Is the FDA’s War on Vaping Coming to an End?

In his non-consecutive terms, President Trump has worked with four FDA commissioners: Scott Gottlieb, Stephen Hahn, Robert Califf, and Marty Makary. Dr. Makary is the second to step down, and this could mean sweeping changes—and the end to one of the most spectacular failures in the agency’s history.

On May 12, 2026, Marty Makary resigned as FDA Commissioner after weeks of tension with the White House. The sticking point: flavored vaping products. Trump pushed the FDA to move quickly in approving two fruit-flavored e-cigarettes. Dr. Makary reportedly opposed the decision in private. Pressure mounted, and Makary stepped down. His chief HHS spokesman resigned the following day for the same reason. One disagreement cost the agency two of its top officials.

Stepping down over differences isn’t new—especially in this administration. But the fact that Dr. Makary is leaving over an anti-vaping stance is remarkable given what the FDA’s tried (and failed) to accomplish in the vaping market. 

The campaign started under Scott Gottlieb, Trump’s first FDA Commissioner. Gottlieb declared teen vaping an “epidemic” and put “all options on the table” to stop it. What followed was a historic crackdown: the FDA fined over 1,300 retailers, raided Juul’s headquarters, demanded compliance plans from e-cigarette companies, and proposed banning flavored e-juices outright. 

Gottlieb left in 2019 amid scrutiny over his financial ties to pharmaceutical and food companies. The war, however, carried on without him. And things never got better. 

The FDA first gained authority to regulate vaping products in 2016. Forty states had already banned e-cigarette sales to minors before the FDA stepped in. Teen vaping rates increased substantially after that. 

Teen vaping rates have declined in recent years. But as I’ve noted before, the FDA’s crackdown deserves little credit. The CDC itself attributes the drop to price increases, public awareness campaigns, and smoke-free policies—not agency raids, market bans, or the six-year war on vaping producers.

In an effort to find some workable middle ground, the FDA spent years trying to promote nicotine replacement therapies (NRTs) as an alternative to vaping. After four years of promotion, revising standards, and soliciting public feedback, the agency approved just three NRTs—each requiring additional behavioral interventions to work. It was an ambitious project with very little to show for it.

More recently, the FDA began selectively approving some vaping products while continuing to push others off the market. The agency was playing gatekeeper in a market it could never actually control. It’s a way to cut losses, and it’s backed by science.

A 2019 study published in the New England Journal of Medicine found vaping to be more effective than FDA-approved nicotine alternatives for helping users quit smoking. Research from Public Health England found that e-cigarettes are 95 percent less harmful than cigarettes and considerably less likely to cause heart disease, lung cancer, or stroke. Since 2020, vaping has been linked to 68 deaths. Smoking kills roughly 480,000 Americans per year. The numbers don’t require much interpretation.

British hospitals have drawn the logical conclusion: the National Health Service runs vaping shops inside hospitals to help patients quit smoking. The FDA, by contrast, spent six years trying to shut down the same products.

Perhaps more importantly, removing Dr. Makary is a clear sign that the FDA is no longer willing to continue on the warpath to end the vaping epidemic. Ample evidence along the way shows it never had control—just the ability to cause chaos and harm.

Any time the FDA stops doing that, we’re all better off.