A funny thing happened on the way to FDA Commissioner Marty Makary’s resignation at the end of May. The President posted Dr. Makary’s resignation notice on Truth Social on May 12, 2026, and his FDA biography confirms his term ended May 13. However, before his term was officially over, the FDA posted a new set of guidelines allowing e-cigarette and vaping devices to come onto the market without full safety approvals.

There appears to be no known author of these new regulations, according to an article at PBS News. The new guidelines came as a surprise to senior FDA officials who regulate tobacco and vaping products. FDA staff told PBS News there’s “internal confusion about how the policy came about and who authorized it.”

Dr. Makary is credited with speeding up drug reviews, speeding approval of drugs for rare conditions, and advancing research into psychedelics. He tussled with the Trump administration, however, over his opposition to the approval of flavored e-cigarettes.

PBS explains the pressure on Dr. Makary to go around his own staff and loosen restrictions on nicotine products:

Trump came to power last year after vowing to ‘save’ the vaping industry. Major tobacco companies, such as Reynolds American and Altria, have contributed millions to political action committees supporting Trump and other administration priorities, including Trump’s inauguration and his proposed White House ballroom. Both companies have invested heavily in e-cigarettes and nicotine pouches, in addition to cigarettes.

Regulators are truly stuck in a Catch-22 situation on e-cigarettes and nicotine pouches. Evidence shows that vaping reduces smoking and therefore has health benefits. As pointed out by Dr. Robert Pretlow, a pediatrician and publisher of AddictionNews, “People aren’t addicted to nicotine but rather to the displacement action of vaping. The behavior of slow inhaling/exhaling is soothing, as is the hand-to-mouth motion.”

“Nicotine is the cue,” writes Dr. Pretlow in a paper entitled “A Unified Theory of Addiction.” “Vaping works as well as smoking, with the slow inhale and exhale stimulated by the nicotine cue, whereas nicotine inhalers do not.” PBS News admits that “underage vaping among U.S. teenagers has fallen to its lowest level in 10 years.”

The theory motivating FDA regulators is that “digital age-verification technology” will keep fruit-flavored or candy-flavored vapes out of the hands of kids while encouraging adults to smoke less. It appears the big tobacco companies have read my colleague Katie McCaskey’s work on substitution. They’re trying to get people hooked on the solution for getting unhooked from tobacco, essentially betting against themselves (they win either way).

The American Academy of Pediatrics is not buying the FDA’s new theories and sued the Trump administration in a lawsuit filed July 14. The lawsuit alleges the guidelines “were issued without prior notice or opportunity for public comment,” writes AAP News.

“The AAP has long been opposed to flavors, including menthol, in any tobacco or nicotine products,” the article explains. “Congress banned flavors other than menthol in traditional cigarettes in 2009.”

Joining the lawsuit, among many others, is Truth Initiative. Started in the 1990s with tobacco industry settlement funds, the organization is now named after its most recognizable campaign: the bright orange TRUTH vans that carried an anti-smoking, anti-vaping message to summer concerts and other youth gatherings.

The organization developed its first anti-vaping initiative in 2021 with Vaping: Know the Truth, a free vaping prevention curriculum developed by Truth Initiative, Kaiser Permanente, and the American Heart Association. A clinical trial of Truth Initiative’s “This Is Quitting” text messaging program shows it “increased quit rates among young adults aged 18-24 by nearly 40%,” according to the nonprofit organization’s website.

In a future post, I’ll take a look at the effectiveness of quit vaping programs to see if they offer solutions involving the displacement of stress.

Written by Steve O’Keefe. First published August 12, 2026.

Sources:

“FDA move allowing more e-cigarettes and nicotine pouches into U.S. blindsides officials,” PBS News, May 22, 2026.

“Resigns After Trump Pressure,” Health Day News, May 18, 2026.

“AAP, public health organizations sue FDA over policy allowing tobacco vaping products,” AAP News, July 15, 2026.

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