The US Food & Drug Administration (FDA) is proposing allowing other flavours for e-cigarettes, like mint, coffees, spices or tea, to appeal to adults – this as illicit candy-flavoured types aimed at teenagers continue to flood the market, and as health experts warn of the dangers of vaping, in general, reports The New York Times.
While the decision is seen as a way to placate MAGA voters, it has not pleased anti-vape activists or advocacy groups.
The FDA said last week it would open the door to e-cigarettes in flavours that it deems appealing to adults, shifting from its previous unsuccessful ban on fruit and candy-flavoured versions that have continued to saturate the shelves.
Flavours it has in mind include mint, coffees, teas and spices, possibly like clove or cinnamon, but it would continue to reject those offering sweet or fruity flavours aimed at teenagers.
The country’s vaping policy has been contentious since 2019, when Juul and other flavoured e-cigarette use spiked among high school students and was labelled an epidemic. President Donald Trump banned most flavoured vapes at the end of that year, and since then, surveys have showed a considerable decline in high school vaping.
The White House views vaping as an election issue, with many MAGA voters embracing e-cigarettes and Trump having promised during the campaign season to “save vaping again”. It is unclear if the new policy would please prospective voters, said Mitch Zeller, a former FDA tobacco official.
“If I were the e-cigarette industry, and expecting that this was going to be a new day for the agency’s consideration of candy and fruit and dessert flavoured e-cigarettes, I would be disappointed with this guidance document,” he said.
The new approach did not please public health groups who reviewed the policy either.
“Allowing any flavours on the market benefits only corporations and harms public health,” said Kelsey Romeo-Stuppy, the managing attorney of the public health group Action on Smoking & Health. “That is not a gamble we should be willing to take.”
Luis Pinto, a spokesman for Reynolds American, which sells Vuse vapes through a subsidiary, said the company supported “safer nicotine alternatives” to help adult smokers migrate from cigarettes.
The agency’s new direction for e-cigarettes dovetails with the moves at the White House to shore up support among voters, including vaping adults, as it heads into the midterm elections. Those voters tend to dislike curbs or regulations that limit their choices on many things, including e-cigarettes.
Dr Marty Makary, the FDA’s commissioner, has been working to back Trump’s efforts to cut health costs by easing the path toward approval for more generic or biosimilar drugs.
For months, he has also been developing a new e-cigarette policy that might align with the Trump administration’s goals.
And while he had insisted he wanted to keep e-cigarettes away from young people, he was also straddling ways to appease major tobacco conglomerates and smaller e-cigarette companies.
The FDA regulates electronic cigarettes based on a 2009 tobacco control law that is meant to favour products protecting the broader public health. In practice, that has meant that vape companies applying for authorisation have had to prove that their products will help adult cigarette smokers quit – while also avoid hooking young people.
Products in the new flavours would face the same calculus.
The bar has been hard to clear. The FDA has authorised only a couple of dozen products in tobacco and menthol flavours, mostly made by major players like Altria, Reynolds American and Juul.
Although smaller companies have challenged the FDA’s millions of product rejections, the agency has prevailed up to the Supreme Court. But while the FDA rejected millions of applications, Chinese suppliers have inundated the American market with products in fruit flavours that work like miniature video games or jewellery or school supplies like highlighters or pens.
Illicit vapes dominate about 70% of e-cigarette sales, according to statements made by Altria and Reynolds to investors. Both companies have begun selling oral nicotine pouches that users tuck under their upper lip, which they say are selling fast.
Public health experts have insisted that the FDA must keep vapes away from young people, who face higher odds of addiction to nicotine and are susceptible to chronic respiratory conditions like elevated risks of COPD (chronic obstructive pulmonary disease), according to studies.
The decline among teenagers in e-cigarette or vaping use in the past few years is not reason enough for the FDA to change course, said Ranjana Caple, director of federal advocacy for the American Lung Association.
“We’ve seen this playbook before – tobacco companies once promoted ‘light’ and ‘low tar’ cigarettes to get around health concerns, and it wouldn’t be surprising to see them rebrand or tweak products to fit these new categories,” she said.
Emerging harms health systems can’t ignore
In similar vein, experts further afield have concurred that e-cigarettes, in any form or flavour, should be avoided, warning that although they were hailed as a breakthrough – nicotine delivery minus the toxic tar and combustion by-products of traditional cigarettes – when they first appeared around 2010, things have changed.
