U.S. health regulators are moving ahead with a plan designed to keep e-cigarettes out of the hands of teenagers by restricting sales of most flavored products in convenience stores and online.
The new guidelines, first proposed in November, are the latest government effort to reverse what health officials call an epidemic of underage vaping.
E-cigarettes typically heat a flavored nicotine solution into an inhalable vapor. Federal law bans their sale to those under 18, but 1 in 5 high school students report using e-cigarettes, according to the latest survey published last year .
Under proposed guidelines released Wednesday by the Food and Drug Administration, e-cigarette makers would restrict sales of most flavored products to stores that verify the age of customers entering the store or include a separate, age-restricted area for vaping products. Companies would also be expected to use third-party identity-verification technology for online sales.
Companies that don't follow the requirements risk having their products pulled from the market, the FDA said.
``The onus is now on the companies and the vaping industry to work with us to try and bring down these levels of youth use, which are simply intolerable,'' FDA Commissioner Scott Gottlieb said in an interview. The restrictions won't apply to three flavors that the FDA says appeal more to adults than teenagers: tobacco, menthol and mint.
The FDA will accept comments on the guidelines for 30 days before finalizing them later this year.
Anti-smoking activists have questioned whether the in-store restrictions will be enough to stop the unprecedented surge in teen vaping. The FDA has little authority over how stores display and sell vaping products. Instead, critics say the agency is essentially telling companies to self-police where and how their products are sold.
"FDA continues to nibble around the edges and that will not end the epidemic," said Erika Sward, of the American Lung Association, which has called on the FDA to remove all flavored e-cigarettes from the market.
Health experts say nicotine is harmful to developing brains, and some researchers worry that addicted teens will eventually switch from vaping to smoking.
Under regulations developed by the Obama administration, manufacturers were supposed to submit e-cigarettes for safety and health review by August 2018. But Gottlieb delayed the deadline until 2022, saying both the agency and industry needed more time to prepare. Under Wednesday's update, the FDA will move the deadline to 2021.
Still, the American Lung Association and several other anti-smoking groups are suing the FDA to begin reviewing the safety and health effects of e-cigarettes immediately.