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The US Food and Drug Administration received its fourth consecutive failing grade on regulation of tobacco products in the American Lung Association's annual State of Tobacco Control report.

A key factor in the grade was the Trump administration's decision to exempt menthol and tobacco-flavored e-cigarettes from the policy it finalized this month to clear the market of cartridge-based e-cigarette flavors. The final policy was a shift from its September announcement that it would clear the market of all e-cigarette flavors except tobacco.