United States: FDA commissioner resigns amid favorable climate for new products

Marty Makary has resigned as commissioner of the Food and Drug Administration (FDA) after thirteen months at the helm of the U.S. health regulatory agency. The decision was confirmed by Donald Trump, who announced the interim appointment of Kyle Diamanta, head of the FDA's food division, as acting replacement.[1]. This decision is part of a shift by the agency towards a general relaxation, under pressure from the tobacco and nicotine industries, breaking with the regulations previously in force.

Strong tensions exist regarding public health policies, including those related to vaping flavors.

According to several American media outlets, disagreements between the White House and the commissioner contributed to his departure. Donald Trump reportedly criticized Marty Makary for not approving certain fruit-flavored vaping products quickly enough. The commissioner had initially suspended their authorization, against the agency's advice., before the FDA finally approves these products. This reflected a concern about the risk of nicotine initiation and addiction among young people and non-smokers., which aligns with the findings of a recent American study on flavors.

In a statement, Dick Durbin, the Senate Democratic leader, said he had« We voted for Dr. Makary to head the FDA because of his commitment to say no if President Trump asked him to do something that would harm America. Dr. Makary kept his word. He opposed Trump's plan to expose millions of children to the dangers of vaping. »

Marty Makary's term was also marked by several controversies regarding vaccination policy and the evaluation of certain medications. Criticism focused on the handling of data related to the safety of Covid-19 and shingles vaccines, as well as decisions concerning treatments related to medical abortion.

The FDA has also faced criticism regarding its internal operations., in a context of job cuts and administrative reorganizations and of delays in certain regulatory assessments. Several Republican lawmakers have criticized the slow pace of procedures concerning certain innovative treatments or rare diseases. This resignation comes as several key positions in US health agencies remain vacant or await Senate confirmation, amidst significant tensions surrounding public health policies in the United States.

The anti-tobacco NGO Campaign for Tobacco-Free Kids reacted to this new decision, stating that it is deeply regrettable that the FDA yielded to political pressure instead of relying on scientific data to better protect children and enforce existing prior authorization requirements before any products are placed on the market.[2]. She points out that flavors play a key role in the initiation and addiction to nicotine among young people: about four out of five young people who have already used tobacco started with a flavored product and nearly 90% of young people who use electronic cigarettes report using flavored products.

A climate favorable to new nicotine products, including illegal products

Meanwhile, Tobacco-Free Kids criticized the FDA's new guidelines regarding tobacco and nicotine products. The organization believes these rules allow certain products, including e-cigarettes and nicotine pouches, to remain on the market without full scientific evaluation or prior official authorization, contrary to the requirements of the U.S. Tobacco Control Act. In effect, the marketing of these products is illegal and constitutes a gift to the tobacco industry, it argues. At the same time, the publication of documents revealing the active role of internal lobbyists close to Congress, as well as FDA oversight committees and influential outside firms, has demonstrated the extent of Philip Morris International US's lobbying efforts in the United States to oppose the regulation of nicotine products.[3].

Tobacco-Free Kids also denounced the lack of public consultation before the publication of these guidelines and highlighted the lack of recent action by authorities against unauthorized products. The vast majority of illegal e-cigarettes are disposable, flavored, and available at low prices, making them accessible to young people, and are often equipped with "smart" features that make them fun and addictive.[4]. The organization is calling on the FDA, customs, and the Department of Justice to strengthen controls across the entire supply chain and to prosecute manufacturers, distributors, importers, and retailers who break the law.

The lack of enforcement against all unauthorized tobacco products has significant consequences for public health: more than 1.4 million secondary school students currently use e-cigarettes, and the use of nicotine pouches has increased among young people in recent years. According to data from the National Youth Tobacco Survey (NYTS), the use of nicotine pouches rose from 1.5 million per 100,000 in 2023 to 1.8 million per 100,000 in 2024, and among the nearly 500,000 middle and high school students who reported using nicotine pouches at the time of the survey, 22.4 million used them daily.[5].

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[1]Melody Schreiber, Marty Makary leaves FDA after clashes with Trump over fruit-flavored vapes, The Guardian, published May 12, 2026, accessed May 13, 2026

[2]Yolonda C. Richardson, New FDA Guidance Gives the Tobacco Industry a Free Pass to Put Illegal Products on the Market, Campaign for Tobacco-Free Kids, published May 12, 2026, accessed May 13, 2026

[3]PMI can be used to lobby the FDA on its own terms, TabakNee, published on May 12, 2026, accessed on May 13, 2026

[4]The majority of e-cigarettes on the market are illegal, Truth Initiative, published May 12, 2026, accessed May 13, 2026

[5]Youth E-Cigarette Use Drops to Lowest Level in a Decade, CDC, published September 5, 2024, accessed May 18, 2026

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