83_FR_55532 83 FR 55318 - Eliminating Youth Electronic Cigarette and Other Tobacco Product Use: The Role for Drug Therapies; Public Hearing; Request for Comments

83 FR 55318 - Eliminating Youth Electronic Cigarette and Other Tobacco Product Use: The Role for Drug Therapies; Public Hearing; Request for Comments

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 83, Issue 214 (November 5, 2018)

Page Range55318-55323
FR Document2018-24126

The Food and Drug Administration (FDA or the Agency) is announcing a public hearing to discuss its efforts to eliminate youth electronic cigarette (e-cigarette) use as well as other tobacco product use, with a focus on the potential role of drug therapies to support youth e-cigarette cessation and the issues impacting the development of such therapies.

Federal Register, Volume 83 Issue 214 (Monday, November 5, 2018)
[Federal Register Volume 83, Number 214 (Monday, November 5, 2018)]
[Proposed Rules]
[Pages 55318-55323]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-24126]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Part 15

[Docket No. FDA-2018-N-3952]


Eliminating Youth Electronic Cigarette and Other Tobacco Product 
Use: The Role for Drug Therapies; Public Hearing; Request for Comments

AGENCY: Food and Drug Administration, HHS.

ACTION: Notification of public hearing; request for comments.

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SUMMARY: The Food and Drug Administration (FDA or the Agency) is 
announcing a public hearing to discuss its efforts to eliminate youth 
electronic cigarette (e-cigarette) use as well as other tobacco product 
use, with a focus on the potential role of drug therapies to support 
youth e-cigarette cessation and the issues impacting the development of 
such therapies.

DATES: The public hearing will be held on December 5, 2018, from 9 a.m. 
to 5 p.m. The public hearing may be extended or may end early depending 
on the level of public participation. Persons seeking to present at the 
public hearing must register by Friday, November 23, 2018. Persons 
seeking to attend, but not present at, the public hearing must register 
by Monday, December 3, 2018. Section II provides attendance and 
registration information. Electronic or written comments will be 
accepted after the public hearing until Wednesday, January 2, 2019.

ADDRESSES: The public hearing will be held at the FDA White Oak Campus, 
10903 New Hampshire Ave., Building 31 Conference Center, the Great Room 
A, Silver Spring, MD 20993-0002. Entrance for public hearing 
participants (non-FDA employees) is through Building 1, where routine 
security check procedures will be performed. For parking and security 
information, please refer to https://www.fda.gov/AboutFDA/WorkingatFDA/BuildingsandFacilities/WhiteOakCampusInformation/ucm241740.htm.
    You may submit comments as follows. Please note that late, untimely 
filed comments will not be considered. Electronic comments must be 
submitted on or before Wednesday, January 2, 2019. The https://www.regulations.gov electronic filing system will accept comments until 
11:59 p.m. Eastern Time at the end of Wednesday, January 2, 2019. 
Comments received by mail/hand delivery/courier (for written/paper 
submissions) will be considered timely if they are postmarked or the 
delivery service acceptance receipt is on or before that date. You may 
submit comments as follows:

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on https://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the

[[Page 55319]]

manner detailed (see ``Written/Paper Submissions'' and 
``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand delivery/Courier (for written/paper 
submissions): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked, and identified 
as confidential if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2018-N-3952 for ``Eliminating Youth Electronic Cigarette and Other 
Tobacco Product Use: The Role for Drug Therapies; Public Hearing; 
Request for Comments.'' Received comments will be placed in the docket 
and, except for those submitted as ``Confidential Submissions,'' 
publicly viewable at https://www.regulations.gov or at the Dockets 
Management Staff between 9 a.m. and 4 p.m., Monday through Friday.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. If you do not wish 
your name and contact information to be made publicly available, you 
can provide this information on the cover sheet and not in the body of 
your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: https://www.fda.gov/regulatoryinformation/dockets/default.htm.
    Docket: For access to the docket to read background documents or 
the received electronic and written/paper comments, go to https://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, 
Rm. 1061, Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: Theresa Wells, Food and Drug 
Administration, 10903 New Hampshire Ave., Bldg. 1, Rm. 1202, Silver 
Spring, MD 20993, 703-380-3900, Theresa.wells@fda.hhs.gov.

SUPPLEMENTARY INFORMATION: 

I. Background

    Nearly all tobacco product use begins during youth and young 
adulthood (Ref. 1). While the current use of any tobacco product among 
U.S. middle and high school students has decreased from 2011-2017, 
there has been an alarming increase in e-cigarette use over this time. 
In fact, since 2014, e-cigarettes \1\ have been the most commonly used 
tobacco products among youth, used by 1.73 million (11.7 percent) high 
school students and 390,000 (3.3 percent) middle school students in 
2017 (Ref. 2). Youth e-cigarette use raises a number of health concerns 
including risk of addiction to nicotine early on in life, potential 
harm to the developing adolescent brain, and exposure to chemicals 
including carbonyl compounds and volatile organic compounds known to 
have adverse health effects; the full range of possible health effects 
is not yet completely understood (Ref. 3).
---------------------------------------------------------------------------

    \1\ An e-cigarette is one type of electronic nicotine delivery 
system, which also includes e-cigars, e-hookah, vape pens, personal 
vaporizers, and electronic pipes. See https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm 
and Ref. 2.
---------------------------------------------------------------------------

    On April 24, 2018, FDA announced its Youth Tobacco Prevention Plan. 
This plan focuses on three key strategies: Prevention of youth access 
to tobacco products, curbing the marketing of tobacco products aimed at 
youth, and educating teens about the dangers of using any tobacco 
products.\2\ FDA recently launched an expansion of its ``The Real 
Cost'' campaign to educate youth on the dangers of e-cigarette use \3\ 
and increased enforcement actions to address this critically important 
public health concern.\4\
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    \2\ https://www.fda.gov/TobaccoProducts/PublicHealthEducation/ProtectingKidsfromTobacco/ucm608433.htm.
    \3\ https://www.fda.gov/tobaccoproducts/publichealtheducation/publiceducationcampaigns/therealcostcampaign/default.htm.
    \4\ https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm620788.htm.
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    In addition to the prevention of initiation, which will be the 
cornerstone of any successful effort to curb youth e-cigarette use, FDA 
is also exploring additional approaches to address youth e-cigarette 
use. One such approach may be the development of drug therapies, as 
part of multimodal treatment strategies, including behavioral 
interventions, to support tobacco product cessation. To date, research 
on youth tobacco product cessation has been limited and focused on 
smoking (i.e., combustible products) cessation. One recent review found 
a paucity of data on either behavioral or drug therapies for smoking 
cessation in young people (age less than 20 years) and concluded that 
``there continues to be a need for well-designed, adequately powered, 
randomized controlled trials of interventions for this population of 
smokers'' (Ref. 4). FDA is not aware of any research examining either 
drug or behavioral interventions for the cessation of youth or adult e-
cigarette use. In contrast, there is a large body of research on adult 
smoking cessation, and multiple drugs for smoking cessation are 
approved for the adult population, including a variety of prescription 
and over-the-counter nicotine replacement therapy (NRT) products, as 
well as the prescription drugs varenicline and bupropion hydrochloride 
sustained release (see Appendix A).

