Knives out for FDA head Marty Makary after he blocks, then OKs vape flavors after Trump criticism

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WASHINGTON — A panoply of critics is trying to take down Food and Drug Administration commissioner Dr. Marty Makary — sensing blood in the water after President Trump forced him to approve flavored e-cigarettes with new “age gate” ID-verifying technology.

The president’s over-the-weekend anger, followed by Makary’s swift capitulation on Wednesday, uncorked an outpouring of attacks, with anti-abortion campaigners, novel nicotine-delivery advocates and some administration officials joining forces to try to topple the telegenic cancer doctor.

The attacks run the gamut of hot-button issues and will test Makary’s skill at navigating administration dynamics while endeavoring to please the president, who recently started to fire second-term agency leaders who brought him negative press.

The jousting started when Makary stood accused of undermining Trump’s 2024 campaign pledge to “save” the vaping industry if elected to a second term.

Most US-made flavor options were quietly banned at the end of Trump’s first term — as the COVID-19 pandemic dominated public health focus — despite Trump’s own concern about riskier Chinese-made products flooding the market, which then proceeded to happen. 

In December, the FDA’s website announced approval of fruit-flavored vapes, including mango, from California manufacturer Glas, which uses Bluetooth technology requiring users to scan a government ID proving they are at least 21, the higher age limit signed into law by Trump in 2019.

The FDA chief blocked implementation for months, reportedly prompting Trump to directly reprimand Makary last weekend. He quickly dropped his opposition. Blueberry was among the offerings approved on Wednesday.

The dustup has Makary on the ropes and critics angling to knock him off.

Anti-abortion campaigners are trying to boot Makary over the Trump administration’s continued support for the mail-distribution of abortion pill mifepristone — though the president’s own feelings are murky.

Social conservatives within the administration, meanwhile, have catalogued Makary’s alleged sins.

Administration officials pointed to Makary approving a $240,000 grant to a “far-left” Chicago charter school, the Academy for Global Citizenship, that touts a focus on “social justice” for grade-school pupils, with role models such as Greta Thunberg and Kamala Harris, and whose founder, Sarah Elizabeth Ippel,  is labeled a “climate hero” on the school website.

Makary visited the campus last month to promote a pilot program hiring a baker to make bread and pastries. 

A defender of Makary told The Post that the connection to the school can be explained by the fact that a member of the school’s board, Mark Hyman, is closely associated with HHS Secretary Robert F. Kennedy Jr. and the administration’s “Make America Healthy Again” agenda, saying that “multicultural” aspects of the school are due to its urban setting.

Further irking skeptics within the administration, Makary hosted a March 3 meeting with representatives of Arnold Ventures, the philanthropic organization of hedge fund billionaire John Arnold. 

Arnold Ventures has donated to politicians from both parties but has poured millions into supporting bail reform in New York, which Republicans, including Trump, said fueled violent crime, and invested $20 million in a youth support initiative led by Maryland Democratic Gov. Wes Moore, with whom Trump has clashed.

The source supportive of Makary insisted that the meeting, whose purpose wasn’t posted on the public FDA calendar entry, “wouldn’t be on those topics” — noting Arnold is “very heterodox” and also an outspoken critic of medicines that “don’t work.”

An administration official said there’s also internal frustration that Makary hasn’t used the FDA’s authority to rein in the use of puberty blockers and hormones for underage transgender treatments.

Makary’s staffing has ruffled others, including his hiring of Vinay Prasad, a onetime supporter of socialist Vermont Sen. Bernie Sanders, to direct the FDA’s Center for Biologics Evaluation and Research. 

Prasad was fired in July, but rehired weeks later, after activist influence Laura Loomer accused him of boasting about stabbing a voodoo doll of Trump to curse him. The fuller context indicated he was speaking in hypothetical terms.

“He went back to UC San Francisco full-time on April 30, last Thursday,” said the Makary defender. “There have been plenty of stories of people that say they didn’t like Vinay Prasad because he used to be a Bernie bro, but he’s pretty on the record from the 2024 cycle on of being on the Trump side.”

