Form FDA 3734 FDA 3734 Tobacco Product Standard Violations on Flavored Cigarett

Form FDA 3734 OMB No. 0910-XXXX Expires mm/dd/yy

Public reporting burden for this collection of information is estimated to average 10 minutes per response including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to:

Department of Health and Human Services

Food and Drug Administration

Office of the Chief Information Officer (HFA-710)

5600 Fishers Lane

Rockville, MD 20857

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Thank you for taking the time to contact us. The information you provide can help FDA to prevent children and adolescents from beginning to smoke, and help reduce the number of people who suffer illness or die from diseases associated with smoking cigarettes.

Effective September 22, 2009, cigarettes and their components, such as filters and papers, that contain certain characterizing flavors are considered adulterated under the Federal Food, Drug, and Cosmetic Act, as amended by the Family Smoking Prevention and Tobacco Control Act. This means that it is now illegal to manufacture, distribute, sell or import into the United States cigarettes that contain characterizing flavors such as herb, spice or fruit flavors, including cinnamon, vanilla, chocolate, clove, strawberry, grape or cherry.

Smoking is the leading preventable cause of death in the United States. An important way to reduce the death and disease caused by smoking is to prevent children and adolescents from starting to smoke. Congress has stated that flavors make cigarettes more appealing to youth and often result in exposure to additional carcinogens and other toxic constituents. The removal from the market of cigarettes that contain certain characterizing flavors is an important step in FDA’s efforts to reduce the burden of illness and death caused by tobacco products.

• Name of person reporting information(Optional)

• Affiliation of person reporting information, such as company, school, public interest group (optional)

• Description of product

  1. Type (Cigarette, filter or papers)

  2. Brand (e.g., Camel, Marlboro, Kent)

  3. Characterizing flavor [please include pick list: cherry, chocolate , cinnamon, clove, cocoa, coconut, grape, licorice, strawberry, orange, pineapple, vanilla, other (write in)]

  4. Package description (pack, carton, roll, box, etc.)

• Did you purchase the product? 

  1. If YES –

• what is the lot# on the package?

2. If you would like to send us packages, ads or labels, please mail them to FDA, Center for Tobacco Products, 9200 Corporate Blvd, Rockville, MD 20850-3229.

• Was the product in a store or on the internet?

  1. STORE –

1. Name of store or retail outlet

2. Address of store or outlet (cross-streets are OK if full address not known)

3. Location of product in store, e.g., in front of counter, behind counter, display case, vending machine, etc.

4. On what date did you see or buy the product in the store?

2. INTERNET

1. What is the internet site’s domain address?

2. Who owns the internet site? (if known)

3. On what date did you see the product on the web site?

• May we contact you if we need additional information? If yes:

  1. phone and/or email address

• If you would like to send us anything, such as packages, ads or labels, please mail them to FDA, Center for Tobacco Products, 9200 Corporate Blvd, Rockville, MD 20850-3229

Field for additional comments: _____________________________________________________________________________________________________________________________________________________________________________________________________________________

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Thank you for taking the time to contact FDA’s Center for Tobacco Products. Be assured that we take your report seriously and will evaluate this matter to determine appropriate follow-up action. FDA does not provide information about ongoing investigations, but once an investigation is closed, you may file a request about it pursuant to the Freedom of Information Act.