II. Purpose and Scope of the Public Hearing

    FDA is holding a public hearing to obtain the public's perspectives 
on the potential role drug therapies may play in the broader effort to 
eliminate youth e-cigarette and other tobacco product use, as well as 
the appropriate methods and study designs for evaluating youth e-
cigarette cessation therapies and the safety and efficacy of such 
therapies. The Agency has determined that a public hearing is the most 
appropriate way to ensure public engagement on this issue, which is of 
great importance to the public health. FDA believes it is critical to 
obtain input across the medical and research fields, the pharmaceutical 
and tobacco industries, and among public health stakeholders (including 
adolescents) regarding approaches to eliminate youth e-cigarette and 
other tobacco product use, including exploring whether there is a need 
for drug therapies to support youth e-cigarette cessation, and if so, 
how FDA

[[Page 55320]]

can support the development of such therapies.

Questions for Commenters To Address

    Considering the broad range of activities focused on this public 
health issue, FDA is interested in the public's view on approaches to 
eliminating e-cigarette and other tobacco product use among youth. 
Although FDA welcomes all feedback on any public health, scientific, 
regulatory or legal considerations relating to this topic, we 
particularly encourage commenters to consider the following questions 
as they prepare their comments or statements. Responses to questions 
should include supporting scientific justification.
    1. FDA notes that the factors driving e-cigarette use among youth 
likely differ from those in the adult population. How might such 
differences impact the need for, or use of, drug therapies for e-
cigarette cessation among youth?
    2. FDA is interested in whether there is a population of youth e-
cigarette users who would be likely to benefit from the use of drug 
therapies for e-cigarette cessation. What age groups (older adolescent 
vs. younger adolescent), patterns in tobacco use (duration and 
frequency of use), and clinical features (level of addiction, presence/
absence of comorbidities including psychiatric disease) might 
characterize this population? What types of products (NRT vs. non-NRT; 
prescription vs. over-the-counter) might be useful?
    3. Describe the scientific, clinical, and societal factors that 
could either encourage or impede the conduct of clinical trials 
designed to evaluate drugs intended for youth e-cigarette cessation. 
What approaches could be used to encourage research and overcome 
barriers to research?
    4. What methods and study designs are appropriate for assessing 
drug therapies for youth e-cigarette cessation? What are the 
appropriate control groups? What are the most informative endpoints and 
the best assessment tools to evaluate these endpoints?
    5. Acknowledging that to date research has been limited, are there 
data available from the adult experience with smoking cessation that 
could potentially be leveraged in the effort to develop drug therapies 
for youth e-cigarette cessation? Have any drug therapies demonstrated 
potential to help adults discontinue e-cigarette use? Are there 
differences between adolescents and adults that impact the ability to 
extrapolate efficacy findings from the adult population to the 
adolescent population? Could existing NRT products be useful for youth 
e-cigarette cessation?
    6. While this hearing is focused on the topic of e-cigarette use 
among youth, as e-cigarettes are currently the most commonly used form 
of tobacco in this population, FDA also welcomes comments regarding the 
potential need for drug therapies to support cessation of other tobacco 
products, including combustible products (i.e., cigarettes or cigars) 
and smokeless tobacco products, among youth and the issues impacting 
the development of such therapies.
    Registration and Requests for Oral Presentations: The FDA 
Conference Center at the White Oak location is a Federal facility with 
security procedures and limited seating. Attendance will be free and on 
a first-come, first-served basis. For those interested in presenting at 
the meeting, either with a formal oral presentation or as a speaker in 
the open public hearing session, please register by Friday, November 
23, 2018, at https://www.eventbrite.com/e/fda-pediatric-tobacco-cessation-part-15-public-hearing-tickets-50167147288. If you wish to 
attend either in person or by Webcast (see Streaming Webcast of the 
Public Hearing), please register for the hearing by Monday December 3, 
2018, at https://www.eventbrite.com/e/fda-pediatric-tobacco-cessation-part-15-public-hearing-tickets-50167147288. Those without internet or 
email access can register and/or request to participate as an open 
public hearing speaker or a formal presenter by contacting Theresa 
Wells by the above dates (see FOR FURTHER INFORMATION CONTACT).
    FDA will try to accommodate all persons who wish to make a 
presentation. Formal oral presenters may use an accompanying slide 
deck, while those participating in the Open Public Hearing will have 
less allotted time than formal oral presenters and will deliver oral 
testimony only (no accompanying slide deck). Individuals wishing to 
present should identify the number of the specific question, or 
questions, they wish to address. This will help FDA organize the 
presentations. Individuals and organizations with common interests 
should consolidate or coordinate their presentations and request time 
for a joint presentation. Individual organizations are limited to a 
single presentation slot. FDA will notify registered presenters of 
their scheduled presentation times. The time allotted for each 
presentation will depend on the number of individuals who wish to 
speak. Registered presenters making a formal oral presentation are 
encouraged to submit an electronic copy of their presentation 
(PowerPoint or PDF) to OMPTFeedback@fda.hhs.gov with the subject line 
``Eliminating Youth Electronic Cigarette and Other Tobacco Product Use: 
The Role for Drug Therapies'' on or before Wednesday, November 28, 
2018. Persons registered to present are encouraged to arrive at the 
hearing room early and check in at the onsite registration table to 
confirm their designated presentation time. Actual presentation times, 
however, may vary based on how the meeting progresses in real-time. An 
agenda for the hearing and any other background materials will be made 
available 5 days before the hearing at https://www.fda.gov/NewsEvents/MeetingsConferencesWorkshops/ucm620744.htm.
    If you need special accommodations because of a disability, please 
contact Theresa Wells (see FOR FURTHER INFORMATION CONTACT) at least 7 
days before the hearing.
    Streaming Webcast of the Public Hearing: For those unable to attend 
in person, FDA will provide a live Webcast of the hearing. To join the 
hearing via the Webcast, please go to https://collaboration.fda.gov/ptc120518.
    Transcripts: Please be advised that as soon as a transcript is 
available, it will be accessible at http://www.regulations.gov. It may 
be viewed at the Dockets Management Staff (see Comments). A transcript 
will also be available in either hard copy or on CD-ROM, after 
submission of a Freedom of Information request. The Freedom of 
Information office address is available on the Agency's website at 
https://www.fda.gov.

