(CNN)More than 50 health and advocacy groups are sending a clear message in letters to US Health and Human Services Secretary Alex Azar and first lady Melania Trump: Stick with the plan that was announced last month that would require e-cigarette companies to take their flavored products off the market, including mint and menthol.
According to an announcement Tuesday, the groups are responding to recent media reports that the Trump administration could back down from its earlier stance by including exceptions for mint and menthol.
The US Food and Drug Administration has not yet finalized its compliance policy to take action on flavors.
Among the organizations that signed the letters are the American Academy of Pediatrics, the American Heart Association, the American Lung Association, the American Medical Association, the American Cancer Society Cancer Action Network, the Campaign for Tobacco-Free Kids and the National Association for the Advancement of Colored People (NAACP).
In the letters, the organizations say the policy would be "weakened" by such an exception: "A policy that does not remove all flavored e-cigarettes will not solve the current epidemic of youth e-cigarette use. Youth who now use mint and menthol e-cigarettes will continue to do so, and youth who use flavors that are removed from the market will simply switch to mint and menthol."
The letters cited recent FDA data that shows nearly 64% of high schoolers who vape use mint or menthol flavors, up from 51.2% in 2018 and 42.3% in 2017.
"Mint and menthol are especially dangerous flavors for teens because they both contain menthol as an ingredient, which has cooling properties that make it easier for teens to tolerate the harsh taste of nicotine," the letter to Azar said.
"Exempting mint and menthol e-cigarettes from the Administration's policy will leave America's kids at risk."
In September, the FDA revealed that 27.5% of high school students were current users of e-cigarettes in 2019 -- up from 20.8% in 2018 and 11.7% in 2017.
A study published Monday found that students who used "nontraditional flavors" such as fruit or candy were more likely to still be vaping six months later and took more puffs when compared to the few who vaped only "traditional flavors" such as mint, menthol or tobacco. Another recent study found that young people who first try a flavored tobacco product are at higher risk of using non-flavored tobacco later on.
Still, advocates for flavored products say they're an important tool in getting adults to switch from combustible cigarettes.
"A ban on flavored nicotine vapes will have zero impact on the health crisis we are seeing with illegal THC cartridges," Gregory Conley, president of the American Vaping Association, a nonprofit that advocates for sensible regulation of vaping products, said in a statement last week. "What this will do is deprive many adult ex-smokers of the vape flavors they rely upon to stay smoke-free."
Conley said "reasonable proposals to actually prevent youth vaping include stronger age verification, strict marketing standards, and increasing the legal vaping and tobacco age to 21."
The FDA has faced criticism for not yet having issued the compliance policy the administration announced on September 11.
"It is past time for the FDA to put into effect what they announced weeks ago, and what they should have done years ago," Sen. Dick Durbin said in a statement last week.
Michael Bloomberg, former New York City mayor and founder of Bloomberg Philanthropies, said in a statement last week, "Forty-four days ago, the Administration announced that it would take all flavored e-cigarettes off the market -- we're still waiting."
"Any plan that doesn't ban those flavors is no plan at all. The Administration must stand firm against tobacco industry pressure and honor its commitment to get rid of all flavors."
Bloomberg Philanthropies recently announced the launch of a new $160 million initiative to curb e-cigarette use among youth in the United States.
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