Hawaii Youth Tobacco Survey Shows Folly of FDA's Current Approach to Tobacco Control

The Hawaii Department of Health has released the results of its 2011 Youth Tobacco Survey. The results have profound implications for a number of current approaches that FDA, and many anti-smoking groups nationally are taking towards controlling tobacco use among youth.

Among the current approaches being taken by the FDA are the following:

1. Regulating the sale of tobacco to minors

The FDA summarizes its efforts as follows:

"FDA is issuing a final rule that contains a broad set of federal requirements designed to significantly curb access to and the appeal of cigarettes and smokeless tobacco products to children and adolescents in the United States. The new rule became effective on June 22, 2010, and has the force and effect of law. Among other things, the rule:

• Prohibits the sale of cigarettes or smokeless tobacco to people
  younger than 18,
• Prohibits the sale of cigarette packages with less than 20 cigarettes,
• Prohibits distribution of free samples of cigarettes."

The key regulations are as follows:

"Age and ID (21 CFR 1140.14, Additional Responsibilities of retailers) 

1. Cigarettes and smokeless tobacco may not be sold to anyone younger than 18 years of age;

2. Retailers must examine a photographic identification bearing the person’s birth date to verify that any person purchasing cigarettes or smokeless tobacco is at least 18 years old. Verification is not required for purchasers who are over the age of 26. 

Packaged or Unpackaged Cigarettes or Smokeless Tobacco (21 CFR 1140.14, Additional Responsibilities of retailers) 

1. Retailers may not sell single cigarettes or packages containing fewer than 20 cigarettes, except in vending machines located in facilities where the retailer ensures that no person younger than 18 years of age is permitted to enter at any time;

2. Retailers may not sell unpackaged smokeless tobacco or packages of smokeless tobacco that are smaller than packages distributed by the manufacturer for individual use;

3. Cigarettes and smokeless tobacco may not be sold through vending machines or self-service displays, except in facilities where persons under the age of 18 are prohibited from entering."

2. Banning the sale of flavored cigarettes

The FDA has banned the sale of cigarettes of which banana, strawberry, cherry, pineapple, kiwi, melon, lemon, or any other fruit or candy (other than menthol) is the characterizing flavor.

3. Scrutinizing the marketing and production of dissolvable tobacco products such as orbs and strips because of concern over youth use of these products

The FDA has placed a focus on the potential use of dissolvable tobacco products by youth and has spent hours and hours deliberating on the topic.

The Rest of the Story

Let's examine the light that the new Hawaii data shed on each of these three major approaches to the prevention of smoking by youth.

1. Regulating the sale of tobacco to minors

The FDA is pouring millions of dollars into reducing youth access to tobacco by restricting the sale of tobacco products to youth in stores, requiring ID checks, conducting compliance checks, requiring retailer training, etc.

But according to the Hawaii Youth Tobacco Survey, only a miniscule fraction of youth smokers obtain their cigarettes by purchasing them. In 2009, prior to the law, only 1.3% of middle school smokers and 5.7% of high school smokers in Hawaii obtained their cigarettes by purchasing them. Very few smokers obtained their cigarettes through vending machines (0.0% of middle school smokers and 3.0% of high school smokers).

Thus, the FDA's regulations and enforcement of youth access restrictions will do nothing to lower smoking rates! It is an utter waste of time, money, and resources. It is not going to "save countless lives" and it is not going to "protect kids from addiction." This aspect of federal tobacco policy has accomplished nothing.

2. Banning the sale of flavored cigarettes

The Hawaii Youth Tobacco Survey provides strong evidence that prior to the Family Smoking Prevention and Tobacco Control Act, youth smokers were in fact primarily using flavored cigarettes. They were using menthol cigarettes. An overwhelming majority - 78.4% - of youth smokers used menthol cigarettes as their usual brand. Sadly, this is the one flavored cigarette that was not banned by the Tobacco Act. There is no evidence that Hawaii youth were smoking banana, strawberry, cherry, pineapple, kiwi, melon, lemon, or any other fruit- or candy-flavored cigarettes, other than menthol.

Thus, the FDA's regulations and enforcement of flavored cigarette restrictions has done nothing to lower smoking rates! It is an utter waste of time, money, and resources. It is not going to "save countless lives" and it is not going to "protect kids from addiction." This aspect of federal tobacco policy has accomplished nothing.

3. Scrutinizing the marketing and production of dissolvable tobacco products such as orbs and strips because of concern over youth use of these products

The Hawaii Youth Tobacco Survey revealed that almost no youth in the state are using dissolvable tobacco products. In 2011, only 0.4% of high school students reported using orbs, only 0.7% reported using sticks, and only 0.1% reported using strips.

Once again, the FDA's efforts in this area have been a waste of time and will accomplish nothing in terms of reducing tobacco use among youth.

It is also of interest to note that in 2011, the number of youth reporting obtaining their cigarettes from pharmacies was so low that it was not reportable. This demonstrates the absurdity of the belief that banning the sale of cigarettes in pharmacies will have any effect on youth smoking rates.

The rest of the story is that when one examines the actual data, one sees a complete discrepancy between those data and the cornerstones of federal and national tobacco policy. What once was an evidence-based movement has deteriorated into a movement that is largely driven by political, economic, and ideological concerns, not pure public health concerns.