The White House sought the resignation of another top Makary aide, Sanjula Jain-Nagpal, in November after she announced herself as deputy chief of staff without approval from the White House. The termination orders were rescinded when she blamed a communication mixup.

Yet another Makary aide, George Tidmarsh, resigned in November as director of the FDA’s Center for Drug Evaluation and Research, after a lawsuit accused him of attempting to “extort and solicit a bribe.”

Makary’s precarious standing is in part due to the fact that Trump is himself an unconventional figure, and the FDA chief’s personal views on some controversial matters aren’t well-known, though he has gone along with recent steps to ease the therapeutic use of psychedelics.

His views on marijuana, which Trump recently reclassified as a Schedule III drug after griping about slow-walking from Justice Department skeptics, also aren’t well-known.

“White House staff tend not to be so pro-reform on weed or psychedelics, so the president needs to push like he is to get this done,” one administration official said.

The vaping dust-up that kicked off the administration intrigue followed a surprise Dec. 20 website update announcing the flavor approvals, revealed online by nicotine industry attorney Gregory Conley.

Conley is a long-time supporter of flavor options in e-cigarettes, dismissing the argument that they appeal to children and contending they can save lives by giving cigarette smokers an appealing and likely safer alternative, and his arguments appeared to sway Trump during a 2019 Cabinet Room debate with then-Sen. Mitt Romney (R-Utah) over a looming flavor ban.

Trump predicted at the time: “Somebody is going to open up a shop in China and ship it in with flavors and you don’t know what standard you’re getting. Isn’t that a problem?”

The flavor ban ultimately took effect as Trump’s administration was focused on the COVID-19 pandemic and Chinese-made vape devices that come in flavors are now sold across the US, owing to the fact that unlike US companies, they don’t fear regulators.

In the 2024 campaign, Trump promised to reverse the trend.

“I saved Flavored Vaping in 2019, and it greatly helped people get off smoking. I raised the age to 21, keeping it away from the ‘kids,’” Trump said in a campaign statement. “Kamala and Joe want everything banned, killing small businesses all over the Country. I’ll save Vaping again!”

Conley accused Makary of undermining Trump’s stance, including by testifying to Congress last year that in some high schools “half of the kids are addicted to these vaping products” — and then touting crackdowns on US firms selling Chinese-made products.

Federal data actually show teen vaping at a 10-year low. The 2025 National Youth Tobacco Survey showed 7.1% of high school students reported past-month use of vapes, with 2.6% of middle schoolers using the devices — down from a high of 27.5% of high schoolers and 10.5% of middle schoolers in 2019 before the higher nicotine-purchasing age took effect.

“We never got the conclusion that we hoped for during the first Trump administration because of COVID,” said Conley said, who added that Trump appears intent on making good on promises to niche constituencies who aided his return to the White House.

“In reality, the products that are going through the FDA process are going to be less harmful, less hazardous than the vapes from the average Chinese manufacturer,” Conley said.

“Why would you stand in the way of this when it’s clear that the president wants flavored vapes to be authorized and you have a product that is age gated?”

The Makary ally told The Post that the battle isn’t over, arguing that first lady Melania Trump has been “very forceful” about concerns of unleashing a “vape epidemic with young kids.”

“Really there’s a consensus against fruity flavors in this administration,” the person said, though the just-approved new age-gating technology mitigates the concern by forcing the scanning of IDs to unlock the devices.

In private, Makary has blamed unnamed lobbyists for vaping firms for the current controversy, his supporter said, and is focused on aligning himself with some of Trump’s other goals, such as speeding the approval of new medicines, including those to fight cancer.

“He knows these lobbyists so well,” the person said. “[Makary] views it as saber rattling to try to get him to change his positions… he does not let what these stories lobbying firms are planting affect his mindset.”

The FDA did not respond to a request for comment.

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