III. Notice of Hearing Under 21 CFR Part 15

    The Commissioner of Food and Drugs is announcing that the public 
hearing will be held in accordance with 21 CFR part 15. The hearing 
will be conducted by a presiding officer, who will be accompanied by 
FDA senior management from the Office of the Commissioner, the Center 
for Drug Evaluation and Research, and the Center for Tobacco Products. 
Under Sec.  15.30(f), the hearing is informal and the rules of evidence 
do not apply. No participant may interrupt the presentation of another 
participant. Only the presiding officer and panel members can pose 
questions; they can question any person during or at the conclusion of 
each presentation. Public hearings under part 15 are subject to FDA's 
policy and procedures for electronic media coverage of FDA's public 
administrative proceedings (21 CFR part 10, subpart C). Under Sec.  
10.205, representatives of the media may be permitted, subject to 
certain limitations, to videotape, film, or otherwise record FDA's 
public

[[Page 55321]]

administrative proceedings, including presentations by participants. 
The hearing will be transcribed as stipulated in Sec.  15.30(b) (see 
Transcripts). To the extent that the conditions for the hearing, as 
described in this notice, conflict with any provisions set out in part 
15, this notice acts as a waiver of those provisions as specified in 
Sec.  15.30(h).

IV. References

    The following references marked with an asterisk (*) are on display 
at the Dockets Management Staff and are available for viewing by 
interested persons between 9 a.m. and 4 p.m., Monday through Friday; 
they also are available electronically at https://www.regulations.gov. 
References without asterisks are not on public display at https://www.regulations.gov because they have copyright restriction. Some may 
be available at the website address, if listed. References without 
asterisks are available for viewing only at the Dockets Management 
Staff. FDA has verified the website addresses, as of the date this 
document publishes in the Federal Register, but websites are subject to 
change over time.

1.* U.S. Department of Health and Human Services (2014). ``The 
Health Consequences of Smoking--50 Years of Progress: A Report of 
the Surgeon General.'' Atlanta, GA: U.S. Department of Health and 
Human Services, Centers for Disease Control and Prevention, National 
Center for Chronic Disease Prevention and Health Promotion, Office 
on Smoking and Health available at: https://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html.
2.* Wang T.W., A. Gentzke, S. Sharapova, et al. (2018). ``Tobacco 
Product Use Among Middle and High School Students--United States, 
2011-2017.'' Morbidity and Mortality Weekly Report (MMWR) 67:629-
633, available at https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a3.htm).
3.* U.S. Department of Health and Human Services (2016). ``E-
Cigarette Use Among Youth and Young Adults: A Report of the Surgeon 
General.'' Atlanta, GA: U.S. Department of Health and Human 
Services, Centers for Disease Control and Prevention, National 
Center for Chronic Disease Prevention and Health Promotion, Office 
on Smoking and Health available at: https://e-cigarettes.surgeongeneral.gov/documents/2016_sgr_full_report_non-508.pdf.
4. Fanshawe T.R., W. Halliwell, N. Lindson, et al. (2017). ``Tobacco 
Cessation Interventions for Young People.'' Cochrane Database of 
Systematic Reviews, Rev.11:CD003289, available at https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003289.pub6/epdf/full.
BILLING CODE 4164-01-P
[GRAPHIC] [TIFF OMITTED] TP05NO18.010


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[[Page 55323]]


     Dated: October 30, 2018.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2018-24126 Filed 11-2-18; 8:45 am]
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     55318                Federal Register / Vol. 83, No. 214 / Monday, November 5, 2018 / Proposed Rules

