New regulations giving the U.S. Food and Drug Administration (FDA) oversight of electronic cigarettes, hookah and other new tobacco products took effect in August 2016 – just in time for the new school year.

A 2015 survey by FDA and the U.S. Centers for Disease Control and Prevention (CDC) showed while traditional cigarette smoking declined among teens, e-cigarette and hookah tobacco use increased.

Under the new regulations, retailers are prohibited from:

  • Selling e-cigarettes, hookah tobacco and cigars to anyone under the age of 18 (in person and online, and in vending machines unless it’s in an adults-only facility)
  • Distributing free samples to anyone under the age of 18

Also, retailers must require age verification by photo ID when selling e-cigarette, hookah tobacco and cigar products.

New regulations will help FDA better evaluate e-cigarettes and other tobacco products such as hookah and cigars. Need help on how to quit smoking tobacco? Visit CDC’s Tips From Former Smokers

The new regulations will also help FDA better evaluate ingredients in e-cigarettes and other tobacco products, prevent misleading claims and communicate potential health risks via warnings on product packages and advertisements.

E-cigarettes are battery-powered devices that turn liquid nicotine and other products into a vapor, which is then inhaled. They mimic traditional cigarettes with a glowing light at the tip and come in a variety of flavors, such as menthol to appeal to traditional smokers and bubblegum, cherry and other candy tastes to appeal to young people.

Numerous organizations including the American College of Allergy, Asthma & Immunology (ACAAI) and the American Academy of Pediatrics (AAP) have raised health concerns about e-cigarettes.

E-cigarettes contain additives and chemicals that, according to multiple studies, put “vapers” at increased risk of respiratory viral infections. E-cigarettes also contain formaldehyde, which has long been associated with triggering asthma flares.

The increased use of e-cigarettes by teens “is a real concern, as the addicting nicotine can lead to use of traditional cigarettes in this vulnerable population,” says Mary Martinasek, PhD, RRT, AE-C, assistant professor of public health at The University of Tampa. “Vapors inhaled from e-cigarettes are known to cause respiratory and mouth irritation and impede air flow. They may have a negative health impact on people with asthma or any underlying lung condition.”

Hookahs are water pipes used to smoke specially made tobacco that come in flavors such as apple, mint, chocolate, cappuccino and watermelon. Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person. Because it contains tobacco, hookah has many of the same health risks as traditional cigarettes.

Reviewed by Neil MacIntyre, MD