ASTHO Policy Watch 2022: E-Cigarettes and Flavored Tobacco Products

January 27, 2022 | Beth Giambrone

white-smoke-on-black-background_1200x740.jpegEach year, ASTHO notes the top public health policy issues to watch in the upcoming year. ASTHO has published a prospectus on several issues, with more coming later this month. ASTHO kicked off its top 10 public health state policy issues to watch in 2022 with Immunization the first week in January. This week, we are focusing on e-cigarettes and flavored tobacco products.

Tobacco use in all forms is associated with severe COVID-19 outcomes. During the COVID-19 pandemic, tobacco use increased among smokers, although other smokers were motivated to quit by the increased COVID-19 risk.

Electronic cigarettes (e-cigarettes) are devices that heat a liquid that may contain flavors to create a vapor or aerosol that is then inhaled. Most e-cigarettes contain nicotine, which is highly addictive, harmful to adolescent brain development, a health danger for pregnant people, and toxic to fetuses. E-cigarette aerosol can also contain cancer-causing chemicals, heavy metals, and volatile organic compounds.

FDA issued final rules in 2021 for premarket review of new tobacco products, authorizing the marketing of an e-cigarette product for the first time and finding that the potential benefits of tobacco-flavored e-cigarettes product helping adult users of combustible cigarettes to quit outweighed the risk of youth vaping. Additionally, FDA announced that it will ban all flavors of combustible tobacco, including menthol, in 2021. After the rulemaking process has concluded and is enforced, the proposed menthol ban should significantly reduce youth smoking and address health disparities experienced by communities of color and LGBTQ+ individuals.

In the meantime, states are adopting laws aimed at reducing youth access to e-cigarettes. Recent actions include:

  • Prohibiting the sale of flavored e-cigarettes.
  • Establishing nicotine content requirements for e-liquids.
  • Limiting the sale of e-liquid products with ingredients linked to use-associated lung injury.
  • Raising taxes on tobacco products, including e-cigarettes.

Read the Tobacco Policy Prospectus