The US Surgeon General, Jerome Adams, has issued an advisory on youth e-cigarette use.

Dr Adams has declared teen vaping in the US to be an “epidemic” and has issued a rare personal advisory on the problem and how it should be tackled in 2019.

Mirroring the rhetoric of FDA Commissioner Scott Gottlieb, the document acknowledges how youth smoking has fallen, but fears that the year’s reported spike in underage use could signal a generation of nicotine addiction:

“We must take aggressive steps to protect our children from these highly potent products that risk exposing a new generation of young people to nicotine.”

Dr Adams has urged health professionals, teachers, parents and “states, communities, tribes and territories” to, “implement evidence-based population-level strategies to reduce e-cigarette use among young people.”

These strategies include everything from adopting household rules against indoor vaping to more institutional crackdowns, like reducing access to flavours and curbing any marketing strategies that teens gravitate towards.

The advisory also makes several other claims that have been challenged by academics and vape industry figures in recent months: repeatedly calling e-cigarettes “tobacco products,” and referring to flavourings as “kid friendly.”

The phenomenon of US teen vaping and its unacceptable nature has not been ignored by the industry, least of all by JUUL, which has been bearing the brunt of accusations.

Vape companies and advocates have not denied the problem, but have diverged from the opinions of certain regulatory authorities on what is to blame, and how the proposed approach from figures like Dr Adams would work.

A study published in Environmental Research and Public Health revealed the importance of  flavours for adult ex-smokers, the target demographic of every good vape company.

Critics of flavour bans argue that such an act would harm adult ex-smokers more than help teens.