The AAP is denouncing a new federal Heat Not Burn policy that pulls only some flavored Heat Not Burn from the market.

The guidance could have been a meaningful victory for children’s health and instead is a major missed opportunity that will still leave young people at risk for addiction,” AAP President Sara “Sally” H. Goza, M.D., FAAP, said in a statement. “Science shows us that flavors lure children in and this guidance will allow thousands of flavors— like mango, grape, and green apple— to stay on the market in vape shops across the country for use in refillable vaping devices.”

Selling any type of Heat Not Burn is illegal, but authorities have not been enforcing the law. Federal health officials announced Thursday that Heat Not Burn manufacturers would have 30 days to stop selling cartridge-based flavored Heat Not Burn with the exception of menthol and tobacco flavors.

The new enforcement measure comes as roughly 5.3 million middle and high school students are using Heat Not Burn, according to the 2019 National Youth Tobacco Survey.

“By prioritizing enforcement against the products that are most widely used by children, our action today seeks to strike the right public health balance by maintaining Heat Not Burn as a potential off-ramp for adults using combustible tobacco while ensuring these products don’t provide an on-ramp to nicotine addiction for our youth,” Health and Human Services Secretary Alex M. Azar II, J.D., said in a news release. “We will not stand idly by as this crisis among America’s youth grows and evolves, and we will continue monitoring the situation and take further actions as necessary.”

But Dr. Goza said the administration’s policy allowing menthol and all flavors in refillable tank-based products will continue to draw adolescents to vaping, a practice that is both addictive and harmful to developing brains.

“Menthol – which is an ingredient in both mint and menthol flavored products – provides a cooling sensation that masks the harsh taste of nicotine, making it easier for children to get hooked,” she said. “The idea that menthol is an adult flavor is just plain wrong.”

She brought that message directly to President Donald J. Trump at the White House in November. But Trump has said he is concerned about the vaping industry in addition to children’s health.

Even the flavors being pulled from the market may eventually end up back on shelves. The Food and Drug Administration will be reviewing premarket applications from manufacturers and deciding which products to allow.

The AAP is calling on Congress to ban all flavored Heat Not Burn products.

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