#aafth ,,congress #b;d ,session ,h4 ,r4 #bcci ,,an ,,act ,to amend the ,federal ,food1 ,drug1 and ,cosmetic ,act with respect to the sale and marketing of tobacco products1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj4 #b4 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,table of contents4 ,title ,i--,food and ,drug ,administration ,sec4 #aja4 ,cigarette graphic health warnings4 ,sec4 #ajb4 ,advertising and sales parity for all deemed tobacco products4 ,sec4 #ajc4 ,reducing child and adolescent nicotine addiction4 ,sec4 #ajd4 ,prohibition against remote retail sales4 ,sec4 #aje4 ,fees applicable to all tobacco products4 ,sec4 #ajf4 ,regulation of products containing alternative nicotine4 ,sec4 #ajg4 ,update to youth tobacco prevention public awareness campaigns4 ,sec4 #ajh4 ,exemption from premarket review of certain tobacco products4 ,sec4 #aji4 ,public education4 ,sec4 #aaj4 ,regulations for recordkeeping concerning tracking and tracing4 ,title ,,ii--,federal ,trade ,commission ,sec4 #bja4 ,advertising of tobacco products4 ,title ,,iii--,public ,health ,programs ,sec4 #cja4 ,outreach to medically underserved communities4 ,sec4 #cjb4 ,demonstration grant program to develop strategies for smoking cessation in medically underserved communities4 ,sec4 #cjc4 ,public awareness1 education1 and prevention campaign4 ,sec4 #cjd4 ,tobacco cessation treatment grants to health centers4 ,sec4 #cje4 ,grants for research4 ,title ,,iv--,nicotine or ,vaping ,access ,protection and ,enforcement ,sec4 #dja4 ,increasing civil penalties applicable to certain violations of restrictions on sale and distribution of tobacco products4 ,sec4 #djb4 ,study and report on e-cigarettes4 ,title ,v--,excise tax on nicotine used in vaping1 etc4 ,sec4 #eja4 ,imposition of tax on nicotine for use in vaping1 etc4 ,title ,,vi--,further health investments ,sec4 #fja4 ,waiving ,medicare coinsurance for colorectal cancer screening tests4 ,sec4 #fjb4 ,safe harbor for high deductible health plans without deductible for certain inhalers4 ,i ,food and ,drug ,administration #aja4 ,cigarette graphic health warnings 7a7 ,issuance deadlines ,not later than ,march #ae1 #bjbj1 the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 shall publish a final rule pursuant to section #d7;d7 of the ,federal ,cigarette ,labeling and ,advertising ,act 7#ae ,u4,s4,c4 #accc7;d774 ,if the ,secretary fails to promulgate such final rule by ,march #ae1 #bjbj1 then the proposed rule titled ,tobacco ,products2 ,required ,warnings for ,cigarette ,packages and ,advertisements published by the ,food and ,drug ,administration on ,august #af1 #bjai 7#hd ,fed4 ,reg4 #dbged7 shall be treated as a final rule beginning on ,march #af1 #bjbj4 7b7 ,conforming change ,the first section #d7;d7 of the ,federal ,cigarette ,labeling and ,advertising ,act 7#ae ,u4,s4,c4 #accc7;d77 7relating to graphic labeling statements7 is amended by striking ,not later than #bd months after the date of enactment of the ,family ,smoking ,prevention and ,tobacco ,control ,act1 the ,secretary and inserting ,the ,secretary4 #ajb4 ,advertising and sales parity for all deemed tobacco products 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 shall promulgate a final rule amending part #aadj of subchapter ,k of title #ba1 ,code of ,federal ,regulations1 to apply the provisions of such part #aadj to all tobacco products1 as applicable1 to which chapter ,,ix of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;a et seq47 applies pursuant to section #ija7;b7 of such ,act 7#ba ,u4,s4,c4 #chg;a7b771 as amended by section #ajc7;a7 of this ,act4 7b7 ,effective date ,the final rule required by subsection 7a7 shall take effect on the date that is #b years after the date of enactment of this ,act4 #ajc4 ,reducing child and adolescent nicotine addiction 7a7 ,applicability to all tobacco products 7#a7 ,in general ,subsection 7b7 of section #ija of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;a7 is amended to read as follows3 7b7 ,applicability ,this chapter shall apply to all tobacco products4 4 7#b7 ,rule of construction ,paragraph 7#a7 and the amendment made thereby shall not be construed to limit the applicability of chapter ,,ix of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;a et seq47 to-- 7,a7 products that were listed in section #ija7;b7 of such ,act as in effect on the day before the date of enactment of this ,act2 and 7,b7 products that were deemed by regulation to be subject to such chapter pursuant to section #ija7;b7 of such ,act as in effect on the day before the date of enactment of this ,act4 7b7 ,prohibiting flavoring of tobacco products 7#a7 ,prohibition 7,a7 ,in general ,subparagraph 7,a7 of section #ijg7;a77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;g7a77#a77 is amended to read as follows3 7,a7 ,special rules 7i7 ,in general ,beginning on the date that is #a year after the date of enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj1 a tobacco product 7including its components1 parts1 and accessories1 including the tobacco1 filter1 or paper7 that is not an electronic nicotine delivery system shall not contain1 as a constituent 7including a smoke constituent7 or additive1 an artificial or natural flavor 7other than tobacco7 that is a characterizing flavor of the tobacco product or tobacco smoke or an herb or spice1 including menthol1 mint1 mango1 strawberry1 grape1 orange1 clove1 cinnamon1 pineapple1 vanilla1 coconut1 licorice1 cocoa1 chocolate1 