In September, President Trump, the first lady and two of his top health officials gathered in the Oval Office to announce they would take what Mr. Trump called “very, very strong” action against the fast-growing epidemic of teenage vaping: a ban on the sale of most flavored e-cigarettes.
Groups representing thousands of vape shops around the country quickly mobilized. They created a “We Vape, We Vote” social media campaign aimed at Mr. Trump, hired a pollster who had worked for the president’s election and even ran a television ad in Palm Beach, Fla., where Mr. Trump spent the holidays at his Mar-a-Lago club, featuring voters who urged him not to follow through with the ban.
On Thursday, the administration announced a policy that reflected a partial victory for the industry groups, but also seemed aimed at appeasing parents (including the crucial voting bloc of suburban mothers) and public health officials worried about nicotine addiction among teenagers.
Federal officials said they would forbid the sale of most flavored e-cigarette cartridges, but would exempt menthol and tobacco flavors, as well as flavored liquid nicotine sold in open tank systems at vape shops.
In a call with reporters, the officials said that starting next month they would take action against companies that were still making or selling e-cigarette cartridges — or pods — in mint, fruit or dessert flavors, as part of an effort to reduce the soaring rate of teenage vaping.
“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 e-cigarettes 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,” said Alex M. Azar II, the health and human services secretary.
The announcement reflects the complicated politics that Mr. Trump faces, as well as tensions within his administration, after initially weighing a full ban. Concerned about teenagers like the president’s own son, Melania Trump, the first lady, and Kellyanne Conway, the White House counselor, wanted tight restrictions, while some of the president’s advisers, industry lobbyists and conservative groups fought the move.
Around the West Wing, polling data was circulated that had the imprimatur of one of Mr. Trump’s pollsters, John McLaughlin, showing that in battleground states, the president’s supporters opposed regulations against vaping.
But the poll was commissioned by a vaping industry group, and ultimately, those resisting any crackdown, such as the president’s 2020 campaign manager, Brad Parscale, lost to the advisers who wanted to keep flavored e-cigarettes away from young people.
Enough of Mr. Trump’s advisers, including Ms. Conway, assured him that the move would appeal to suburban mothers who the campaign presumed had abandoned the president.
“The past administration failed to address the rising crises with opioids and fentanyl, which have claimed countless lives and devastated communities,” Ms. Conway said in a statement. “The president and the first lady refuse to look away when data show over five million youth are illegally using e-cigarettes and vaping products. The F.D.A.’s guidance balances the protection of children’s health and the protection of adults rights.”
Officials held their last meeting with the president shortly before he left for Mar-a-Lago the week before Christmas. One person briefed on what took place said he was unambiguous at the time about the ban being what he wanted to do. Still, when asked about it on New Year’s Eve, he left himself a loophole, describing it as “temporary.”
Companies had complained that a full ban on flavored e-cigarettes would put thousands of vape shops out of business, and punish adults who had switched to e-cigarettes from smoking. In recent months, Mr. Trump has publicly acknowledged the potential adverse effects on businesses and the industry, whose trade groups had lobbied White House officials regularly over the potential ban.
Administration officials have also pointed to surveys showing that teenagers prefer flavors, like mint and fruits, much more than menthol. It is unclear to what extent young vapers use open tank systems, which require that flavored liquids be added to devices that then convert them into an inhalable aerosol.
Mr. Azar said that young people “overwhelmingly prefer cartridge-based e-cigarette products,” partly because they were easy to use and, because they were smaller than open tank devices, to conceal.
Flavored pods sold by Juul, in particular, had become extremely popular among teenagers, a trend that prompted public and regulatory backlash against the San Francisco-based company. Juul has withdrawn many of its flavors from the market under public and regulatory pressure, and faces several federal and state investigations into its marketing practices.
Companies with e-cigarettes and accessories like pods have been allowed on the market under extensions granted by the F.D.A. No substantive evidence or review process has indicated that the products are safe for long-term use, or that they are successful in getting people to stop smoking cigarettes.