     must be tested (Aviation flight crew                    are not required to apply drug testing to             November 23, 2018. Persons seeking to
     members and air traffic controllers);                   any applicants for whom the only                      attend, but not present at, the public
        (c) An occupation identified in 49                   suitable work is available in any or all              hearing must register by Monday,
     CFR 382.103 by the Federal Motor                        of the occupations listed.                            December 3, 2018. Section II provides
     Carrier Safety Administration, in which                   (c) No State is required to drug test               attendance and registration information.
     the employee must be tested                             UC applicants under this part 620.                    Electronic or written comments will be
     (Commercial drivers);                                                                                         accepted after the public hearing until
        (d) An occupation identified in 49                   § 620.5 Conformity and substantial
                                                                                                                   Wednesday, January 2, 2019.
                                                             compliance.
     CFR 219.3 by the Federal Railroad                                                                             ADDRESSES: The public hearing will be
     Administration, in which the employee                     (a) In general. A State law
                                                                                                                   held at the FDA White Oak Campus,
     must be tested (Railroad operating crew                 implementing the drug testing of
                                                                                                                   10903 New Hampshire Ave., Building
     members);                                               applicants for unemployment
                                                                                                                   31 Conference Center, the Great Room
        (e) An occupation identified in 49                   compensation must conform with—and
                                                                                                                   A, Silver Spring, MD 20993–0002.
     CFR 655.3 by the Federal Transit                        the law’s administration must
                                                                                                                   Entrance for public hearing participants
     Administration, in which the employee                   substantially comply with—the
                                                                                                                   (non-FDA employees) is through
     must be tested (Public transportation                   requirements of this part 620 for
                                                                                                                   Building 1, where routine security
     operators);                                             purposes of certification under 42
                                                                                                                   check procedures will be performed. For
        (f) An occupation identified in 49 CFR               U.S.C. 502(a), governing State eligibility
                                                                                                                   parking and security information, please
     199.2 by the Pipeline and Hazardous                     to receive Federal grants for the
                                                                                                                   refer to https://www.fda.gov/AboutFDA/
     Materials Safety Administration, in                     administration of its UC program.
                                                                                                                   WorkingatFDA/BuildingsandFacilities/
     which the employee must be tested                         (b) Resolving Issues of Conformity and
                                                                                                                   WhiteOakCampusInformation/
     (Pipeline operation and maintenance                     Substantial Compliance. For the
                                                                                                                   ucm241740.htm.
     crew members);                                          purposes of resolving issues of
                                                             conformity and substantial compliance                    You may submit comments as
        (g) An occupation identified in 46                                                                         follows. Please note that late, untimely
     CFR 16.201 by the United States Coast                   with the requirements of this part 620,
                                                             the provisions of 20 CFR 601.5 apply.                 filed comments will not be considered.
     Guard, in which the employee must be                                                                          Electronic comments must be submitted
     tested (Crewmembers and maritime                        Molly E. Conway,                                      on or before Wednesday, January 2,
     credential holders on a commercial                                                                            2019. The https://www.regulations.gov
                                                             Acting Assistant Secretary for Employment
     vessel);                                                and Training, Labor .                                 electronic filing system will accept
        (h) An occupation specifically
                                                             [FR Doc. 2018–23952 Filed 11–2–18; 8:45 am]           comments until 11:59 p.m. Eastern Time
     identified in Federal law as requiring an
                                                             BILLING CODE 4510–FW–P                                at the end of Wednesday, January 2,
     employee to be tested for controlled
                                                                                                                   2019. Comments received by mail/hand
     substances;
                                                                                                                   delivery/courier (for written/paper
        (i) An occupation specifically
                                                             DEPARTMENT OF HEALTH AND                              submissions) will be considered timely
     identified in the State law of that State
                                                             HUMAN SERVICES                                        if they are postmarked or the delivery
     as requiring an employee to be tested for
                                                                                                                   service acceptance receipt is on or
     controlled substances; and
        (j) An occupation where the State has                Food and Drug Administration                          before that date. You may submit
     a factual basis for finding that                                                                              comments as follows:
     employers hiring employees in that                      21 CFR Part 15
                                                                                                                   Electronic Submissions
     occupation conduct pre- or post-hire                    [Docket No. FDA–2018–N–3952]
                                                                                                                     Submit electronic comments in the
     drug testing as a standard eligibility
                                                             Eliminating Youth Electronic Cigarette                following way:
     requirement for obtaining or
                                                             and Other Tobacco Product Use: The                      • Federal eRulemaking Portal:
     maintaining employment in the
                                                             Role for Drug Therapies; Public                       https://www.regulations.gov. Follow the
     occupation.
                                                             Hearing; Request for Comments                         instructions for submitting comments.
     § 620.4 Testing of unemployment                                                                               Comments submitted electronically,
     compensation applicants for the unlawful                AGENCY:    Food and Drug Administration,              including attachments, to https://
     use of a controlled substance.                          HHS.                                                  www.regulations.gov will be posted to
       (a) States may require drug testing for               ACTION: Notification of public hearing;               the docket unchanged. Because your
     unemployment compensation                               request for comments.                                 comment will be made public, you are
     applicants, as defined in § 620.2, for the                                                                    solely responsible for ensuring that your
     unlawful use of one or more controlled                  SUMMARY:     The Food and Drug                        comment does not include any
     substances, as defined in § 620.2, as a                 Administration (FDA or the Agency) is                 confidential information that you or a
     condition of eligibility for                            announcing a public hearing to discuss                third party may not wish to be posted,
     unemployment compensation, if the                       its efforts to eliminate youth electronic             such as medical information, your or
     individual is one for whom suitable                     cigarette (e-cigarette) use as well as                anyone else’s Social Security number, or
     work, as defined in State law, as defined               other tobacco product use, with a focus               confidential business information, such
     in § 620.2 of, is only available in an                  on the potential role of drug therapies               as a manufacturing process. Please note
     occupation that regularly conducts drug                 to support youth e-cigarette cessation                that if you include your name, contact
     testing as identified under § 620.3.                    and the issues impacting the                          information, or other information that
       (b) A State conducting drug testing as                development of such therapies.                        identifies you in the body of your
     a condition of unemployment                             DATES: The public hearing will be held                comments, that information will be
     compensation eligibility, as provided in                on December 5, 2018, from 9 a.m. to 5                 posted on https://www.regulations.gov.
     paragraph (a) of this section, may only                 p.m. The public hearing may be                          • If you want to submit a comment
     elect to require drug testing of                        extended or may end early depending                   with confidential information that you
     applicants for whom the only suitable                   on the level of public participation.                 do not wish to be made available to the
     work is available in one or more of the                 Persons seeking to present at the public              public, submit the comment as a
     occupations listed under § 620.3. States                hearing must register by Friday,                      written/paper submission and in the


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                          Federal Register / Vol. 83, No. 214 / Monday, November 5, 2018 / Proposed Rules                                                  55319

