Comment from Tom Miller

I strongly support the enforcement priorities set forth by the Center for Tobacco Products (CTP) under Docket No. FDA-206-D-5083-0002. I believe the timing of these priorities is ideal for three key reasons: First, the United States has successfully transitioned into a tobacco harm reduction nation, meaning more adults now use noncombustible tobacco products than smoke cigarettes. There are currently 21 million adult e-cigarette users in the country, more than 8 million have completely switched from combustibles to e-cigarettes. The CDC recently reported that the adult smoking rate has dropped to an unprecedented 9.1%. As adults switch from cigarettes to e-cigarettes in large numbers the public health benefits continue to increase dramatically. Second, youth e-cigarette use is declining sharply. Youth vaping dropped 74% from 2019 to 2025, falling 12% between 2024 and 2025. We can reduce youth e-cigarette use to the same historic lows as youth cigarette smoking by maintaining current practices without eliminating flavored e-cigarette options for adults. Because youth usage is down, the overall harm to youth is decreasing substantially. Third, illegal sales of unauthorized e-cigarettes, primarily flavored products, remain a massive challenge for the CTP. The single most effective way to reduce this illicit market is to allow law-abiding companies to sell regulated, flavored e-cigarettes. This allows legitimate businesses to compete on an equal footing with illegal operators and significantly cut into the illegal market. It is very important that the CTP take the next step to authorize PMTAs of flavored e-cigarettes. The evidence is there to show that they are “appropriate for the protection of public health.” These enforcement priorities come within the broader context of shifting trends between combustible and noncombustible products. The current data reflects an enormously successful public health trajectory: Lowest adult smoking rate in 75 years Lowest youth cigarette use in 50 years Lowest youth use of any nicotine product in 50 years Lowest youth e-cigarette use in 11 years Thank you for your consideration of my thoughts. Sincerely, Tom Miller Former Iowa Attorney General