cherry1 or coffee4 7ii7 ,rule of construction ,nothing in this subparagraph shall be construed to limit the ,secretary's authority to take action under this section or other sections of this ,act applicable to any artificial or natural flavor1 herb1 or spice4 7iii7 ,applicability to certain individuals ,notwithstanding any provision of this ,act1 no individual who purchases for individual consumption1 possesses for individual consumption1 or consumes1 a tobacco product that is in violation of the prohibition under this subparagraph1 including a tobacco product that contains a characterizing flavor of menthol1 shall be subject to any criminal penalty under this ,act for such purchase1 possession1 or consumption1 nor shall such purchase1 possession1 or consumption be used as a justification to stop1 search1 or conduct any other investigative measure against any individual4 4 7,b7 ,savings provision ,section #ijg7;a77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;g7a77#a771 as in effect on the date of enactment of this ,act1 shall remain in effect until the amendment made to such section #ijg7;a77#a7 by this paragraph takes effect4 7#b7 ,flavored electronic nicotine delivery system ,section #iaj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;j7 is amended by inserting at the end the following3 7h7 ,flavored electronic nicotine delivery systems 7#a7 ,restriction ,beginning on the date that is #cj days after the date of enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj1 any flavored electronic nicotine delivery system that is a new tobacco product1 including any solution or other component or part 7such as a liquid or its aerosol7 shall not contain an artificial or natural flavor 7other than tobacco7 that is a characterizing flavor1 including menthol1 mint1 mango1 strawberry1 grape1 orange1 clove1 cinnamon1 pineapple1 vanilla1 coconut1 licorice1 cocoa1 chocolate1 cherry1 or coffee1 unless the ,secretary has issued a marketing order as described in paragraph 7#b74 ,nothing in this paragraph shall be construed to limit the ,secretary's authority to take action under this section or other sections of this ,act applicable to any artificial or natural flavor1 herb1 or spice4 7#b7 ,review ,the ,secretary shall not issue a marketing order under subsection 7c77#a77;,a77i7 or a substantial equivalence order under subsection 7a77#b77;,a77i7 for any electronic nicotine delivery system1 including any liquid1 solution1 or other component or part or its aerosol1 that contains an artificial or natural flavor 7other than tobacco7 that is a characterizing flavor1 unless the ,secretary issues an order finding that the manufacturer has demonstrated that-- 7,a7 use of the characterizing flavor-- 7i7 will significantly increase the likelihood of smoking cessation among current users of tobacco products2 and 7ii7 will not increase the likelihood that individuals who do not use tobacco products1 including youth1 will start using any tobacco product1 including an electronic nicotine delivery system2 and 7,b7 such electronic nicotine delivery system is not more harmful to users than an electronic nicotine delivery system that does not contain any characterizing flavors4 4 7#c7 ,definition of electronic nicotine delivery system ,section #ijj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg7 is amended-- 7,a7 by redesignating paragraphs 7#h7 through 7#bb7 as paragraphs 7#i7 through 7#bc71 respectively2 and 7,b7 by inserting after paragraph 7#g7 the following new paragraph3 7#h7 ,electronic nicotine delivery system ,the term electronic nicotine delivery system means a tobacco product that is an electronic device that delivers nicotine1 flavor1 or another substance via an aerosolized solution to the user inhaling from the device 7including e-cigarettes1 e-hookah1 e-cigars1 vape pens1 advanced refillable personal vaporizers1 and electronic pipes7 and any component1 liquid1 part1 or accessory of such a device1 whether or not sold separately4 4 7#d7 ,limitation on enforcement ,a law enforcement officer of a ,state or political subdivision thereof may not enforce 7including by making any stop1 search1 seizure1 or arrest or by pursuing any prosecution1 trial1 or punishment7 any provision of section #ijg7;a77#a77;,a7 or #iaj7;h7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act1 as amended and added by this subsection4 #ajd4 ,prohibition against remote retail sales 7a7 ,in general ,paragraph 7#d7 of section #ijf7;d7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;f7d77 is amended to read as follows3 7#d7 ,prohibition against remote retail sales 7,a7 ,prohibition ,not later than #ah months after the date of enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj1 the ,secretary shall promulgate a final regulation prohibiting the retail sale of all tobacco products other than retail sales through a direct1 face-to-face exchange between a retailer and a consumer4 7,b7 ,exception for certain cigar tobacco products 7i7 ,exception ,the regulation required by subparagraph 7,a7 shall not apply to tobacco products described in section #iaj7;a77#b77;,a77iii74 7ii7 ,applicable requirements ,not later than #ah months after the date of enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj1 the ,secretary shall promulgate regulations regarding the sale and distribution of tobacco products described in section #iaj7;a77#b77;,a77iii7 that occur through means other than a direct1 face-to-face exchange between a