     manner detailed (see ‘‘Written/Paper                       Docket: For access to the docket to                  address this critically important public
     Submissions’’ and ‘‘Instructions’’).                    read background documents or the                        health concern.4
                                                             received electronic and written/paper                     In addition to the prevention of
     Written/Paper Submissions
                                                             comments, go to https://                                initiation, which will be the cornerstone
        Submit written/paper submissions as                  www.regulations.gov and insert the                      of any successful effort to curb youth e-
     follows:                                                docket number, found in brackets in the                 cigarette use, FDA is also exploring
        • Mail/Hand delivery/Courier (for                    heading of this document, into the                      additional approaches to address youth
     written/paper submissions): Dockets                     ‘‘Search’’ box and follow the prompts                   e-cigarette use. One such approach may
     Management Staff (HFA–305), Food and                    and/or go to the Dockets Management                     be the development of drug therapies, as
     Drug Administration, 5630 Fishers                       Staff, 5630 Fishers Lane, Rm. 1061,                     part of multimodal treatment strategies,
     Lane, Rm. 1061, Rockville, MD 20852.                    Rockville, MD 20852.                                    including behavioral interventions, to
        • For written/paper comments                         FOR FURTHER INFORMATION CONTACT:                        support tobacco product cessation. To
     submitted to the Dockets Management                     Theresa Wells, Food and Drug                            date, research on youth tobacco product
     Staff, FDA will post your comment, as                   Administration, 10903 New Hampshire                     cessation has been limited and focused
     well as any attachments, except for                     Ave., Bldg. 1, Rm. 1202, Silver Spring,                 on smoking (i.e., combustible products)
     information submitted, marked, and                      MD 20993, 703–380–3900,                                 cessation. One recent review found a
     identified as confidential if submitted as              Theresa.wells@fda.hhs.gov.                              paucity of data on either behavioral or
     detailed in ‘‘Instructions.’’                                                                                   drug therapies for smoking cessation in
        Instructions: All submissions received               SUPPLEMENTARY INFORMATION:
                                                                                                                     young people (age less than 20 years)
     must include the Docket No. FDA–                        I. Background                                           and concluded that ‘‘there continues to
     2018–N–3952 for ‘‘Eliminating Youth                                                                             be a need for well-designed, adequately
     Electronic Cigarette and Other Tobacco                     Nearly all tobacco product use begins                powered, randomized controlled trials
     Product Use: The Role for Drug                          during youth and young adulthood (Ref.                  of interventions for this population of
     Therapies; Public Hearing; Request for                  1). While the current use of any tobacco                smokers’’ (Ref. 4). FDA is not aware of
     Comments.’’ Received comments will be                   product among U.S. middle and high                      any research examining either drug or
     placed in the docket and, except for                    school students has decreased from                      behavioral interventions for the
     those submitted as ‘‘Confidential                       2011–2017, there has been an alarming                   cessation of youth or adult e-cigarette
     Submissions,’’ publicly viewable at                     increase in e-cigarette use over this                   use. In contrast, there is a large body of
     https://www.regulations.gov or at the                   time. In fact, since 2014, e-cigarettes 1               research on adult smoking cessation,
     Dockets Management Staff between 9                      have been the most commonly used                        and multiple drugs for smoking
     a.m. and 4 p.m., Monday through                         tobacco products among youth, used by                   cessation are approved for the adult
     Friday.                                                 1.73 million (11.7 percent) high school                 population, including a variety of
        • Confidential Submissions—To                        students and 390,000 (3.3 percent)                      prescription and over-the-counter
     submit a comment with confidential                      middle school students in 2017 (Ref. 2).                nicotine replacement therapy (NRT)
     information that you do not wish to be                  Youth e-cigarette use raises a number of                products, as well as the prescription
     made publicly available, submit your                    health concerns including risk of                       drugs varenicline and bupropion
     comments only as a written/paper                        addiction to nicotine early on in life,                 hydrochloride sustained release (see
     submission. You should submit two                       potential harm to the developing                        Appendix A).
     copies total. One copy will include the                 adolescent brain, and exposure to
                                                             chemicals including carbonyl                            II. Purpose and Scope of the Public
     information you claim to be confidential
                                                             compounds and volatile organic                          Hearing
     with a heading or cover note that states
     ‘‘THIS DOCUMENT CONTAINS                                compounds known to have adverse                            FDA is holding a public hearing to
     CONFIDENTIAL INFORMATION.’’ The                         health effects; the full range of possible              obtain the public’s perspectives on the
     Agency will review this copy, including                 health effects is not yet completely                    potential role drug therapies may play
     the claimed confidential information, in                understood (Ref. 3).                                    in the broader effort to eliminate youth
     its consideration of comments. The                         On April 24, 2018, FDA announced                     e-cigarette and other tobacco product
     second copy, which will have the                        its Youth Tobacco Prevention Plan. This                 use, as well as the appropriate methods
     claimed confidential information                        plan focuses on three key strategies:                   and study designs for evaluating youth
     redacted/blacked out, will be available                 Prevention of youth access to tobacco                   e-cigarette cessation therapies and the
     for public viewing and posted on                        products, curbing the marketing of                      safety and efficacy of such therapies.
     https://www.regulations.gov. Submit                     tobacco products aimed at youth, and                    The Agency has determined that a
     both copies to the Dockets Management                   educating teens about the dangers of                    public hearing is the most appropriate
     Staff. If you do not wish your name and                 using any tobacco products.2 FDA                        way to ensure public engagement on
     contact information to be made publicly                 recently launched an expansion of its                   this issue, which is of great importance
     available, you can provide this                         ‘‘The Real Cost’’ campaign to educate                   to the public health. FDA believes it is
     information on the cover sheet and not                  youth on the dangers of e-cigarette use 3               critical to obtain input across the
     in the body of your comments and you                    and increased enforcement actions to                    medical and research fields, the
     must identify this information as                                                                               pharmaceutical and tobacco industries,
     ‘‘confidential.’’ Any information marked                  1 An e-cigarette is one type of electronic nicotine
                                                                                                                     and among public health stakeholders
     as ‘‘confidential’’ will not be disclosed               delivery system, which also includes e-cigars, e-       (including adolescents) regarding
                                                             hookah, vape pens, personal vaporizers, and
     except in accordance with 21 CFR 10.20                  electronic pipes. See https://www.fda.gov/              approaches to eliminate youth e-
     and other applicable disclosure law. For                TobaccoProducts/Labeling/ProductsIngredients            cigarette and other tobacco product use,
     more information about FDA’s posting                    Components/ucm456610.htm and Ref. 2.                    including exploring whether there is a
     of comments to public dockets, see 80                     2 https://www.fda.gov/TobaccoProducts/
                                                                                                                     need for drug therapies to support youth
     FR 56469, September 18, 2015, or access                 PublicHealthEducation/ProtectingKidsfrom
                                                             Tobacco/ucm608433.htm.
                                                                                                                     e-cigarette cessation, and if so, how FDA
     the information at: https://www.fda.gov/                  3 https://www.fda.gov/tobaccoproducts/
     regulatoryinformation/dockets/                          publichealtheducation/publiceducationcampaigns/           4 https://www.fda.gov/NewsEvents/Newsroom/

     default.htm.                                            therealcostcampaign/default.htm.                        PressAnnouncements/ucm620788.htm.



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     55320                Federal Register / Vol. 83, No. 214 / Monday, November 5, 2018 / Proposed Rules

