We know smoking is bad for us, and yet tobacco use continues to be the single largest source of preventable death and disease in the U.S., killing 480,000 Americans each year. The Centers for Disease Control and Prevention recently released data from the 2018 Youth Tobacco Survey that showed a 78 percent increase in e-cigarette use among high school age children and a 48 percent increase among middle school age children. The CDC estimates that there are now 3.6 million kids in the U.S. who have reported using an e-cigarette product in the past 30 days.
In 2009, Congress gave the Food and Drug Administration authority to regulate all tobacco products; however, that does not mean that the agency has fully exercised that authority. Thus, ATS anti-tobacco advocacy has recently increased pressure on the FDA to use its power to maintain and increase regulation. The ATS joined several court actions to force the FDA to take timely action. For example, this year the ATS submitted an amicus brief in a federal court case submitted by the American Academy of Pediatrics seeking to force the agency to take immediate action to regulate e-cigarettes and cigars. The Society has also lobbied Congress to oppose efforts to limit the agency's powers to regulate tobacco products and has had direct contact with senior FDA officials urging effective policy on regulation.
To date, this initiative has had some mixed results. While the FDA has promised to increase regulations, it has equivocated on timing. The agency implied that new restrictions on e-cigarette points of sale would be accomplished in a matter of months. The FDA says that other actions that require official regulations, like bans on menthol cigarettes and flavored cigars, would be issued in the form of a notice of proposed rule-making sometime in calendar year 2019.
These announced policy actions are welcome news. However, it will likely take years for these policies to be implemented. Proposed rules have yet to be issued and once the proposed rules are out, there will be a lengthy public comment period before a final rule is issued. As it has in the past, the ATS will review and comment on the proposals to represent our members and their patients in the decision-making process. Even once a final rule is issued, it is safe to assume the tobacco industry will challenge it in court – potentially delaying implementation of the tobacco control policy even further.
While the new regulations from the FDA at the national level have a long road ahead, other work is being done on a more local level to curb tobacco use. For example, in 350 municipalities, the legal age to buy tobacco has been raised from 18 to 21. Others have raised tobacco taxes. Both these policies have been shown to be effective in reducing youth nicotine initiation, and in the world of advocacy, where progress is slow and victories sporadic, these policies are hopeful steps forward.
If you would like to learn more about tobacco advocacy, or advocacy more generally at the ATS, visit thoracic.org/advocacy.