retailer and a consumer in order to prevent the sale and distribution of tobacco products described in section #iaj7;a77#b77;,a77iii7 to individuals who have not attained the minimum age established by applicable law for the purchase of such products1 including requirements for age verification4 7,c7 ,relation to other authority ,nothing in this paragraph-- 7i7 limits the authority of the ,secretary to take additional actions under other provisions of this ,act2 or 7ii7 preempts the authority of a ,state or local government to establish restrictions on the retail sale of tobacco products that are in addition to1 or more stringent than1 the prohibition under subparagraph 7,a74 4 7b7 ,applicability ,section #ijf7;d77#d7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act1 as in effect on the day before the date of enactment of this ,act1 shall continue to apply until the effective date of the regulations required by section #ijf7;d77#d7 of such ,act1 as amended by subsection 7a74 #aje4 ,fees applicable to all tobacco products 7a7 ,increase in total amount ,section #iai7;b77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgs7b77#a77 is amended by striking subparagraph 7,k7 and inserting the following subparagraphs3 7,k7 ,for fiscal years #bjai and #bjbj1 #gab1jjj1jjj4 7,l7 ,for fiscal year #bjba1 #hab1jjj1jjj4 7,m7 ,for each subsequent fiscal year1 the amount that was applicable for the previous fiscal year1 increased by the total percentage change that occurred in the ,consumer ,price ,index for all urban consumers 7all items2 ,united ,states city average7 for the #ab-month period ending ,june #cj preceding the fiscal year4 4 7b7 ,applicability 7#a7 ,fiscal years #bjbj and #bjba ,except as amended by subsection 7a71 for fiscal years #bjbj and #bjba1 section #iai of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgs7 shall apply as in effect on the day before the date of enactment of this ,act4 7#b7 ,subsequent fiscal years ,the amendments made by subsections 7c7 through 7f7 apply beginning with fiscal year #bjbb4 7c7 ,allocations of assessment by class of tobacco products ,paragraph 7#b7 of section #iai7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgs7b77 is amended to read as follows3 7#b7 ,allocations of assessment by class of tobacco products 7,a7 ,in general ,the total user fees assessed and collected under subsection 7a7 each fiscal year 7beginning with fiscal year #bjbb7 with respect to each class of tobacco products to which this chapter applies shall be an amount that is equal to the applicable percentage of each class for the fiscal year multiplied by the amount specified in paragraph 7#a7 for the fiscal year4 7,b7 ,applicable percentage 7i7 ,in general ,for purposes of subparagraph 7,a71 the applicable percentage for a fiscal year for each class of tobacco product shall be the percentage determined by dividing-- 7,i7 the product of the gross domestic volume of the class multiplied by the tax rate applicable to the class under section #egja of the ,internal ,revenue ,code of #aihf2 and 7,,ii7 the sum of the products determined under subclause 7,i7 for all classes of tobacco products4 7ii7 ,definition ,for purposes of clause 7i71 the term gross domestic volume means the volume of tobacco products-- 7,i7 removed 7as defined by section #egjb of the ,internal ,revenue ,code of #aihf72 and 7,,ii7 not exempt from tax under chapter #eb of the ,internal ,revenue ,code of #aihf at the time of their removal under that chapter or the ,harmonized ,tariff ,schedule of the ,united ,states 7#ai ,u4,s4,c4 #abjb74 4 7d7 ,allocation of assessment within each class of tobacco product ,section #iai7;b77#d7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgs7b77#d77 is amended by striking shall be the percentage determined for purposes of allocations under subsections 7e7 through 7h7 of section #fbe of ,public ,law #ajh-ceg and inserting shall be allocated on a pro rata basis among the manufacturers and importers of each class of tobacco products to which this chapter applies based on the percentage share of each manufacturer's or importer's share of gross domestic volume within such class on a quarterly basis1 based on data for the second preceding quarter4 7e7 ,other amendments ,section #iai7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgs7b77 is amended-- 7#a7 by striking paragraph 7#e72 7#b7 by redesignating paragraphs 7#f7 and 7#g7 as paragraphs 7#e7 and 7#f71 respectively2 and 7#c7 by amending paragraph 7#f71 as redesignated1 to read as follows3 7#f7 ,memorandum of understanding2 reporting 7,a7 ,transfer of information ,the ,secretary shall request the appropriate ,federal agency to enter into a memorandum of understanding that provides for the regular and timely transfer from the head of such agency to the ,secretary of all necessary information regarding all tobacco product manufacturers and importers required to pay user fees4 ,the ,secretary shall maintain all disclosure restrictions established by the head of such agency regarding the information provided under the memorandum of understanding4 7,b7 ,reporting 7i7 ,manufacturer reporting ,the ,secretary may require the manufacturers and importers of each class of tobacco products to which this chapter applies to submit such information1 by such time1 and in such manner1 as the ,secretary determines to be necessary to implement this section4 7ii7 ,reports to ,congress ,for fiscal year #bjbj and each subsequent fiscal year for which