WASHINGTON - Federal regulators warned Tuesday that more than a dozen manufacturers, distributors and retailers that they are endangering children by marketing e-cigarette liquids to resemble kid-friendly products such as juice boxes, candy and whipped cream.
The Food and Drug Administration and the Federal Trade Commission said the packaging of the products - some of which feature cartoonlike images - could mislead children into thinking the liquids, which can be highly toxic if swallowed, are actually things they commonly eat and drink.
"E-liquids," as they are called, are typically a mix of nicotine, flavors and other ingredients. Ingesting them can cause nicotine poisoning - and even death - for small children. The government cited a recent analysis that found there were more than 8,200 e-cigarette and liquid nicotine exposures among children younger than six between January 2012 and 2017.
The products being targeted include: "One Mad Hit Juice Box," which resembles children's apple juice boxes, such as Tree Top-brand juice boxes; "Vape Heads Sour Smurf Sauce," which looks like War Heads candy; and "V'Nilla Cookies & Milk," which resembles Nilla Wafer and Golden Oreo cookies; "Whip'd Strawberry," which resembles Reddi-wip dairy whipped topping, and "Twirly Pop," which the FDA said, "not only resembles a Unicorn Pop lollipop but is shipped with one."
The warning letters cover eight different products. Not all e-liquids contain nicotine; the government action Tuesday targeted only items that have nicotine.
The agencies told the companies that the products are "misbranded" under the Federal Food, Drug, and Cosmetic Act "because their labeling and/or advertising imitating kid-friendly foods is false or misleading." In joining the FDA, the FTC cited its authority under the Federal Trade Commission Act, which prohibits unfair or deceptive advertising.
The companies have 15 days to respond to the FDA on how they will change the labels and packaging of the products. Failure to make changes "may result in further action such as seizure or injunction," the FDA said.
"It is easy to see how a child could confuse these e-liquid products for something they believe they've consumed before - like a juice box," said FDA Commissioner Scott Gottlieb. "These are preventable accidents that have the potential to result in serious harm or even death. Companies selling these products have a responsibility to ensure they aren't putting children in harm's way or enticing youth use, and we'll continue to take action against those who sell tobacco products to youth and market products in this egregious fashion."
"Protecting young children from unwarranted health and safety risks is one of our highest priorities," said Acting FTC Chair Maureen K. Ohlhausen. "Nicotine is highly toxic, and these letters make clear that marketing methods that put kids at risk of nicotine poisoning are unacceptable."
Several of the entities also were cited for illegally selling the products to minors, the FDA said.
FDA commissioner Gottlieb said the letters were one part of the FDA's new Youth Tobacco Prevention Plan. Last week, the agency announced a nationwide undercover "blitz" to crack down on the sale of e-cigarettes - particularly the hugely popular Juul products - to children and teenagers by regular and online retailers.
The agency said it had uncovered dozens of violations of the law and issued 40 warning letters related to Juul e-cigarettes.
Juul e-cigarettes resemble a USB flash drive but contain high levels of nicotine. They come in such flavors as mango, creme brulee and cool mint, and their emissions can be virtually invisible, making it difficult for teachers to spot and stop use of the product.
Gottlieb, as part of a comprehensive tobacco policy announced last summer, pledged to reduce the level of nicotine in conventional cigarettes to minimally addictive levels and said he believes e-cigarettes could be an important tool in helping adult smokers switch to less harmful nicotine-delivery products. The policy also delayed for several years a requirement that e-cigarette makers get agency approval for their products. Health groups have sued the agency over the delay.
Gottlieb said last week that while e-cigarettes could be helpful for addicted adults, the viability of the products "is severely undermined if those products entice youth to start using tobacco and nicotine."