Under NO circumstances will your personal information be shared. * Information that is required for the form to be accepted.
To understand why this information is needed, click the [?] following each text box
In order for your comments to be much more effective, this information is needed to identify you as an Individual to the FDA, and to your respective Congressional Legislators.
Your Congressional Representative needs this information, in order to accurately identify you as a Constituent of their District.
Your Congressional Senators' need this information, to accurately identify you as a Resident of their respective state.
This is needed by the backend software - to correctly select your Congressional Representative and your Congressional Senators - in order to fax them your submittal in real time.
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Your age provides the FDA and your respective Legislators with influential data regarding electronic and traditional tobacco cigarette users.
Your email address is used to provide you with a personal copy of your FreeToVape submission, and timely updates regarding progress of your concerns and efforts here.
Gender:
COMMENT SECTION
Here you will answer questions that organizes your comments into a concise, personal message. Also, you have a section where you can tell how electronic cigarettes have changed your life.
Do you use Electronic Cigarettes?
If so for how long?
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Do you or have you smoked traditional tobacco cigarettes?
If so for how long?
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How has the use of Electronic Cigarettes impacted your use of Traditional Tobacco Cigarettes?
Are you familiar with the current proposed FDA regulations regarding hardware? [Learn More]
Do you support the FDA proposed warning labels regarding the addictive properties of nicotine?
Do you agree with the FDA proposal that there will be no sales of electronic cigarettes to anyone under the age of 18?
Do you feel that all eLiquid bottles should have childproof caps?
Do you feel that having a variety of eLiquid flavors has helped you quit traditional tobacco cigarettes?
Do you support AEMSA's standards in regards to making juice?
AEMSA (American eLiquid Manufacturing Standards Association)
AEMSA Standards: Creating responsible and sustainable practices and process for the safe manufacturing of "eLiquids" used in electronic cigarettes.
AEMSA standards are established based on the following Core Beliefs:
We have a responsibility to verify the accuracy of any nicotine content in the products we distribute
We have a responsibility to ensure the quality and safety of all ingredients in our e-Liquids.
We have a responsibility to prepare our products in a clean, sanitary and safe environment.
We have a responsibility to ensure our products are packaged and delivered in a safe manner.
We have a responsibility to provide a level of transparency into the monitoring and verification process.
Do you Vape using:
(Check all that apply)
Variable Voltage/Wattage (APV) Advanced Personal Vaporizer
Have you read the current proposed FDA regulations?:
If so, what do you disagree with? [learn more]
Should the FDA regulate:
How has vaping helped you?
(Check all that apply)
Please provide any links to vaping related studies that you feel are important for the FDA to look into:
Tell Your Story (How has vaping changed your life? How will these regulations impact you? Etc... )
(Please refrain from profanity, slander, and slang.)