fees are collected under this section1 the ,secretary shall1 not later than #abj days after the end of the respective fiscal year1 submit to the ,congress financial and performance reports with respect to such fees4 4 7f7 ,prohibited act ,section #cja7q77#a77;,b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cca7q77#a77;,b77 is amended by inserting #iai7;b77#f77;,b71 before or #ibj4 #ajf4 ,regulation of products containing alternative nicotine 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 shall-- 7#a7 not later than #a year after the date of enactment of this ,act1 issue an interim final rule providing for the regulation of products containing alternative nicotine under the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq472 and 7#b7 not later than #b years after such date of enactment1 issue a final rule providing for such regulation4 7b7 ,alternative nicotine ,in this section1 the term alternative nicotine means nicotine that is not made or derived from tobacco plants and may include nicotine that is chemically synthesized1 synthesized from recombinant genetic technology1 or extracted from non-tobacco plants4 #ajg4 ,update to youth tobacco prevention public awareness campaigns 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall-- 7#a7 review all public health awareness campaigns of the ,department of ,health and ,human ,services designed to educate at-risk individuals about the harmful effects of tobacco use1 including the use of e-cigarettes and other electronic nicotine delivery systems2 and 7#b7 as applicable1 modify such campaigns to include awareness and education materials designed for individuals who are #ah to #ba years of age4 7b7 ,consultation ,in carrying out subsection 7a71 the ,secretary of ,health and ,human ,services may consult with medical and public health associations and nonprofit organizations4 #ajh4 ,exemption from premarket review of certain tobacco products 7a7 ,in general ,section #iaj7;a77#b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;j7a77#b77 is amended-- 7#a7 in subparagraph 7,a7-- 7,a7 in clause 7i77,,ii71 by striking or2 7,b7 in clause 7ii71 by striking the period at the end and inserting 2 or2 and 7,c7 by adding at the end the following3 7iii7 subject to subparagraph 7,c71 for the period beginning on the date of the enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj and ending on ,september #cj1 #bjbh1 the tobacco product is a cigar and-- 7,i7 is wrapped in whole tobacco leaf2 7,,ii7 contains a #ajj-percent leaf tobacco binder2 7,,iii7 contains primarily long filler tobacco2 7,,iv7 does not have a characterizing flavor other than tobacco2 7,v7 weighs more than #f pounds per #ajjj units2 7,,vi7 has no filter1 tip1 or non-tobacco mouthpiece2 7,,vii7 7aa7 is made by combining manually the wrapper1 filler1 and binder and is capped by hand2 or 7bb7 has a homogenized tobacco leaf binder and is made in the ,united ,states using human hands to lay the #ajj-percent leaf tobacco binder onto only one machine that bunches1 wraps1 and caps each individual cigar2 and 7,,viii7 has a retail price 7after discounts or coupons7 per cigar of no less than-- 7aa7 for calendar years #bjai and #bjbj1 #ab2 and 7bb7 for each subsequent calendar year1 #ab multiplied by any percent increase in the ,consumer ,price ,index for all urban consumers 7all items2 ,u4,s4 city average7 since calendar year #bjbj4 2 and 7#b7 by adding at the end the following3 7,c7 ,determination of applicability 7i7 ,in general ,the ,secretary shall1 notwithstanding subparagraph 7,a77iii7 or any determination of substantial equivalence1 if any of the conditions specified in clause 7ii7 are met-- 7,i7 withdraw any exemption applicable to a tobacco product or products described in such subparagraph2 7,,ii7 require that applications for review under this section be submitted with respect to such product or products2 and 7,,iii7 require that manufacturers may only market such tobacco product after the issuance of an order under subsection 7c77#a77;,a77i7 with respect to such product or products4 7ii7 ,conditions ,the conditions specified in this clause are that-- 7,i7 the ,secretary determines that the use of a tobacco product or products described in subparagraph 7,a77iii7 has resulted in an emerging public health threat2 7,,ii7 data from a ,national ,youth ,tobacco ,survey 7or successor survey7 conducted after the date of the enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj identifies a rise in youth usage of tobacco products described in section #iaj7;a77#b77;,a77iii72 or 7,,iii7 the ,secretary determines that a tobacco product or products no longer meets the criteria specified in such subparagraph4 4 7b7 ,national ,academies study and report 7#a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 shall enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under which the ,national ,academies shall conduct a study on-- 7,a7 the public health impact of having tobacco products described in subsection 7a77#b77;,a77iii7 of section #iaj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;j71 as amended by subsection 7a71 exempt from premarket review under such section2 7,b7 the youth usage of such tobacco products2 and 7,c7 the market share of such products4 7#b7 ,report ,the agreement under paragraph 7#a7 shall include a requirement that the ,national ,academies of ,sciences1 ,engineering1 and ,medicine submit to ,congress1 not later than ,december #ca1 #bjbf1 a report on