The U.S. Food and Drug Administration (FDA) recently announced that it is considering restrictions on the sale and distribution of flavored tobacco products, and called upon stakeholders to share data, research and information on the role that flavors – including menthol – play in initiation, use and cessation of tobacco products, including e-cigarettes.

The California Medical Association (CMA) has long recognized that tobacco use is a costly habit that often leads to illness and poor health. Despite decades of policies and education about tobacco’s deadly toll, however, new and novel candy-flavored products that appeal to young people (and that are falsely thought to be healthier) have led to an uptick in people starting smoking and in continued use among established smokers.

Flavored and menthol tobacco products are “starter” products that establish daily habits and increase addiction to tobacco products, make it harder to quit and increase use of multiple tobacco products concurrently.

Snuff, hookah and liquid nicotine solution are just a few of the substances on the market that contain tobacco and tobacco-derived nicotine, but are not subject to the same strict flavor restrictions as traditional cigarettes. Notably, these products are sold in a variety of flavors and bright packaging which, complemented by targeted advertisements, appeal to youth, certain ethnic minorities and other priority populations. CMA submitted comments urging the FDA to weigh these concerns as it moves forward with possible regulatory action.

In 2016, CMA produced a white paper that assessed evidence and research on the impact of flavored and mentholated tobacco products on public health, particularly among priority populations. The white paper found that populations disproportionately targeted by tobacco company marketing tactics are particularly vulnerable to sweet flavors and menthol, and are largely driving this increased uptake and sustained use of flavored tobacco products. The paper was prepared by CMA and reviewed by its Council on Science and Public Health, a panel of physician experts, with input from subject matter researchers.

For more information, see CMA’s white paper: “Flavored and Mentholated Tobacco Products: Enticing a New Generation of Users.”