Chris Hansen, ACS CAN President

ACS CAN President Lisa Lacasse shares her views on the impact of advocacy on the cancer fight.


A Decade After FDA Authorized to Regulate Tobacco, the Epidemic Rages On

June 27, 2019

It’s been ten years. Ten years since the Food and Drug Administration (FDA) was given the mandate from Congress to fully regulate the tobacco industry and tasked with the critical responsibility of protecting the health of our nation. And still, the FDA has not fulfilled its mission to reduce the deadly toll of tobacco use, an epidemic that persists in our country and around the world. Tobacco use is the leading cause of preventable death in our nation, and according to a U.S. Surgeon General report, more than 20 million premature deaths over the past half century can be attributed to cigarette use in the U.S. We cannot achieve our mission of ending death and suffering from cancer without significantly driving down tobacco use.

Signed into law by President Obama in June 2009, the Family Smoking Prevention and Tobacco Control Act (TCA) was a milestone piece of legislation in our fight against the major public health epidemic of tobacco use. The TCA granted the FDA the authority to regulate the manufacturing, marketing and distribution of tobacco products and created the Center for Tobacco Products. Prior to the law, tobacco products went largely unregulated, boosting Big Tobacco’s profits and its ability to mislead the public about the danger of its products and to target youth and other vulnerable populations with its marketing. This landmark law represented an unprecedented opportunity for the FDA to directly address tobacco use, the leading cause of preventable death in our country.

Certainly, the FDA has taken deliberate action in the past 10 years to address tobacco addiction, including:

  • Implementing several phases of “The Real Cost” prevention campaign aimed at reducing the number of youth who experiment with cigarettes, smokeless tobacco and, most recently, e-cigarettes. It is estimated that these successful campaigns prevented 350,000 teens ages 11 to 18 from smoking between 2014 and 2016.
  • Issuing a final rule in 2016 deeming all categories of tobacco products, including cigars, e-cigarettes and hookah, under its authority. To ensure the tobacco industry can’t skirt regulation with new and emerging products like e-cigarettes, it was critical that the FDA extended its authority over all products, with no exceptions.
  • Taking steps to implement meaningful regulation of the tobacco industry and its dangerous products, including prohibiting menthol flavoring in combustible cigarettes and flavors in cigars, restricting the sale of some flavored e-cigarettes to age-restricted locations; and issuing a proposed rule to reduce nicotine levels in cigarettes to levels that no longer cause addiction.

And we have seen results. The number of young adults aged 18 to 24 years who smoked combustible cigarettes dropped from 13 percent in 2016 to 10 percent in 2018. However, despite these discrete steps, nearly one-third of cancer deaths in the U.S. are still caused by smoking. And more alarmingly, E-cigarette use has increased by 78 percent from 2017 to 2018, and previous declines in other tobacco product use has stalled. In the same timeframe, an additional 1.3 million and high school students became new tobacco product users. These surging rates in youth use of e-cigarettes are very alarming.  There’s simply no denying that more work needs to be done to make sure that our children do not succumb to nicotine addiction and tobacco use. Ultimately, the FDA is responsible for protecting the nation from the dangers of tobacco and must do much more protect the lives of the American public.

For the past 10 years ACS CAN and our partners have continually urged the FDA to exercise its full regulatory authority.

  • ACS CAN and several partner organizations sued the FDA in March 2018 for allowing e-cigarettes and other new tobacco products to remain on the market for years without review of their public health impact. A federal judge ruled in our favor earlier this month, deciding that the FDA had acted illegally by delaying review of these products, which allowed the tobacco industry to continue targeting youth with their addictive products, at a time – as the judge noted – “when minors’ use of tobacco products like e-cigarettes is at an epidemic level and rising.”
  • In a separate lawsuit, a federal judge ruled in our favor that the FDA must expedite a rule requiring graphic warnings on cigarette packages and advertisements, a key provision of the TCA. We continue to press the FDA to issue the final rule by January 2020.
  • We urged the FDA to take strong, immediate action to address the rise of teen use of Juul e-cigarettes, including removing any Juul flavors on the market without required FDA review and authorization and suspending internet sales of Juul until stronger rules are established to prevent sales to kids.

It’s been ten years since Congress passed the monumental Family Smoking Prevention and Tobacco Control Act and it is unacceptable that an entirely new generation is falling victim to Big Tobacco as we witness a public health epidemic evolve before our eyes. The FDA must, once and for all, exercise its full regulatory authority over all tobacco products and take concerted, comprehensive measures to protect this nation’s children from Big Tobacco.