     can support the development of such                        6. While this hearing is focused on the            Electronic Cigarette and Other Tobacco
     therapies.                                              topic of e-cigarette use among youth, as              Product Use: The Role for Drug
                                                             e-cigarettes are currently the most                   Therapies’’ on or before Wednesday,
     Questions for Commenters To Address
                                                             commonly used form of tobacco in this                 November 28, 2018. Persons registered
        Considering the broad range of                       population, FDA also welcomes                         to present are encouraged to arrive at
     activities focused on this public health                comments regarding the potential need                 the hearing room early and check in at
     issue, FDA is interested in the public’s                for drug therapies to support cessation               the onsite registration table to confirm
     view on approaches to eliminating e-                    of other tobacco products, including                  their designated presentation time.
     cigarette and other tobacco product use                 combustible products (i.e., cigarettes or             Actual presentation times, however,
     among youth. Although FDA welcomes                      cigars) and smokeless tobacco products,               may vary based on how the meeting
     all feedback on any public health,                      among youth and the issues impacting                  progresses in real-time. An agenda for
     scientific, regulatory or legal                         the development of such therapies.                    the hearing and any other background
     considerations relating to this topic, we                  Registration and Requests for Oral                 materials will be made available 5 days
     particularly encourage commenters to                    Presentations: The FDA Conference                     before the hearing at https://
     consider the following questions as they                Center at the White Oak location is a                 www.fda.gov/NewsEvents/
     prepare their comments or statements.                   Federal facility with security procedures             MeetingsConferencesWorkshops/
     Responses to questions should include                   and limited seating. Attendance will be               ucm620744.htm.
     supporting scientific justification.                    free and on a first-come, first-served                   If you need special accommodations
        1. FDA notes that the factors driving                basis. For those interested in presenting             because of a disability, please contact
     e-cigarette use among youth likely differ               at the meeting, either with a formal oral             Theresa Wells (see FOR FURTHER
     from those in the adult population. How                 presentation or as a speaker in the open              INFORMATION CONTACT) at least 7 days
     might such differences impact the need                  public hearing session, please register               before the hearing.
     for, or use of, drug therapies for e-                   by Friday, November 23, 2018, at                         Streaming Webcast of the Public
     cigarette cessation among youth?                        https://www.eventbrite.com/e/fda-                     Hearing: For those unable to attend in
        2. FDA is interested in whether there                pediatric-tobacco-cessation-part-15-                  person, FDA will provide a live Webcast
     is a population of youth e-cigarette users              public-hearing-tickets-50167147288. If                of the hearing. To join the hearing via
     who would be likely to benefit from the                 you wish to attend either in person or                the Webcast, please go to https://
     use of drug therapies for e-cigarette                   by Webcast (see Streaming Webcast of                  collaboration.fda.gov/ptc120518.
     cessation. What age groups (older                       the Public Hearing), please register for                 Transcripts: Please be advised that as
     adolescent vs. younger adolescent),                     the hearing by Monday December 3,                     soon as a transcript is available, it will
     patterns in tobacco use (duration and                   2018, at https://www.eventbrite.com/e/                be accessible at http://
     frequency of use), and clinical features                fda-pediatric-tobacco-cessation-part-15-              www.regulations.gov. It may be viewed
     (level of addiction, presence/absence of                public-hearing-tickets-50167147288.                   at the Dockets Management Staff (see
     comorbidities including psychiatric                     Those without internet or email access                Comments). A transcript will also be
     disease) might characterize this                        can register and/or request to participate            available in either hard copy or on CD–
     population? What types of products                      as an open public hearing speaker or a                ROM, after submission of a Freedom of
     (NRT vs. non-NRT; prescription vs.                      formal presenter by contacting Theresa                Information request. The Freedom of
     over-the-counter) might be useful?                      Wells by the above dates (see FOR                     Information office address is available
        3. Describe the scientific, clinical, and            FURTHER INFORMATION CONTACT).                         on the Agency’s website at https://
     societal factors that could either                         FDA will try to accommodate all                    www.fda.gov.
     encourage or impede the conduct of                      persons who wish to make a                            III. Notice of Hearing Under 21 CFR
     clinical trials designed to evaluate drugs              presentation. Formal oral presenters                  Part 15
     intended for youth e-cigarette cessation.               may use an accompanying slide deck,
     What approaches could be used to                        while those participating in the Open                    The Commissioner of Food and Drugs
     encourage research and overcome                         Public Hearing will have less allotted                is announcing that the public hearing
     barriers to research?                                   time than formal oral presenters and                  will be held in accordance with 21 CFR
        4. What methods and study designs                    will deliver oral testimony only (no                  part 15. The hearing will be conducted
     are appropriate for assessing drug                      accompanying slide deck). Individuals                 by a presiding officer, who will be
     therapies for youth e-cigarette cessation?              wishing to present should identify the                accompanied by FDA senior
     What are the appropriate control                        number of the specific question, or                   management from the Office of the
     groups? What are the most informative                   questions, they wish to address. This                 Commissioner, the Center for Drug
     endpoints and the best assessment tools                 will help FDA organize the                            Evaluation and Research, and the Center
     to evaluate these endpoints?                            presentations. Individuals and                        for Tobacco Products. Under § 15.30(f),
        5. Acknowledging that to date                        organizations with common interests                   the hearing is informal and the rules of
     research has been limited, are there data               should consolidate or coordinate their                evidence do not apply. No participant
     available from the adult experience with                presentations and request time for a                  may interrupt the presentation of
     smoking cessation that could potentially                joint presentation. Individual                        another participant. Only the presiding
     be leveraged in the effort to develop                   organizations are limited to a single                 officer and panel members can pose
     drug therapies for youth e-cigarette                    presentation slot. FDA will notify                    questions; they can question any person
     cessation? Have any drug therapies                      registered presenters of their scheduled              during or at the conclusion of each
     demonstrated potential to help adults                   presentation times. The time allotted for             presentation. Public hearings under part
     discontinue e-cigarette use? Are there                  each presentation will depend on the                  15 are subject to FDA’s policy and
     differences between adolescents and                     number of individuals who wish to                     procedures for electronic media
     adults that impact the ability to                       speak. Registered presenters making a                 coverage of FDA’s public administrative
     extrapolate efficacy findings from the                  formal oral presentation are encouraged               proceedings (21 CFR part 10, subpart C).
     adult population to the adolescent                      to submit an electronic copy of their                 Under § 10.205, representatives of the
     population? Could existing NRT                          presentation (PowerPoint or PDF) to                   media may be permitted, subject to
     products be useful for youth e-cigarette                OMPTFeedback@fda.hhs.gov with the                     certain limitations, to videotape, film, or
     cessation?                                              subject line ‘‘Eliminating Youth                      otherwise record FDA’s public


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                          Federal Register / Vol. 83, No. 214 / Monday, November 5, 2018 / Proposed Rules                                               55321

     administrative proceedings, including                   Some may be available at the website                       67:629–633, available at https://
     presentations by participants. The                      address, if listed. References without                     www.cdc.gov/mmwr/volumes/67/wr/
     hearing will be transcribed as stipulated               asterisks are available for viewing only                   mm6722a3.htm).
     in § 15.30(b) (see Transcripts). To the                 at the Dockets Management Staff. FDA                  3.* U.S. Department of Health and Human
     extent that the conditions for the                      has verified the website addresses, as of                  Services (2016). ‘‘E-Cigarette Use Among
                                                                                                                        Youth and Young Adults: A Report of
     hearing, as described in this notice,                   the date this document publishes in the
                                                                                                                        the Surgeon General.’’ Atlanta, GA: U.S.
     conflict with any provisions set out in                 Federal Register, but websites are
                                                                                                                        Department of Health and Human
     part 15, this notice acts as a waiver of                subject to change over time.                               Services, Centers for Disease Control and
     those provisions as specified in                        1.* U.S. Department of Health and Human                    Prevention, National Center for Chronic
     § 15.30(h).                                                 Services (2014). ‘‘The Health                          Disease Prevention and Health
                                                                 Consequences of Smoking—50 Years of                    Promotion, Office on Smoking and
     IV. References                                              Progress: A Report of the Surgeon                      Health available at: https://e-
                                                                 General.’’ Atlanta, GA: U.S. Department                cigarettes.surgeongeneral.gov/
       The following references marked with                      of Health and Human Services, Centers
     an asterisk (*) are on display at the                                                                              documents/2016_sgr_full_report_non-
                                                                 for Disease Control and Prevention,                    508.pdf.
     Dockets Management Staff and are                            National Center for Chronic Disease               4. Fanshawe T.R., W. Halliwell, N. Lindson,
     available for viewing by interested                         Prevention and Health Promotion, Office
                                                                                                                        et al. (2017). ‘‘Tobacco Cessation
     persons between 9 a.m. and 4 p.m.,                          on Smoking and Health available at:
                                                                 https://www.surgeongeneral.gov/library/                Interventions for Young People.’’
     Monday through Friday; they also are                                                                               Cochrane Database of Systematic
     available electronically at https://                        reports/50-years-of-progress/index.html.
                                                             2.* Wang T.W., A. Gentzke, S. Sharapova, et                Reviews, Rev.11:CD003289, available at
     www.regulations.gov. References                             al. (2018). ‘‘Tobacco Product Use Among                https://www.cochranelibrary.com/cdsr/
     without asterisks are not on public                         Middle and High School Students—                       doi/10.1002/14651858.CD003289.pub6/
     display at https://www.regulations.gov                      United States, 2011–2017.’’ Morbidity                  epdf/full.
     because they have copyright restriction.                    and Mortality Weekly Report (MMWR)                BILLING CODE 4164–01–P