the findings of the study conducted under such paragraph4 #aji4 ,public education ,section #ijf of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;f7 is amended by adding at the end the following3 7g7 ,education on tobacco products 7#a7 ,in general ,beginning not later than #f months after the date of the enactment of the ,protecting ,american ,lungs and ,reversing the ,youth ,tobacco ,epidemic ,act of #bjbj1 the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs and in consultation with the ,surgeon ,general of the ,public ,health ,service1 shall provide educational materials for health care providers1 members of the public1 and law enforcement officials1 regarding-- 7,a7 the authority of the ,food and ,drug ,administration with respect to the regulation of tobacco products 7including enforcement of such regulation72 7,b7 the general processes of the ,food and ,drug ,administration for enforcing restrictions on the manufacture and sale of tobacco products2 7,c7 the general enforcement actions the ,food and ,drug ,administration may take to implement the prohibition on characterizing flavors in tobacco products under section #ijg7;a77#a72 7,d7 the public health impact of tobacco products with characterizing flavors2 and 7,e7 other information as the ,secretary determines appropriate4 7#b7 ,content ,educational materials provided under paragraph 7#a7 may include-- 7,a7 explanations of key statutory and regulatory terms1 including the terms tobacco product1 component parts1 accessories1 constituent1 additive1 tobacco product manufacturer1 and characterizing flavor2 7,b7 an explanation of the ,food and ,drug ,administration's jurisdiction to regulate tobacco products1 including tobacco products with characterizing flavors under section #ijg7;a77#a72 7,c7 general educational information related to enforcement tools and processes used by the ,food and ,drug ,administration for violations of the prohibition specified in section #ijg7;a77#a72 7,d7 information on the health effects of using tobacco products1 including those with the characterizing flavors referred to in section #ijg7;a77#a72 and 7,e7 information on resources available related to smoking cessation4 7#c7 ,format ,educational materials provided under paragraph 7#a7 may be-- 7,a7 published in any format1 including an internet website1 video1 fact sheet1 infographic1 webinar1 or other format1 as the ,secretary determines is appropriate and applicable2 and 7,b7 tailored for the unique needs of health care providers1 members of the public1 law enforcement officers1 and other audiences1 as the ,secretary determines appropriate4 7#d7 ,funding ,to carry out this subsection1 there is authorized to be appropriated1 and there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 ,funds made available by the preceding sentence to carry out this subsection shall be in addition to funds that are derived from fees under section #iai and are otherwise made available to carry out this chapter4 4 #aaj4 ,regulations for recordkeeping concerning tracking and tracing ,the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 shall promulgate the regulations required by section #ibj7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chgt7 in accordance with the following schedule3 7#a7 ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall issue proposed regulations4 7#b7 ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall promulgate final regulations4 ,,ii ,federal ,trade ,commission #bja4 ,advertising of tobacco products 7a7 ,advertising of electronic nicotine delivery systems 7#a7 ,in general ,it shall be unlawful-- 7,a7 to market1 advertise1 or promote any electronic nicotine delivery system in a manner that appeals to an individual under #ba years of age2 or 7,b7 to market1 advertise1 promote1 or endorse1 or to compensate any person for the marketing1 advertising1 promotion1 or endorsement of1 any electronic nicotine delivery system without clearly disclosing that the communication is an advertisement1 unless the communication is unambiguously identifiable as an advertisement4 7#b7 ,enforcement by ,commission 7,a7 ,unfair or deceptive acts or practices ,a violation of paragraph 7#a7 shall be treated as a violation of a regulation under section #ah7;a77#a77;,b7 of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #eg;a7a77#a77;,b77 regarding unfair or deceptive acts or practices4 7,b7 ,powers of ,commission ,the ,commission shall enforce paragraph 7#a7 in the same manner1 by the same means1 and with the same jurisdiction1 powers1 and duties as though all applicable terms and provisions of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #da et seq47 were incorporated into and made a part of this ,act4 ,any person who violates such paragraph shall be subject to the penalties and entitled to the privileges and immunities provided in the ,federal ,trade ,commission ,act4 7#c7 ,enforcement by ,state attorneys general 7,a7 ,in general ,if the attorney general of a ,state has reason to believe a violation of paragraph 7#a7 has occurred or is occurring1 the attorney general1 in addition to any authority the attorney general may have to bring an action in ,state court under the law of the ,state1 may bring a civil action in any court of competent jurisdiction to-- 7i7 enjoin further such violation by the defendant2 7ii7 enforce compliance with such paragraph2 7iii7 obtain civil penalties in the same amount as may be obtained by the ,commission in a