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U.S. health regulators are moving ahead with a plan designed to keep e-cigarettes out of the hands of teenagers by restricting sales of most flavored products in convenience stores and online.

The new guidelines, first proposed in November, are the latest government effort to reverse what health officials call an epidemic of underage vaping.

E-cigarettes typically heat a flavored nicotine solution into an inhalable vapor. Federal law bans their sale to those under 18, but 1 in 5 high school students report using e-cigarettes, according to the latest survey published last year .

Under proposed guidelines released Wednesday by the Food and Drug Administration, e-cigarette makers would restrict sales of most flavored products to stores that verify the age of customers entering the store or include a separate, age-restricted area for vaping products. Companies would also be expected to use third-party identity-verification technology for online sales.

Companies that don’t follow the requirements risk having their products pulled from the market, the FDA said.

“The onus is now on the companies and the vaping industry to work with us to try and bring down these levels of youth use, which are simply intolerable,” FDA Commissioner Scott Gottlieb said in an interview. The restrictions won’t apply to three flavors that the FDA says appeal more to adults than teenagers: tobacco, menthol and mint.

The FDA will accept comments on the guidelines for 30 days before finalizing them later this year.

Anti-smoking activists have questioned whether the in-store restrictions will be enough to stop the unprecedented surge in teen vaping. The FDA has little authority over how stores display and sell vaping products. Instead, critics say the agency is essentially telling companies to self-police where and how their products are sold.

“FDA continues to nibble around the edges and that will not end the epidemic,” said Erika Sward, of the American Lung Association, which has called on the FDA to remove all flavored e-cigarettes from the market.

Health experts say nicotine is harmful to developing brains, and some researchers worry that addicted teens will eventually switch from vaping to smoking.

Under regulations developed by the Obama administration, manufacturers were supposed to submit e-cigarettes for safety and health review by August 2018. But Gottlieb delayed the deadline until 2022, saying both the agency and industry needed more time to prepare. Under Wednesday’s update, the FDA will move the deadline to 2021.

Still, the American Lung Association and several other anti-smoking groups are suing the FDA to begin reviewing the safety and health effects of e-cigarettes immediately.

 
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United Nations investigators say intercommunal attacks that killed more than 500 people in the Democratic Republic of Congo were orchestrated. The investigators from the U.N. human rights office in Congo say the attacks may amount to crimes against humanity.

The clashes between the Banunu and Batende communities took place in Yumbi territory, in Mai-Ndombe province, between December 16 and 18.

U.N. investigators who went there found the violence was planned and carried out with the support of traditional chiefs.

U.N. human rights spokeswoman Ravina Shamdasani says the investigators verified at least 535 people were killed and more than 100 others injured.

“These figures are most likely an underestimate,” she said. “The number of casualties is believed to be much higher as the bodies of some who died are believed to have been thrown into the Congo River. It is also not possible to confirm the number of people who are still missing as an estimated 19,000 people were displaced by the violence, 16,000 of whom crossed over into the Republic of Congo.”

Shamdasani says fights between the two communities over land and fishing resources have broken out in the past, but never on this scale.

She says the violence was triggered by a dispute over the burial of a Banunu chief. She says the similarity of the attacks carried out over a three-day period across four different villages indicates prior consultation and organization.

“Certain chiefs of the Batende-majority villages were cited by many sources as having taken part in the planning of the attacks. The investigation concluded that the crimes documented in Yumbi may amount to crimes against humanity of murder, torture, rape and other forms of sexual violence, as well as persecution,” said Shamdasani.

The report warns violence is likely to flare up again if the tensions and resentment between the two communities are allowed to fester.

The U.N. high commissioner for human rights, Michelle Bachelet, is calling for the perpetrators of the crimes to be punished.

She is also urging the government to establish a truth and reconciliation process to address the problems between the Banunu and Batende communities and prevent further violence.

 
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Americans most at risk from more frequent and intense heat waves tend to misjudge the deadly dangers hot spells can pose to their health, scientists said on Tuesday.

People’s vulnerability to heat waves is growing as cooler states become hotter, in part because air conditioning and other ways to cool down are less common there, according to a study in the Proceedings of the National Academy of Sciences of the United States of America.

Right now, people in cooler areas “don’t experience hotter weather as frequently,” said co-author Peter Howe from Utah State University. That means “they have less of that experience… to handle those hot days.”

Global temperatures are on course for a 3 to 5 degrees Celsius (5 to 9 degrees Fahrenheit) rise this century, overshooting a global target of limiting the increase to 2C (3.6F) or less, the U.N. World Meteorological Organization has said.

In the United States, hot years are projected to soon become more common as annual average temperatures — already a degree higher than in 1901 — continue to rise, according to the National Climate Assessment, a U.S. government report.

After surveying more than 9,000 people in all 50 states, researchers carrying out the heat wave study discovered that people in northern states, including in the northern Midwest, had fewer health concerns about extreme heat than those living in the country’s south.

Residents of the normally temperate Rocky Mountains and Appalachians were among the least concerned by extreme heat, the study said, while those in sweltering Hawaii, Texas and Louisiana were most worried.

But previous research has shown that as climate change pushes temperatures up, residents of the northeastern United States and those living in high elevations are at particularly high risk of heat-related complications, the researchers said.

That’s because they often lack air conditioning and other means of combatting extreme heat, and are less acclimatized to potentially dangerous temperatures.

Heat can exacerbate existing health conditions and contribute to heat strokes, dehydration and heat exhaustion, Howe said.

Elderly people also were often oblivious to the risks of extreme heat to their health, even though they constitute one of the highest risk groups, the findings showed.

“People generally, if they are older, they don’t consider themselves to be elderly,” he said — and so don’t see themselves as particularly at risk.

Heat in 2017 killed more people than any other weather-related disaster except floods, according to the National Weather Service. Over the last 30 years heat has been the biggest cause of weather-related deaths.

A 2014 study published in the journal Environmental Health Perspectives said a 5 degree Fahrenheit increase in average temperature would lead an extra 1,900 deaths per summer across 105 U.S. cities.
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