medical devices.

"This case appears to be yet another example of FDA's aggressive efforts to regulate recreational tobacco products as drugs or devices," Judge Leon said in his ruling. He added the FDA's "tenacious drive to maximize its regulatory power has resulted in its advocacy of an interpretation of the relevant law that I find, at first blush, to be unreasonable and unacceptable."

The FDA has seized shipments of e-cigarettes, saying the electronic cigarettes were essentially drugs or devices that were being imported without FDA approval.

Meanwhile, California Attorney General Jerry Brown has filed suit seeking to halt the sale of one company's electronic cigarettes in the state, saying they contain dangerous chemicals and are being marketed to children.
Brown says Florida-based Smoking Everywhere Inc., a leading manufacturer of e-cigarettes, has no evidence to back up claims their product is safe.

The nation's first-ever "tobacco czar" says his office will be working with tobacco manufacturers to evaluate new products and possibly block them from the marketplace.

"Congress has set a new standard based on the public health and population impact," Lawrence Deyton, Director of the FDA's Center for Tobacco Products, said in an interview with Congressional Quarterly. We have to work with tobacco companies to evaluate the pros and cons of every new product, and a lot of smart people will be working on figuring out how we do that."

USA Today ran a front page story on Oct. 26 detailing the growing controversy posed by electronic cigarettes. Proponents claim the cigarette alternative is safe and shouldn’t be regulated. Public health officials want the Food and Drug Administration (FDA) with its new authority over tobacco products, to test and regulate e-cigarettes. Electronic cigarettes are battery-operated devices that turn nicotine and other chemicals into a vapor inhaled by the user. The smokers’ argument is “no smoke, no problem.” Not so easy say others. Potential dangers not known, so we can’t give it a pass.

Diane Canova Managing Senior Fellow
& Senior Program Officer
Partnership for Prevention

Nearly 25 years ago, the FDA banned the sale of turtles with a carapace length of less than four inches to reduce turtle-associated Salmonella transmission, especially among young children who love to pick up handle the tiny pets. The ban apparently has been flouted, because turtles are still available on pet store shelves and have been linked to disease outbreaks.

During a 2007 outbreak, youngsters who handled a small turtle were at a 41-fold increased risk of contracting Salmonella, compared with controls (95% CI 6.9 to unbounded), the CDC's Julie R. Harris, PhD, and colleagues reported online in Pediatrics.

"Small turtles continue to be sold and pose a health risk, especially to children," the researchers said. "And many people remain unaware of the link between Salmonella infection and reptile contact."

The Internet can be a great source of information about the pandemic H1N1 flu, but it's also the mother lode of swine flu scams, the FDA is warning.In a news release, the agency said it recently purchased and analyzed several products that purported to be oseltamivir (Tamiflu), one of two antiviral drugs thought to be effective against the pandemic flu.

"One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper," the agency said. Analysis showed the tablets contained talc and acetaminophen, but no oseltamivir, the FDA said. The Web site disappeared shortly after the order was placed. The agency said it bought four similarly advertised products from other Web sites. These did contain some oseltamivir, but were not approved for use in the U.S. Several Web merchants did not require a prescription, and none of the drugs arrived quickly enough to treat someone infected with the pandemic flu or with an immediate exposure to the virus.

As of today, September 22, 2009, candy and fruit-flavored cigarettes are illegal.
The FDA has begun to implement the new Family Smoking Prevention and Tobacco Control Act that gives the FDA broad authority to regulate the manufacture and sale of tobacco products.

Given the appeal of candy-like flavors to children, the FDA recognized the importance of quickly reducing access to tobacco products that were appealing to children. FDA Commissioner Margaret Hamburg stated that “almost 90 percent of adult smokers started smoking as teenagers. These flavored cigarettes are a gateway for many children and young adults to become regular smokers.”

Companies that violate the ban are subject to FDA enforcement actions. The new ban does not apply to menthol cigarettes and other flavored tobacco products, but the FDA is looking additional ways to regulate these products.

You can access a link to the FDA flavored tobacco web site at: www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/FlavoredTobacco/default.htm


Diane M. Canova
Managing Senior Fellow
& Senior Program Officer