Teen temptations beware: MAHA-era FDA gives vapes, tanning beds a boost

Driving the news: The FDA handed the vaping industry two wins in May: authorizing its first fruit-flavored vaping products for adults, a decision opposed by the American Academy of Pediatrics, and signaling it won't prioritize enforcement against some unauthorized products.

• Former FDA commissioner Marty Makary reportedly resisted approving flavored vapes before reversing course under White House pressure. His resistance reportedly contributed to his ouster.
• Rich Danker, Health Secretary Robert F. Kennedy Jr.'s chief spokesperson, resigned in protest over the decision Wednesday, according to a letter obtained by the New York Times.
• Reached for comment, Health and Human Services referred Axios to the FDA's press release.

What they're saying: Mitch Zeller, who led the FDA's Center for Tobacco Products from 2013 to 2022, tells Axios the company that won authorization appear to have strong age verification and that the agency concluded there was evidence of a public health benefit, though he has yet to see the details.

• But possible political interference in the process concerned him — as did new guidance outlining when the FDA does and doesn't intend to enforce rules.

Context: In new guidance, the FDA said it won't prioritize enforcement against certain vapes and nicotine pouches that have applied for authorization but have yet to complete review, citing a lack of resources and saying it is "focusing on the most deceptive and dangerous products."

• "This is a get-out-of-jail-free card for companies that have broken the law and have not waited for FDA to complete their scientific review," Zeller says. Those products could line the shelves alongside authorized ones, confusing consumers.
• He continues: "I think it was a misguided, wrongheaded policy that both was illegal from a process standpoint and just substantively flawed."

What they're saying: FDA decisions shape young people's perceptions of a product's safety, says Bonnie Halpern-Felsher, a Stanford University pediatrics professor.

• "If you tell them that the FDA had a role in approving or disapproving something, they wake up and pay attention to that," says Halpern-Felsher, who also founded the university's REACH Lab to reduce adolescent substance use and risky behavior.
• She adds: "We're absolutely going backwards."

Zoom out: The vaping changes are part of a broader pattern that opponents warn could put young people at risk, from overhauling the childhood vaccine schedule to walking away from a proposed ban on kids using sunlamp products, like tanning beds.

• In March, the FDA yanked a decade-old proposal to ban minors from tanning beds, which a recent study tied to a nearly threefold increase in melanoma risk.
• The FDA wants "to reassess how best to address the issues it raised, including how to balance public health considerations with consumer access and choice," HHS said.
• "Withdrawal of the proposed rule does not change the established science on UV exposure."

Hunter Shain, a dermatology professor at UC San Francisco, tells Axios that "childhood is a uniquely vulnerable window" for skin damage.

• "By the same logic that we have a drinking age and a smoking age, it seems like we could and should have a ban for minors regarding the usage of tanning beds," he says, "because there really is no strong use case for why minors ever need to use tanning beds."

The bottom line: Zeller says he hopes this moment does not signal a retreat from protecting young people and that Makary's departure brings an opportunity to "restart the public health clock."

• But he emphasizes, "There's a tremendous unknown."

Go deeper: DMV schools install vape detectors amid national crackdown