                                                                                                                                                                    EP05NO18.010</GPH>




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55322                      Federal Register/ Vol. 83, No. 214/Monday, November 5, 2018 /Proposed Rules


              Product Name                 OTC or Rx                   Route                    Indication                   Adult Treatment Duration and          Pediatric Labeling
             (NDA # holder)      (Date approved, Date Rx—>OTC)      (Doses)                                                    .         Schedule                              .
             Nicotrol NS        Prescription                     Nasal spray    | & Indicated as an                     2 sprays (one per nostril) =1 dose.     Under Pediatric Use:
             {nicatine)         (3/22/96; N/A)                   {50 microliter     aid to smoking                                                              Not recommended for
             (NDA020385;,                                        spray                        cessation for the.|       * Starting dose: 1—2 doseshour          use in the pediatric
             Pfizer)                                             delivering0.3                relief ofnicotine\        * Maximum doses/hour: 5                 population because its
                                                                 mg)                         withdrawal              |—* Maximum doses/day: 40                  safety and effectiveness [
                                                                                          \_ symptoms                                    ~                      in children and
                                                                                          * Should be used as Masximum recommendedduration adolescents who smoke
                                                                                              apart of a                of treatment: 3 months                  havenot been
                                                                                              comprehensive                                                     evaluated.
                                                                                              behavicral                The safety and efficacy ofthe:
                                                                                              smoking                       continued use of Nicotrol NS for
                                                                                              cessation                 —| periods longer than 6 months
                                                                                              program                       have not been adequatelystudied
                                                                                                                          | and such use is not
         ;                                                                                                          _.|     recommended.
             Nicotrol Inhaler   Prescription                     Inhalant             ~ * Indicated as an               Therecommended duration of              Safety and effectiveness
             {nicotine)         (572597, N/A)                    (10 mg               _       aid to smoking            treatment is 3 months,after which| in pediatricand
             (NDA 020714;                                        cartridge; 4                 cessation for the:        patients maybe weaned from the          adolescentpatients—
             Pharmacia and                                       mg delivered)                relief of nicotine.       inhaler by gradual reduction of         belowthe age of 18
             Upjohn)                                                                          withdrawal               —the daily dose over the following       years have not been
    ‘                                                                                         symptoms                  6to 12 weeks.                           established for any
                                                                                          e Recommended        [| _                                             nicotine replacement
                                                                                            for use as part of —| The safety and efficacy of the                product. However, no
                                                                                            a comprehensive       confinued use of Nicotrol Inhaler             specific medicaltisk is
                                                                                            behavioral            for periods longerthan 6 months.              known or expected in
                                                                                              smoking                   have not been studied and such          nicgtim dependent
                                                                                              cessation                 use is not recommended.                 adolescents,
                                                                                              «program.                                                         NICOTROL Enhaier
                                                                                                                                                                should be used for the
                                                                                                                                                                treatment of tobaceo
                                                                                                                                                                dependence in the older
                                                                                                                                                                adolescent onlyif the
                                                                                                                                                                potential benefit
                                                                                                                                                                justifies the potential
                                                                                                                                                                tisk.


        . Product Name                     OTC or Rx       .           Route                     Indication                  Adult Treatment Duration and               Pediatric Labeling
             {(NDA #; holder) | (Date approved; Date Rx>OTC)        (Doses)                                             —                 Schedule
     Nicorette                  OTe                              Oral                       Reduces withdrawal              12 weeks (for longer—use, talk to     If you are under 18
     lozenge                    (10/3142; N/A                    (2, 4 mg)                | symptoms,                       health care provider):                years of age ask a
    {nicotine:                                                                              including nicotine                                                    doctor before use: No
        polacrilex)                                                                        craving, associated              * Wk1—6; 1 per 1—2 hr                 studies have been done
        . [(NDA 021330;                                                                   . with quitting                   » WEkT—9 1 per 2—4 hr                 to showifthis product
          GSK)                                                                              smoking.                        * Whk1G—42; 1 per 4—8 hr              will work for you.

                                                                                                                            If smoke 1*cigarette within 30
                                                                                                                            min ofwaking up, use 4 mg; if
                                                                                                                            more than 30 min, use 2 mg.
       Nicorette mini           OfC                              Oral                      Seme as above                —Same as above                            Same as above
   | lozerige                   (5/18/09; NiIA)                  (2.4mg)
     ‘ {nicotine
       polacrilex)
        (NDA 022360;
        GSK)                                                                   .          i         .
    ‘                                                                              Non—NRT Therapies
        Zyban                   Prescription                     Oral                      * Indicated as an                7—12 weeks:                           Safety and effectiveness
        (bupropion              (514/97; N/AQ                    (150 mg)                      aidto smoking                * Start at one 150—mg tablet per     inthe pediatric
        hydrochloride                                                                          cessation.                     day for 3 days                     population have not
        sustained                                                                              treatment                    * Can increase to 300 mg per          been established.
        release)                                                                                                              day given as one 150—mg tablet      Boxed Warning for
        —(NDA 020711;                                                                                                         twice each day, with 8 hours        suicidalityinchildren,
         GSK)                                                                                                                 between                             adolescents, and young
                                                                                                                            Patient may benefit from ongoing      adults in setting of
                                                                                                                            treatment.                            bupropion use as an
                                                                                                                                                                  antidepressant.


                          Federal Register / Vol. 83, No. 214 / Monday, November 5, 2018 / Proposed Rules                                            55323

