FDA sends another signal that it will authorize menthol ecigs despite high youth use

The FDA continues to telegraph that it is going to authorize the sale of menthol e-cigarettes. The first strong indication was not acting on the Vuse Solo menthol PMTA, which has allowed RJ Reynolds to continue selling menthol Vuse side-by-side (screen capture below) with the authorized tobacco flavor. Now, the FDA press release announcing its authorization to sell tobacco flavor Logic Vapeleaf, Logic Power and Logic Pro e-cigarettes pointedly leaves out mention of menthol when talking about the role of flavors in youth use of e-cigarettes:

As evidenced through data collected via the National Youth Tobacco Survey, compared to users of non-tobacco-flavored ENDS products, young people are less likely to start using tobacco-flavored ENDS products. The data also suggest that most youth and young adults who use ENDS begin with flavors such as fruit, candy or mint, and not tobacco flavors. [emphasis added]

In contrast, FDA and CDC published results from the 2021 National Youth Tobacco Survey just two weeks earlier that shows that menthol use falls right along with candy and mint, all being used by around 30% of kids:

Clove or spice2%1%-8%
Here is the specific NYTS question: Current (past 30-day) e-cigarette users were asked, “Were any of the e-cigarettes that you used in the past 30 days flavored to taste like menthol, mint, clove or spice, alcohol (wine, cognac), candy, fruit, chocolate, or any other flavor?” (response options were “yes,” “no,” or “don’t know”). Those who responded yes were then asked, “What flavors were the [tobacco product] that you have used in the past 30 days? (Select one or more).”

In addition, FDA has already authorized sale of menthol mini-cigarettes (heetsticks) for Philip Morris’ (Altria) IQOS, 22nd Century menthol low nicotine cigarettes, and US Smokeless Tobacco (Altria) mint disks and chews.

Why does the FDA continue to give menthol a pass? Because, despite overwhelming evidence that e-cigarettes as consumer products keep smokers smoking, FDA clings to the myth that do not help while downplaying risks to kids: “For the authorized products, the manufacturer demonstrated that possible benefits to adult smokers outweigh the risk of youth possibly initiating.” Possibly initiating?

More important, FDA is writing off the one-third of kids who use tobacco or menthol e-cigs (32%; 95% CI 29%-35%). And that doesn’t account for the well-documented shift from other flavors to menthol when other flavors are banned.

Two wrongs still don’t make a right

Published by Stanton Glantz

Stanton Glantz is a retired Professor of Medicine who served on the University of California San Francisco faculty for 45 years. He conducts research on tobacco and cannabis control and cardiovascular disease/

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