Truth Initiative® is dedicated to achieving a culture where all youth and young adults reject tobacco. As we actively pursue our vision of a future where tobacco is a thing of the past, we recognize two important factors.

First, combustible tobacco products are responsible for the overwhelming majority of the toll of death and disease caused by tobacco. Second, some tobacco users may be unable or unwilling to quit using combustible products.

As we continue to work toward our ultimate goal, we endorse the important public health strategy of harm minimization — where those who cannot or will not quit combustible tobacco use, switch completely to the exclusive use of regulated, least-harmful, non-combustible products. Regulated e-cigarettes may fall into this category.

Therefore, we support the following policies with regard to e-cigarettes:

  • Given their particular vulnerability to nicotine, there is no appropriate use of tobacco or nicotine-containing products by youth — including e-cigarettes.
  • FDA must expeditiously undertake premarket review for e-cigarettes. This is necessary because e-cigarettes vary widely in quality and nicotine delivery, causing confusion for consumers trying to switch from cigarettes to a less harmful product.  Regulation would both ensure the effectiveness of e-cigarettes as devices that may help facilitate complete switching from cigarettes for adult smokers and protect youth from tobacco and nicotine use.
  • Manufacturing requirements that ensure all e-cigarettes:
    • Deliver nicotine as indicated on product packaging
    • Are free of hazardous constituents
    • Are manufactured consistently to high quality standards
  • FDA must issue product standards eliminating flavors from all tobacco products. A narrow exception may apply to proven harm-minimized products where a manufacturer can demonstrate that the flavored product helps smokers completely switch from combustible tobacco to the harm-minimized product and show that it does not appeal to or attract youth (verified with careful post-market surveillance of actual usage patterns).
  • Restrict e-cigarette marketing so that it does not target or appeal to youth.
  • Limit sales of all e-cigarette products and their components to those aged 21 or older.
  • Prohibit Internet and other non-face-to-face sales of e-cigarettes.
  • Require e-cigarette use to be subject to clean indoor air laws and requirements.
  • Set taxes proportional to the harms of each type of tobacco product to discourage use of the most harmful products. Combusted tobacco products should be taxed at the highest levels, and the least harmful, non-combusted tobacco products should be taxed at lower levels.