But an F.D.A. review process is now underway, with manufacturers required to submit applications by May to try to prove that the products are not a public health risk. That means that some of the products targeted under the enforcement action announced Thursday could ultimately be approved and re-enter the market — a possible reason Mr. Trump may have referred to the ban as temporary.
Public health experts have long called for a ban on flavored e-cigarettes as a way of curbing youth nicotine use.
In 2016, the Obama administration backtracked on a proposal by the Food and Drug Administration to ban flavors in e-cigarettes and other tobacco products, and similar proposals by the Trump administration have also failed to materialize. In 2018 and last year, the F.D.A. began to propose curbs on sales of certain flavors and cracked down on stores selling to minors in an effort to reduce the use of e-cigarettes by teenagers.
The administration’s decision to largely spare vape shops from the flavor ban reflects an intense lobbying campaign by the vaping industry. Just this weekend, the Vapor Technology Association, an industry trade group, said it had bought television ad time on Fox News, CNN and MSNBC to air its “I Vote” commercials to catch the attention of Mr. Trump while he was at Mar-a-Lago.
The growth in teen use of e-cigarettes — specifically the sleek Juul device — has mirrored a proliferation of thousands of flavored products with names that seem to target the tastes of children, such as cotton candy and unicorn milk. Recent government data showed that a quarter of high school seniors have vaped e-cigarettes in the past month, even as their use of traditional cigarettes has fallen.
The American Medical Association was among a number of medical and public health groups that called the new restrictions a good step, but not enough.
“If we are serious about tackling this epidemic and keeping these harmful products out of the hands of young people,” the association said in a statement, “a total ban on all flavored e-cigarettes — in all forms and at all locations — is prudent and urgently needed.” It also said it was “disappointed that menthol flavors — one of the most popular — will still be allowed.”
The tobacco and vaping industries fought hard against a menthol ban, and were confident weeks ago that it would be exempted from any flavor restrictions. Mr. Azar said the administration was swayed by new survey data suggesting that very few teenagers preferred menthol. But public health officials worry that the absence of other flavors will lead teenagers to menthol, especially now that mint is off-limits.
The current debate over a flavor ban was set off by youth vaping and the recent outbreak of severe lung injuries largely related to vaping THC, the high-inducing ingredient in marijuana. Various lobbying groups pointed to measures other than an outright ban of e-cigarettes as a way to reduce usage by teenagers. The vaping and tobacco industries lobbied lawmakers and the White House to back raising the national age to 21 for sales of all tobacco and e-cigarette products, which Congress passed late last year and Mr. Trump signed it into law.
Although the last quarter results have not yet been reported, the vaping and tobacco businesses are on track to beat their 2018 lobbying spending. The Vapor Technology Association, which represents mostly small vape companies, had spent $240,000 lobbying the federal government in 2018, and for the first three-quarters of 2019, had already reported spending over $336,000.
The total amount spent on lobbying by the tobacco and vaping business was $23.5 million in 2018, and for the first three-quarters of 2019, it was more than $20 million. Juul increased its spending to $3 million in the first three quarters of 2019, from $1.6 million for all of 2018.
Amanda Wheeler, a vape shop owner in Prescott, Ariz., who started the “We Vape, We Vote” campaign in Arizona and Colorado, said she was amazed that the efforts against a full ban had worked. But while she and other shop owners say that their products help people to stop smoking, the Food and Drug Administration has not accepted that argument.
In a legal brief filed on Monday in the United States Court of Appeals for the Fourth Circuit, the agency wrote, “It is far from clear that e-cigarettes help smokers quit in meaningful numbers, although it is possible that e-cigarettes provide less unhealthy alternatives to combustible tobacco products.”
For vape shop owners like Ms. Wheeler, the next challenge is the May deadline to apply for F.D.A. approval to stay on the market. She sees it as another hurdle that can kill her business. Her products include 1,700 different combinations of flavor nicotine strength and other variations, and she said she lacked the resources to apply for approval for each one.
Mitch Zeller, who heads tobacco regulation at the F.D.A., said the agency would do “everything we can, especially for small businesses, to help guide them through the process.”
“But at the end of the day,” he added, “they are subject to that May 12 deadline.”
Katie Thomas and Nicholas Corasaniti contributed reporting.
