Kids Drawn to 'Gateway' Flavored Tobacco Products, FDA Finds

Sweet-tasting additives have widespread appeal, expose teens to nicotine

Monday, October 26, 2015

MONDAY, Oct. 26, 2015 (HealthDay News) -- Candy, fruit and other flavorings are hooking America's next generation of nicotine addicts, a new U.S. government study finds.

Among kids aged 12 to 17 who had used tobacco, four out of five said the first product they tried was flavored, whether it was hookah, e-cigarettes, little cigars or smokeless tobacco, U.S. Food and Drug Administration researchers found.

In addition, most current teen tobacco users said that they had indulged in a flavored tobacco product within the past 30 days, according to findings published Oct. 26 in the Journal of the American Medical Association.

"This confirms our worst fears," said Dr. Norman Edelman, senior scientific advisor for the American Lung Association. "Young people are being hooked on tobacco products through the use of flavoring that appeals to them. When you see flavorings like bubble gum in a tobacco product, it's obvious who they're appealing to."

Although flavors other than menthol are prohibited in cigarettes in the United States, flavored non-cigarette tobacco products are widely available and may appeal to youth, according to background information in the article.

In the study, researchers at the FDA's Center for Tobacco Products examined flavored tobacco use among kids using data from the 2013-2014 Population Assessment of Tobacco and Health Study, a nationally representative survey that included 13,651 U.S. teens.

The survey revealed that about 21 percent had used tobacco. About 81 percent of these teens said the first tobacco product they ever tried had been flavored to taste of menthol, mint, clove, spice, candy, fruit, chocolate or some other sweet flavor.

In addition, about 80 percent of kids who'd used tobacco over the past 30 days said they had used a flavored product, the FDA researchers found.

Kids who said they use tobacco "because they come in flavors I like" include about four out of five e-cigarette users and hookah users; nearly three-quarters of cigar users; and more than two-thirds of smokeless tobacco users.

"Flavored tobacco products have become increasingly common in the United States and are especially attractive to youth," said FDA spokesman Michael Felberbaum. "As such, the FDA is particularly interested in monitoring and assessing the use of flavored tobacco products among youth."

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, called the findings "pretty horrifying." He noted tobacco is tremendously addictive for young people.

"These are often the patients who can never walk away from smoking," Horovitz said. "The switch has been turned on at an early age, and it is particularly hard for them to walk away from cigarettes once they've started smoking."

Patricia Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y., agreed.

"For most long-term smokers, just one experience with tobacco can result in addiction," Folan said. "The flavors entice young people to try these tobacco products, exposing them to nicotine, contributing to the development of addiction, and potentially serving as a gateway to conventional cigarette smoking."

In April 2014, the FDA announced its intention to place new regulations on all tobacco products, including e-cigarettes. These regulations could include a prohibition on flavorings, Edelman said.

However, the FDA has not yet laid down final regulations, to the dismay of anti-smoking advocates.

"As the FDA goes through its process of turning its intentions into policies, the American Lung Association strongly supports elimination of the use of all flavorings in all tobacco products," Edelman said. "The announcement that they were in the process of framing the regulations is more than a year old. The American Lung Association very much would like to see something happen."

Folan noted that FDA regulations could also help address other reasons teens gave in this survey for using tobacco products, including affordability, ease of use in public places, and the fact that people in the media use them.

"With stricter tobacco control measures, as we have for conventional cigarettes, teens would be less likely to use these products," Folan said.

SOURCES: Norman Edelman, M.D., senior scientific advisor, American Lung Association; Michael Felberbaum, U.S. Food and Drug Administration spokesman; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Patricia Folan, DNP, director, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, N.Y.; Oct. 26, 2015, Journal of the American Medical Association

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