Restrictions on the marketing and sale of e-cigarettes in the United States are now uniform. No matter where you live, vape pens cannot be sold or given away to anyone under the age of 18.

The regulations are among new rules from the Food and Drug Administration (FDA) designed to keep previously unregulated tobacco products out of the hands of teenagers. In addition to e-cigarettes, the new regulations include cigars, hookah tobacco and pipe tobacco. The FDA already has authority over cigarettes, roll-your-own tobacco and smokeless tobacco products.

According to the Centers for Disease Control and Prevention (CDC), smoking is the leading cause of preventable disease and death in the United States. The number of people smoking continues to decline (42 percent of Americans were smokers in 1965 compared to 17 percent in 2014) but the habit is still responsible for 480,000 deaths per year. In addition, more than 16 million Americans have smoking-related diseases that cost more than $170 billion annually to treat.

LHSFNA Management Co-Chairman Noel C. Borck

The new regulations, years in the making, come amid surging popularity of e-cigarettes. Like the other previously unregulated tobacco products, e-cigarettes are often promoted as being safer than traditional cigarettes. U.S. sales of the battery-operated devices reached $1.5 billion in 2014 and are expected to increase annually by more than 24 percent through 2018.

Adults are also driving sales of e-cigarettes and other tobacco products, but teenagers are the focus of the new rules, as they are at the age when tobacco use typically starts. One in four high school students and one in 13 middle school students reported being tobacco users in 2015. Three million middle and high school students used e-cigarettes, 1.4 million used cigarettes or cigars and 1.2 million used hookahs.

“A whole new generation is being introduced and becoming addicted to nicotine through what, until now, has been easy access to these products,” says LHSFNA Management Co-Chairman Noel C. Borck. “Restricting sales and marketing is a step in the right direction in protecting the health of young people and the nation’s health in general.”

The new regulations will be implemented in stages, with the restrictions on youth access effective August 8, 2016. They include:

• No tobacco products sold to persons under the age of 18 unless state and local jurisdictions dictate higher limits (In Hawaii, California and at least 145 localities in 11 other states, the legal age is 21)
• Requiring age verification by photo ID
• No selling of tobacco products in vending machines (unless in an adult-only facility)
• No free samples

The legislation also requires that within two years, all tobacco products will carry warning labels that they contain nicotine, which is highly addictive. In addition, manufacturers of e-cigarettes and tobacco products introduced after February 2007 must submit applications to the FDA, allowing the agency to review product ingredients for health risks.

The American Public Health Association (APHA) said the FDA regulations are “an important first step” in eliminating the youth tobacco market, but that more needs to be done, particularly with e-cigarettes. The age restriction will be difficult to enforce in online sales and liquid nicotine can continue to be sold in flavors designed to attract young people, like “cotton candy” and “gummy bears.”

“We know kids will remain exposed to nicotine and tobacco products,” said Dr. Georges Benjamin, executive director of the APHA. “We’ve still got a long way to go to end tobacco’s destructive impact in our country.”

[Janet Lubman Rathner]