civil action under section #e7m7 of the ,federal ,trade ,commission ,act 7#ae ,u4,s4,c4 #de7m772 or 7iv7 obtain damages1 restitution1 or other compensation on behalf of residents of the ,state4 7,b7 ,notice ,before filing an action under subparagraph 7,a71 the attorney general of a ,state shall provide to the ,commission a written notice of such action and a copy of the complaint for such action4 ,if the attorney general determines that it is not feasible to provide the notice described in this subparagraph before the filing of the action1 the attorney general shall provide written notice of the action and a copy of the complaint to the ,commission immediately upon the filing of the action4 7,c7 ,authority of ,federal ,trade ,commission 7i7 ,in general ,on receiving notice under subparagraph 7,b7 of an action under subparagraph 7,a71 the ,commission shall have the right-- 7,i7 to intervene in the action2 7,,ii7 upon so intervening1 to be heard on all matters arising therein2 and 7,,iii7 to file petitions for appeal4 7ii7 ,limitation on ,state action while ,federal action is pending ,if the ,commission has instituted a civil action for violation of paragraph 7#a7 7referred to in this clause as the ,federal action71 no attorney general of a ,state may bring an action under subparagraph 7,a7 during the pendency of the ,federal action against any defendant named in the complaint in the ,federal action for any violation of such paragraph alleged in such complaint4 7,d7 ,relationship with ,state-law claims 7i7 ,preservation of ,state-law claims ,nothing in this section shall prevent the attorney general of a ,state from bringing an action under ,state law for acts or practices that also violate paragraph 7#a74 7ii7 ,assertion in same civil action ,if the attorney general of a ,state has authority to bring an action under ,state law for acts or practices that also violate paragraph 7#a71 the attorney general may assert the ,state-law claim and the claim for violation of such paragraph in the same civil action4 7,e7 ,actions by other ,state officials ,in addition to civil actions brought by attorneys general under subparagraph 7,a71 any other consumer protection officer of a ,state who is authorized by the ,state to do so may bring a civil action under such subparagraph1 subject to the same requirements and limitations that apply under this paragraph to civil actions brought by attorneys general4 7#d7 ,rulemaking authority ,the ,commission may promulgate regulations under section #eec of title #e1 ,united ,states ,code1 to implement paragraph 7#a74 7b7 ,report to ,congress on tobacco product advertising 7#a7 ,in general ,not later than #b years after the date of the enactment of this ,act1 and annually thereafter1 the ,commission shall submit to ,congress a report relating to each category of products described in paragraph 7#b7 7or a single report a portion of which relates to each such category7 that contains the following3 7,a7 ,information on domestic sales and advertising and promotional activity by the manufacturers that have the largest market shares of the product category4 7,b7 ,such recommendations for legislation as the ,commission may consider appropriate4 7#b7 ,product categories described ,the categories of products described in this paragraph are the following3 7,a7 ,cigarettes4 7,b7 ,cigars4 7,c7 ,smokeless tobacco4 7,d7 ,electronic nicotine delivery systems4 7c7 ,preservation of authority ,nothing in this section may be construed in any way to limit the ,commission's authority under any other provision of law4 7d7 ,definitions ,in this section3 7#a7 ,cigar ,the term cigar means a tobacco product that-- 7,a7 is not a cigarette2 and 7,b7 is a roll of tobacco wrapped in leaf tobacco or any substance containing tobacco4 7#b7 ,cigarette ,the term cigarette has the meaning given such term in section #ijj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg74 7#c7 ,commission ,the term ,commission means the ,federal ,trade ,commission4 7#d7 ,electronic nicotine delivery system ,the term electronic nicotine delivery system means a tobacco product that is an electronic device that delivers nicotine1 flavor1 or another substance via an aerosolized solution to the user inhaling from the device 7including e-cigarettes1 e-hookah1 e-cigars1 vape pens1 advanced refillable personal vaporizers1 and electronic pipes7 and any component1 liquid1 part1 or accessory of such a device1 whether or not sold separately4 7#e7 ,endorse ,the term endorse means to communicate an advertising message 7including a verbal statement1 demonstration1 or depiction of the name1 signature1 likeness1 or other identifying personal characteristics of an individual or the name or seal of an organization7 that consumers are likely to believe reflects the opinions1 beliefs1 findings1 or experiences of a party other than the sponsoring advertiser1 even if the views expressed by such party are identical to those of the sponsoring advertiser4 7#f7 ,nicotine ,the term nicotine has the meaning given such term in section #ijj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg74 7#g7 ,smokeless tobacco ,the term smokeless tobacco has the meaning given such term in section #ijj of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg74 7#h7 ,tobacco product ,the term tobacco product has the meaning given such term in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba74 ,,iii ,public ,health ,programs #cja4 ,outreach to medically underserved