FDA Commissioner Marty Makary said he resigned in protest against the Trump administration’s push to allow tobacco companies to begin selling fruit-flavored vapes.
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Rich Danker, the chief spokesperson for Health and Human Services Secretary Robert F. Kennedy Jr., resigned this week due to “irreconcilable differences” over the promotion of fruit-flavored e-cigarettes. This resignation follows that of FDA Commissioner Marty Makary, who reportedly left due to disagreements with the Trump administration’s initiative to allow tobacco companies to sell flavored vapes. Both Makary and Danker voiced concerns about potentially increasing addiction among young people, which echoes the stance of the first Trump administration on this issue.
The first and second Trump administrations differ significantly, particularly with some unconventional cabinet selections, including Robert F. Kennedy Jr. as Secretary of Health and Human Services. Despite Kennedy’s unusual leadership style, several top officials at HHS, like FDA Commissioner Makary, have earned respect from the establishment. However, the departures of Makary and Kennedy’s spokesperson indicate not only personnel changes but also a shift in policy regarding vaping and nicotine-containing products between the two Trump administrations.
Makary’s stance against fruit-flavored vapes conflicted with President Trump’s goal to “save vaping.” This marks a significant policy shift from 2019 when Trump and his health officials announced plans to ban most flavored e-cigarettes due to a rise in teen vaping and the need for strong regulations. At that time, the Centers for Disease Control and Prevention advised people to consider refraining from using e-cigarette or vaping products containing nicotine.
Currently, the FDA still prioritizes banning illicit vapes but has recently authorized the sale of the first fruit-flavored e-cigarettes to adults 21 and over. These are meant to provide a smoking cessation alternative for adults wishing to quit. Other long-term options include bupropion and nicotine replacement therapy.
With the exception of traditional cigarettes, the Trump administration has notably eased regulations on nicotine-containing products. This includes e-cigarettes and nicotine pouches, despite potential public health concerns. E-cigarettes are devices that deliver nicotine or other substances through inhalation. Vaping involves inhaling vapor via e-cigarettes or vape pens. Nicotine pouches are small sachets placed between the gum and lip, with nicotine absorbed into the bloodstream. The pouches are considered a harm reduction aid by the FDA for smokers wishing to quit, although many users are not smokers and include a growing number of non-adults. The nicotine content poses potential cardiovascular, oral health, and addiction risks.
The new vape policy has raised concerns from pediatrician groups and advocacy organizations about the potential impact on minors if these products reach them. Critics argue that the flavors could attract youth and expose them to possible nicotine addiction, lung damage, and other health risks. They reference the FDA’s longstanding position that flavors pose a significant risk to young people.
Manufacturers state there are adequate safeguards against youth consumption and that they will not target those under 21. Public health experts view e-cigarettes and nicotine pouches as less harmful alternatives to tobacco-burning cigarettes. A review by Public Health England concluded that vaping is 95% less dangerous than smoking. In the UK, the Royal College of Physicians encourages doctors to promote e-cigarettes to those trying to quit smoking.
However, vaping-related pulmonary illnesses and deaths have been reported, often linked to added substances. For instance, a study found that 87% of patients with vaping-related illnesses had used THC, the psychoactive component in marijuana, from prefilled cartridges bought from informal sources. Another study supports the idea that most vaping-related harms come from inhaled toxic substances.
High-level resignations protesting the Trump administration’s decision to allow fruit-flavored vapes suggest a notable policy shift. It remains to be seen if this approach will extend to other contentious areas, such as the abortion pill mifepristone, where differences of opinion between Makary and administration officials may have existed.
