President Trump’s White House meeting with various interest groups to discuss the teen vaping epidemic yielded lots of contradictory opinions but few conclusions.
“We want to take care of our kids; we’ve got to take care of our kids,” Trump said Friday before the press corps left the room where the meeting was being held.
Trump had the stakeholders at the meeting introduce themselves and make a brief statement at the meeting, which came about a week after press reports suggesting that the White House was backing off of a previous commitment — made public on September 11th — to ban flavored e-cigarettes.
Several healthcare groups represented at the meeting urged the president to keep that commitment. “We’re totally aligned with and supportive of the position you took on September 11,” said Gary Reedy, CEO of the American Cancer Society Cancer Action Network (ACS CAN).
“The children are counting on us,” added Sally Goza, MD, president-elect of the American Academy of Pediatrics (AAP).
A flavor ban also got support from a non-medical corner. “We have half a million members, many of whom are moms, and they’re very concerned,” said Penny Young Nance, CEO and president of Concerned Women for America, a conservative Christian group that tries to bring Biblical principles into all areas of public policy. “We very much support what you put forward in September.”
Opposing Opinions
Christopher Butler, executive director of Americans for Tax Reform, said his organization was “concerned about the public policy implications for adult vapers” when it came to a flavor ban, and added that allowing people a choice of flavors was “also a prerequisite of keeping people in the Liberty Coalition that are necessary to us doing everything we care about on the economy, taxes, and regulatory policy.”
Scott Eley, president of the American E-Liquid Manufacturing Standards Association, which advocates for self-regulation and standard-setting among e-cigarette makers, spoke of the need to maintain high standards in the industry. Trump seemed to agree. “If you don’t have high standards, you can have very dangerous things happen — that’s what’s been happening, right?” he said. “Where people are using devices and other things that are not good.”
Sen. Mitt Romney (R-Utah) also attended the meeting, noting that he and Sen. Jeff Merkley (D-Ore.) have co-sponsored legislation to ban flavored e-cigarettes “so we don’t have kids getting hooked on nicotine products,” Romney said. “We also insist that cartridges are tamper-proof so kids can’t add contaminants to the cartridges.”
Health and Human Services Secretary Alex Azar said the administration was at the meeting to listen to all sides of the issue. “While e-cigarettes can potentially be an off ramp for adults addicted to combustible tobacco, we can all agree that we can’t allow them to become an on-ramp for nicotine and combustible tobacco use by our kids,” he said. However, “the question of how to regulate e-cigarettes is highly complex.”
Menthol Versus Other Flavors
Kentucky state senator Julie Raque Adams (R) said that in her state, “we clearly have a problem with teen smoking, but having access to vaping products is not necessarily the answer.” In addition to getting rid of the flavors, “We shouldn’t have access for any vaping product until 21 years of age,” she added. “The more you introduce nicotine into a kid’s brain, the more it’s been shown they become addicted to other substances, so the longer we can keep nicotine out of the hands of kids, it’s in everyone’s best interest.” Trump seemed interested in this topic, saying that “age is a big factor; I think we have to come up with a hard number at some point.”
President Trump also asked about the idea of getting rid of most e-cigarette flavors — except menthol. “I’ve heard that from a lot of people.” But Reedy disagreed. “I think what we have seen in the data is that if you leave the menthol, then they’ll just start using menthol. So — and what we’ve seen so far is that even when the flavors — some flavors are eliminated, that they’ll still keep on going to anything that’s flavored,” he said. “So that is not the solution.”
On the other hand, Henry Armour, president of the National Association of Convenience Stores, which represents 153,000 stores that sell vaping products, was in favor of keeping the menthol flavor. “If part of the reason why we have vaping is to try and help people that are smokers migrate to a lower-risk product, a third of the smokers are menthol smokers,” he said. “And by eliminating that, I think that cuts off that path.” Instead of banning menthol, he said that “we have to really be very serious about preventing sales of vape products to any minor, and stores need to face the consequences if they do that. I mean, they should get their licenses pulled.”
Armour, whose members employ 2.5 million people, suggested several mechanisms for restricting access to e-cigarettes, including keeping the products behind the counter, restricting sales to those 21 and older, limiting the number of items purchased per transaction, and requiring training programs for employees or reprogramming of point-of-sale terminals.
Hoping for a Positive Outcome
American Vaping Association president Gregory Conley raised questions about the meeting’s anti-vaping participants. “It’s important that you know: Michael Bloomberg, who is no friend to your presidency, he is funding $160 million to try to ban these flavors,” Conley said to Trump. “And many people in this room are the recipients of those monies. So they are not here with the position of ‘We can come to a compromise.’ They have money specifically to get these products banned.”
After the meeting, healthcare groups who attended issued a statement re-enforcing their position.
“We reiterate our strong and united support for the Administration’s plan, announced in September, to clear the market of all flavored e-cigarettes including mint and menthol, and we urge the administration to implement this plan without further delay and without weakening it,” said the statement, which was endorsed by the American Medical Association, the AAP, the American Lung Association, and ACS CAN, among other groups. “There is no time to waste as the youth e-cigarette epidemic continues to get worse and over 5 million kids now use e-cigarettes. The evidence is clear that flavored products have fueled this epidemic as most youth e-cigarette users report using flavored products and cite flavors as a key reason for their use.”
Goza said Monday that she was “a little optimistic” after the meeting. “I think the president and [Azar] heard our concerns; we were very consistent on what we were asking for about the flavors being taken off the market,” she said. “We don’t know what will happen, but I’m optimistic they did hear us and we may get some good things out of the meeting.”
Reedy also seemed cautiously optimistic. “It is clear that President Trump and his administration recognize the gravity of the youth e-cigarette epidemic,” he said in an email to MedPage Today. “It was clear the president was interested in hearing the proposed regulatory approach offered by the American Cancer Society and our public health partners to ensure a new generation of Americans does not become addicted to a lifetime of nicotine and tobacco use.”
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