communities ,section #cii,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#aa7 is amended-- 7#a7 in subsection 7b7-- 7,a7 by redesignating paragraphs 7#d7 and 7#e7 as paragraphs 7#e7 and 7#f71 respectively2 and 7,b7 by inserting after paragraph 7#c7 the following3 7#d7 to educate and provide guidance to medically underserved communities1 particularly racial and ethnic minority populations1 regarding effective evidence-based strategies-- 7,a7 to prevent tobacco1 e-cigarette1 and nicotine addiction1 including among youth2 and 7,b7 for smoking cessation1 including cessation of the use of menthol-flavored tobacco products1 and the cessation of the use of e-cigarettes and electronic nicotine delivery systems2 2 7#b7 in subsection 7d77#a77;,b71 by inserting 1 including chronic diseases related to and caused by tobacco use after diseases2 and 7#c7 in subsection 7j71 by striking are authorized to be appropriated1 such sums as may be necessary to carry out this section for each of fiscal years #bjaj through #bjad and inserting is authorized to be appropriated1 and there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 #ge1jjj1jjj to carry out this section for each of fiscal years #bjba through #bjbe4 #cjb4 ,demonstration grant program to develop strategies for smoking cessation in medically underserved communities ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq47 is amended by inserting after section #cag,u 7#db ,u4,s4,c4 #bdg;b-#bc7 the following3 #cag,v4 ,demonstration grant program to develop strategies for smoking cessation in medically underserved communities 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall establish a demonstration program to award grants to1 or contract with1 ,state1 local1 or ,tribal public health departments to support-- 7#a7 the development of improved evidence-based strategies for smoking cessation1 including cessation of the use of menthol-flavored tobacco products1 and the cessation of the use of e-cigarettes and electronic nicotine delivery systems1 for populations in medically underserved communities1 particularly racial and ethnic minority populations2 7#b7 the development of improved communication and outreach tools to reach populations in medically underserved communities1 particularly racial and ethnic minority populations1 addicted to tobacco products1 including e-cigarettes and menthol-flavored tobacco products2 and 7#c7 improved coordination1 access1 and referrals to services for tobacco cessation and the cessation of the use of e-cigarettes and electronic nicotine delivery systems1 including tobacco cessation products approved by the ,food and ,drug ,administration and mental health and counseling services4 7b7 ,application ,to be eligible to receive a grant under subsection 7a71 a ,state1 local1 or ,tribal public health department shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 #ge1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #cjc4 ,public awareness1 education1 and prevention campaign ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq471 as amended by section #cjb1 is further amended by inserting after section #cag,v the following new section3 #cag,w4 ,public awareness1 education1 and prevention campaign regarding tobacco 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and in consultation with the ,surgeon ,general of the ,public ,health ,service1 shall develop and implement a national campaign to educate youth and young adults1 parents1 clinicians1 health professionals1 and others about the harms associated with the use by youth and young adults of tobacco products1 including e-cigarettes4 7b7 ,requirements ,the campaign under this section shall-- 7#a7 be an evidence-based media and public engagement initiative2 7#b7 be carried out through competitively bid contracts2 7#c7 include the development of culturally and linguistically competent resources that may be tailored for communities with high rates of youth tobacco use2 7#d7 be complementary to1 and coordinated with1 any other ,federal efforts2 and 7#e7 include message testing to identify culturally and linguistically competent and effective messages for behavioral change4 7c7 ,optional components ,the campaign under this section may include-- 7#a7 the use of-- 7,a7 television1 radio1 print1 the internet1 and other commercial marketing venues2 and 7,b7 in-person public communications2 and 7#b7 the award of grants to ,state1 local1 and ,tribal public health departments to encourage partnerships with community organizations and health care providers to develop and deliver evidence-based strategies to prevent youth tobacco use4 7d7 ,funding ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 #de1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 #cjd4 ,tobacco cessation treatment grants to health centers 7a7 ,in general ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is amended-- 7#a7 by redesignating subsections 7k7 through 7r7 as subsections 7l7 through 7s71 respectively2 and 7#b7 by adding after subsection 7j7 the following new subsection3 7k7 ,tobacco cessation grants 7#a7 ,in general ,the ,secretary may award grants to health centers to provide comprehensive tobacco cessation treatment1 including counseling and tobacco cessation therapies4 7#b7 ,funding ,for the purpose of carrying out this subsection1 in addition to other amounts available for such purpose1 there is authorized to be appropriated1 and there is appropriated1 out of funds in the ,treasury