       Dated: October 30, 2018.                                • Federal eRulemaking Portal:                       with a heading or cover note that states
     Leslie Kux,                                             https://www.regulations.gov. Follow the               ‘‘THIS DOCUMENT CONTAINS
     Associate Commissioner for Policy.                      instructions for submitting comments.                 CONFIDENTIAL INFORMATION.’’ We
     [FR Doc. 2018–24126 Filed 11–2–18; 8:45 am]             Comments submitted electronically,                    will review this copy, including the
     BILLING CODE 4164–01–C                                  including attachments, to https://                    claimed confidential information, in our
                                                             www.regulations.gov will be posted to                 consideration of comments. The second
                                                             the docket unchanged. Because your                    copy, which will have the claimed
     DEPARTMENT OF HEALTH AND                                comment will be made public, you are                  confidential information redacted/
     HUMAN SERVICES                                          solely responsible for ensuring that your             blacked out, will be available for public
                                                             comment does not include any                          viewing and posted on https://
     Food and Drug Administration                            confidential information that you or a                www.regulations.gov. Submit both
                                                             third party may not wish to be posted,                copies to the Dockets Management Staff.
     21 CFR Part 101                                         such as medical information, your or                  If you do not wish your name and
     [Docket No. FDA–2018–D–1459]                            anyone else’s Social Security number, or              contact information to be made publicly
                                                             confidential business information, such               available, you can provide this
     Food Labeling: Serving Sizes of Foods                   as a manufacturing process. Please note               information on the cover sheet and not
     That Can Reasonably Be Consumed at                      that if you include your name, contact                in the body of your comments and you
     One Eating Occasion, Reference                          information, or other information that                must identify this information as
     Amounts Customarily Consumed,                           identifies you in the body of your                    ‘‘confidential.’’ Any information marked
     Serving Size-Related Issues, Dual-                      comments, that information will be                    as ‘‘confidential’’ will not be disclosed
     Column Labeling, and Miscellaneous                      posted on https://www.regulations.gov.                except in accordance with 21 CFR 10.20
     Topics; Draft Guidance for Industry;                      • If you want to submit a comment                   and other applicable disclosure law. For
     Availability                                            with confidential information that you                more information about FDA’s posting
                                                             do not wish to be made available to the               of comments to public dockets, see 80
     AGENCY:    Food and Drug Administration,                public, submit the comment as a                       FR 56469, September 18, 2015, or access
     HHS.                                                    written/paper submission and in the                   the information at: https://www.gpo.gov/
     ACTION:   Notification of availability.                 manner detailed (see ‘‘Written/Paper                  fdsys/pkg/FR-2015-09-18/pdf/2015-
                                                             Submissions’’ and ‘‘Instructions’’).                  23389.pdf.
     SUMMARY:   The Food and Drug
     Administration (FDA or Agency) is                       Written/Paper Submissions                                Docket: For access to the docket to
     announcing the availability of a draft                                                                        read background documents or the
                                                                Submit written/paper submissions as
     guidance for industry entitled ‘‘Food                                                                         electronic and written/paper comments
                                                             follows:
     Labeling: Serving Sizes of Foods That                                                                         received, go to https://
                                                                • Mail/Hand Delivery/Courier (for
     Can Reasonably Be Consumed At One                                                                             www.regulations.gov and insert the
                                                             written/paper submissions): Dockets
     Eating Occasion, Reference Amounts                                                                            docket number, found in brackets in the
                                                             Management Staff (HFA–305), Food and
     Customarily Consumed, Serving Size-                                                                           heading of this document, into the
                                                             Drug Administration, 5630 Fishers
     Related Issues, Dual-Column Labeling,                                                                         ‘‘Search’’ box and follow the prompts
                                                             Lane, Rm. 1061, Rockville, MD 20852.
     and Miscellaneous Topics.’’ The draft                      • For written/paper comments                       and/or go to the Dockets Management
     guidance, when finalized, will provide                  submitted to the Dockets Management                   Staff, 5630 Fishers Lane, Rm. 1061,
     questions and answers on topics related                 Staff, FDA will post your comment, as                 Rockville, MD 20852.
     primarily to implementing two final                     well as any attachments, except for                      You may submit comments on any
     rules, one entitled ‘‘Food Labeling:                    information submitted, marked and                     guidance at any time (see 21 CFR
     Serving Sizes of Foods That Can                         identified, as confidential, if submitted             10.115(g)(5)).
     Reasonably Be Consumed At One Eating                    as detailed in ‘‘Instructions.’’                         Submit written requests for single
     Occasion; Dual-Column Labeling;                            Instructions: All submissions received             copies of the draft guidance to the Office
     Updating, Modifying, and Establishing                   must include the Docket No. FDA–                      of Nutrition and Food Labeling, Center
     Certain Reference Amounts Customarily                   2018–D–1459 for ‘‘Food Labeling:                      for Food Safety and Applied Nutrition,
     Consumed; Serving Size for Breath                       Serving Sizes of Foods That Can                       Food and Drug Administration, 5001
     Mints; and Technical Amendments,’’                      Reasonably Be Consumed At One Eating                  Campus Dr., College Park, MD 20740.
     and the other entitled ‘‘Food Labeling:                 Occasion, Reference Amounts                           Send two self-addressed adhesive labels
     Revision of the Nutrition and                           Customarily Consumed, Serving Size-                   to assist that office in processing your
     Supplement Facts Labels.’’ This draft                   Related Issues, Dual-Column Labeling,                 request. See the SUPPLEMENTARY
     guidance also discusses formatting                      and Miscellaneous Topics; Draft                       INFORMATION section for electronic
     issues for dual-column labeling,                        Guidance for Industry.’’ Received                     access to the draft guidance.
     products that have limited space for                    comments will be placed in the docket                 FOR FURTHER INFORMATION CONTACT:
     nutrition labeling, and additional issues               and, except for those submitted as                    Jillonne Kevala, Center for Food Safety
     dealing with compliance.                                ‘‘Confidential Submissions,’’ publicly                and Applied Nutrition, Food and Drug
     DATES: Submit either electronic or                      viewable at https://www.regulations.gov               Administration, 5001 Campus Dr.,
     written comments on the draft guidance                  or at the Dockets Management Staff                    College Park, MD 20740, 240–402–1450.
     by January 4, 2019 to ensure that we                    between 9 a.m. and 4 p.m., Monday                     SUPPLEMENTARY INFORMATION:
     consider your comment on the draft                      through Friday.
                                                                • Confidential Submissions—To                      I. Background
     guidance before we begin work on the
     final version of the guidance.                          submit a comment with confidential                       We are announcing the availability of
     ADDRESSES: You may submit comments                      information that you do not wish to be                a draft guidance for industry entitled
     on any guidance at any time as follows:                 made publicly available, submit your                  ‘‘Food Labeling: Serving Sizes of Foods
                                                             comments only as a written/paper                      That Can Reasonably Be Consumed At
     Electronic Submissions                                  submission. You should submit two                     One Eating Occasion, Reference
       Submit electronic comments in the                     copies total. One copy will include the               Amounts Customarily Consumed,
     following way:                                          information you claim to be confidential              Serving Size-Related Issues, Dual-


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Document Created: 2018-11-03 00:28:07
Document Modified: 2018-11-03 00:28:07
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionNotification of public hearing; request for comments.
DatesThe public hearing will be held on December 5, 2018, from 9 a.m. to 5 p.m. The public hearing may be extended or may end early depending on the level of public participation. Persons seeking to present at the public hearing must register by Friday, November 23, 2018. Persons seeking to attend, but not present at, the public hearing must register by Monday, December 3, 2018. Section II provides attendance and registration information. Electronic or written comments will be accepted after the public hearing until Wednesday, January 2, 2019.
ContactTheresa Wells, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 1, Rm. 1202, Silver Spring, MD 20993, 703-380-3900, [email protected]
FR Citation83 FR 55318 

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