Public health bodies cautiously endorsed them as a tool for adult smokers to quit, often citing early claims that vaping was 95% less harmful than smoking, but more than a decade later, with millions now vaping regularly, the picture is less clear, writes Vikram Niranjan, Assistant Professor in Public Health at the University of Limerick, Ireland, in The Conversation.
A recent study published in the American Journal of Physiology: Heart and Circulatory Physiology, found that people who vape or smoke have nearly 50% higher odds of elevated blood pressure than non-users.
This isn’t proof that vaping directly causes high blood pressure – other factors like diet or exercise could play a role – but it adds to a growing body of evidence that vaping’s early reputation for safety deserves a harder look.
The science behind the concern isn’t complicated. Nicotine in e-cigarette vapour triggers immediate spikes in heart rate and blood pressure. The flavourings and other chemicals can damage the lining of blood vessels, the tissue that prevents clotting and keeps blood flowing smoothly.
Research reviews have found elevated rates of heart attack among vapers, particularly among those who also still smoke traditional cigarettes.
The lungs tell a similarly worrying story. A 2022 study comparing vapers, smokers and non-users found that vapers had measurably reduced lung function, even after accounting for any previous smoking history, as well as higher rates of wheezing, coughing and bronchitis-like symptoms.
Further research from 2023-2025 links vaping to increased airway resistance and asthma flare-ups, with some effects persisting well beyond a single vaping session.
Perhaps the most urgent concern is what has happened among young people. The World Health Organisation now describes e-cigarettes as “harmful and not safe”, warning of a new wave of nicotine addiction among teenagers who never smoked in the first place – and who are three times more likely to go on to smoke traditional cigarettes as a result.
Large surveys have linked regular vaping in young people to depression, anxiety and suicidal thoughts, with nicotine’s known effects on the developing brain almost certainly playing a role.
Supporters of vaping argue that its risks are acceptable if it helps established smokers quit, and there is something to this. A 2024 review by Ireland’s Health Research Board found that e-cigarettes do help some adults stop smoking, particularly when combined with behavioural support.
But many people who vape to quit end up doing both, vaping and smoking, which means they are still exposed to tobacco’s most harmful chemicals. And the evidence for traditional nicotine replacement therapies such as patches and gum, backed by decades of clinical trials, remains stronger.
We don’t yet have human data confirming that vaping causes cancer. But this reflects how new the habit is rather than how safe it is. A review of laboratory studies shows that e-cigarette vapour causes DNA damage and cell death in ways that look uncomfortably familiar to early tobacco research – research that preceded the smoking-related cancer epidemic by two or three decades.
Safer not the same as safe
The original message – that vaping is far safer than smoking, and a reasonable tool for quitting – made sense at a time when tobacco was killing enormous numbers of people. But “safer than smoking” is not the same as safe, and that distinction matters enormously when teenagers are interpreting the message as permission to start.
We’ve tasted the bitter waters of tobacco, where delayed action fuelled generations of disease. To fix smoking, we’re now engineering a “solution” that could spawn tomorrow’s crises – akin to ditching petrol cars for electric vehicles to slash emissions, only to grapple with toxic lithium battery e-waste mountains clogging landfills and supply chains.
Both trades address one urgent harm while blindsiding us to downstream perils: leaching chemicals, recycling nightmares and resource wars. With vaping, signals of cardiovascular strain, lung irritation, youth gateways and addiction are flashing red, even if full epidemics lie years ahead.
The sensible conclusion is not complicated. If you have never smoked, don’t vape. If you do smoke and want to quit, patches, gum, medication and proper support remain the best-evidenced options. Vaping may have a role as a short-term bridge – but not as a permanent habit, and not for anyone who wouldn’t otherwise have been a smoker.
The warning signs are there. The question is whether we act on them before the long-term consequences become impossible to ignore.
Vikram Niranjan – Assistant Professor in Public Health, School of Medicine, Health Research Institute, University of Limerick
The New York Times article – F.D.A. Opens Door to More Flavored E-Cigarettes
See more from MedicalBrief archives:
Supreme Court rules for FDA in flavoured vapes dispute
Millions of children vaping, fuelling new wave of nicotine addiction – WHO
Vaping scourge among children prompts long-term health effects study
Judge approves multi-million dollar class action settlement against vaping giant