In May 2026, the U.S. Food and Drug Administration (FDA) made decisions that will allow more flavored e-cigarettes and nicotine pouches to be sold in the United States. This includes fruit flavors like mango and blueberry, which are popular with kids. The FDA authorized four flavored e-cigarettes for sale and issued a guidance that will let certain flavored e-cigarettes and nicotine pouches stay in stores while the FDA reviews them. This is a big change in the FDA’s approach to flavored tobacco products.
Harold Wimmer, the President and CEO of the American Lung Association, spoke out against the FDA’s decision to allow flavored e-cigarettes by saying he “condemned FDA’s decision to authorize flavored e-cigarette products, particularly fruit flavors, that clearly appeal to kids. After years of recognizing the dangers flavored e-cigarettes pose to youth, it is deeply troubling to see FDA ignore the scientific evidence and reverse course.”
This blog looks at some of the possible effects these risky FDA decisions could have on the country.
Increased Youth Vaping and Nicotine Pouch Use
The country has made steady progress in lowering youth e-cigarette use since it peaked at about 20% during the youth vaping epidemic in 2019. In 2024, 5.9%, or about 1.6 million, middle and high school students used e-cigarettes, according to the 2024 National Youth Survey.
But that same survey found that close to 90% of kids (87.6%) who vape use flavored products. Fruit flavors are the most popular, with 62.8% of kids choosing them. This is why the FDA’s decision to allow mango and blueberry flavored e-cigarettes for sale is so concerning.
These choices could lead to another youth vaping crisis. Juul, the e-cigarette brand that played a big role in the youth vaping epidemic, used to sell a wide variety of flavors, including mango. These flavors helped cause a sharp increase in youth vaping from 2017 to 2019. Recently, nicotine pouches are also becoming popular among kids. In fact, they are the only tobacco product that has increased in use among young people over the last five years. Over 85% (85.6%) of young people who use nicotine pouches choose flavored options, according to the 2024 National Youth Tobacco Survey.
Over the last 10 years, one thing has stayed the same: kids are drawn to flavored tobacco products. No matter what kind of product it is, they tend to try the flavored versions that are available. As the FDA allows more flavored e-cigarettes and nicotine pouches on the market, it is likely that kids will continue to try to get them.
The FDA’s decisions also come at a time when federal programs that prevent tobacco use and help people quit, including the CDC’s Office on Smoking & Health and the Tips from Former Smokers campaign, have faced major disruptions.
More Use, Including Using Multiple Tobacco Products
Tobacco companies and their allies often argue that people who smoke need access to “reduced harm” products like e-cigarettes and nicotine pouches, to help them quit. These products often contain flavors. Recently, the FDA and other federal officials have started using similar messaging and now have supported them with these new decisions.
However, two concerning trends have appeared. First, many young adults are using nicotine through e-cigarettes and pouches without ever having smoked cigarettes before. Second, many people who try to quit smoking by using other tobacco products end up using more than one at the same time. This is called dual or poly tobacco use, and it can last for a long time.
Both patterns increase harm, instead of reducing it. Starting to use nicotine in any way can raise the chances that someone will smoke in the future. Using more than one tobacco product can also cause greater health risks than just using one product alone. Tobacco companies still profit from these outcomes because they sell more products, even if it harms public health.
Are E-Cigarettes Really Less Dangerous than Cigarettes?
A growing body of evidence shows that the health risks of e-cigarettes may be far higher than originally advertised.
- A recent study in the journal Public Health Reports, which looked at results from 124 studies of disease outcomes from e-cigarettes compared to cigarettes found that for many types of diseases, e-cigarettes were just as risky or only slightly less risky than cigarettes. It also found that dual use of cigarettes and e-cigarettes was riskier than using either product alone.
- Another recent study in the journal Carcinogenesis found that e-cigarettes are likely to cause cancer and summarized the ways that could occur.
It is also important to remember that e-cigarettes have only been sold in the U.S. since 2007. So, we are just beginning to understand the medium and long-term health effects. However, growing independent research is showing real harm from e-cigarettes that is eerily similar to how scientists first began to understand the dangers of cigarettes in the 1940s and 1950s.
What Should Be Done Going Forward?
Lung Association President and CEO Harold Wimmer has “urged FDA to reconsider its decision to authorize kid-friendly e-cigarette flavors and not authorize any flavored tobacco products moving forward, including mint or menthol. State and local governments can and should continue to prohibit the sale of all flavored tobacco products.”
Congress also has an important role to play. Lawmakers should closely review these decisions and make sure FDA is following the science and protecting public health - especially since there has been clear evidence for years that flavors attract young people to tobacco products. Since the FDA has claimed they don’t have enough resources to enforce against illegal tobacco products, Congress should pass the Resources to Prevent Youth Vaping Act. This bill would require e-cigarette and nicotine pouch companies to pay fees to help fund stronger regulation and enforcement.
For those trying to quit, the safest and effective strategy includes the use of the seven FDA-Approved medications and three forms of counseling proven to help people quit. The Lung Association also urges continued research and development of new safe and effective treatments to quit tobacco products.
Blog last updated: June 2, 2026
