Adolescents’ Use of “Pod Mod” E-Cigarettes — Urgent Concerns

Introduction:
This text provides an overview of the FDA Amendments Act of 2007 (FDAAA) and its impact on the FDA's capacity to track medication effects and mitigate risk. The authors also discuss the urgent concerns around adolescents' use of pod mod e-cigarettes and the need for regulation.

Key Points:

* The FDAAA introduced important improvements in the FDA's capacity to track medication effects and mitigate risk.
* Adolescents' use of e-cigarettes, specifically pod mods, is a public health concern, and there is reason to be concerned about the addictiveness and health consequences of pod mods.
* Pod mods may deliver high levels of nicotine with few deterrents, making them appealing to a wide audience and easy to conceal.
* The FDA has begun to take action to prevent Juul-ing by young people, including undercover operations, restrictions on third-party resale, and detailed requests for information from Juul's manufacturer.
* The CMS proposed collapsing Medicare fees for levels 2 through 5 office visits into a single price, which could exacerbate workforce deficiencies and remove physicians' incentive to spend time with patients who have complex needs.
* The text highlights the need for regulation of pod mods and other e-cigarettes, as well as the importance of maintaining incentives for physicians to spend time with patients who have complex needs.

Main Message:
The FDAAA has had a lasting power in improving the FDA's capacity to track medication effects and mitigate risk, and it will continue to serve as an important reminder of the power of health-related legislation. Adolescents' use of pod mod e-cigarettes is a public health concern, and comprehensive actions are needed to counteract this emerging trend. The CMS's proposal to collapse Medicare fees for office visits could exacerbate workforce deficiencies and remove physicians' incentives to spend time with patients who have complex needs, highlighting the need for careful consideration of regulatory changes.

Barrington-Trimis, Jessica L., and Adam M. Leventhal. “Adolescents’ Use of ‘Pod Mod’ E-Cigarettes — Urgent Concerns.” New England Journal of Medicine 379, no. 12 (September 20, 2018): 1099–1102. https://doi.org/10.1056/NEJMp1805758.