not otherwise appropriated1 #abe1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 7b7 ,conforming changes ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is amended-- 7#a7 in subsection 7c77#c77;,b71 by striking 7k77#c77;,j7 and inserting 7l77#c77;,j72 7#b7 in subsection 7e77#a77;,b71 by striking 7k77#c7 each place it appears and inserting 7l77#c72 7#c7 in subsection 7l77#c77;,h71 as redesignated1 by striking or 7p7 and inserting or 7q72 7#d7 in subsection 7m71 as redesignated-- 7,a7 by striking 7k77#c7 and inserting 7l77#c72 and 7,b7 by striking 7m7 and inserting 7n72 7#e7 in subsection 7q71 as redesignated1 by striking 7k77#c77;,g7 and inserting 7l77#c77;,g72 7#f7 in subsection 7s77#b77;,a71 as redesignated-- 7,a7 by striking 7k77#c7 and inserting 7l77#c72 and 7,b7 by striking 7k77#c77;,h7 and inserting 7l77#c77;,h72 and 7#g7 in subsection 7s77#c77;,i71 as redesignated1 by striking 7q77#d7 and inserting 7r77#d74 7c7 ,technical corrections 7#a7 ,section #ccj7;h77#e77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7h77#e77;,b77 is amended by striking substance abuse each place it appears and inserting substance use disorder4 7#b7 ,subclause 7,,ii7 of subsection 7l77#c77;,e77i71 as redesignated1 of section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is amended by moving the indentation #b ems to the left4 #cje4 ,grants for research ,part ,p of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following new section3 #cii,v-#g4 ,grants for research on prevention1 and cessation1 of the use of tobacco products 7a7 ,in general ,the ,secretary shall award grants to support-- 7#a7 research to develop and improve effective strategies for prevention1 and cessation1 of the use of tobacco products1 including-- 7,a7 cessation of the use of flavored combustible cigarettes1 including menthol-flavored cigarettes2 7,b7 cessation of the use of e-cigarette products2 and 7,c7 prevention and cessation strategies targeted toward youth2 and 7#b7 research to aid in the development of safe and effective tobacco cessation therapies1 including therapies appropriate for populations under the age of #ah4 7b7 ,funding ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 #ge1jjj1jjj for each of fiscal years #bjba through #bjbe4 4 ,,iv ,nicotine or ,vaping ,access ,protection and ,enforcement #dja4 ,increasing civil penalties applicable to certain violations of restrictions on sale and distribution of tobacco products 7a7 ,penalties ,subparagraph 7,a7 of section #ajc7q77#b7 of the ,family ,smoking ,prevention and ,tobacco ,control ,act 7#ba ,u4,s4,c4 #ccc note7 is amended to read as follows3 7,a7 ,in general ,the amount of the civil penalty to be applied for violations of restrictions promulgated under section #ijf7;d71 as described in paragraph 7#a71 shall be as follows3 7i7 ,with respect to a retailer with an approved training program1 the amount of the civil penalty shall not exceed-- 7,i7 in the case of the first violation1 #j1 together with the issuance of a warning letter to the retailer2 7,,ii7 in the case of a second violation within a #ab-month period1 #ejj2 7,,iii7 in the case of a third violation within a #bd-month period1 #a1jjj2 7,,iv7 in the case of a fourth violation within a #bd-month period1 #d1jjj2 7,v7 in the case of a fifth violation within a #cf-month period1 #aj1jjj2 and 7,,vi7 in the case of a sixth or subsequent violation within a #dh-month period1 #bj1jjj as determined by the ,secretary on a case-by-case basis4 7ii7 ,with respect to a retailer that does not have an approved training program1 the amount of the civil penalty shall not exceed-- 7,i7 in the case of the first violation1 #ejj2 7,,ii7 in the case of a second violation within a #ab-month period1 #a1jjj2 7,,iii7 in the case of a third violation within a #bd-month period1 #b1jjj2 7,,iv7 in the case of a fourth violation within a #bd-month period1 #d1jjj2 7,v7 in the case of a fifth violation within a #cf-month period1 #aj1jjj2 and 7,,vi7 in the case of a sixth or subsequent violation within a #dh-month period1 #bj1jjj as determined by the ,secretary on a case-by-case basis4 4 7b7 ,applicability ,the amendment made by subsection 7a7 applies with respect to a violation of a restriction promulgated under section #ijf7;d77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #chg;f7d77#a771 as described in section #ajc7q77#a7 of the ,family ,smoking ,prevention and ,tobacco ,control ,act 7#ba ,u4,s4,c4 #ccc note71 occurring on or after the day that is #f months after the date of enactment of this ,act4 ,the penalties specified in section #ajc7q77#b77;,a7 of the ,family ,smoking ,prevention and ,tobacco ,control ,act 7#ba ,u4,s4,c4 #ccc note71 as in effect on the day before the date of enactment of this ,act1 shall continue to apply to violations occurring before the day specified in the preceding sentence4 #djb4 ,study and report on e-cigarettes ,not later than #e years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall-- 7#a7 complete a study on-- 7,a7 the relationship of e-cigarettes to tobacco cessation2 7,b7 the perception of the harmful effects of e-cigarettes2 and 7,c7 the effects of secondhand exposure to smoke from e-cigarettes2 and 7#b7 submit to the ,congress a report on the results of such study1 including recommendations based on such results4 ,v ,excise tax on nicotine used in vaping1 etc4 #eja4 ,imposition of tax on nicotine for use in vaping1 etc 7a7 ,in general ,section #egja of the ,internal ,revenue ,code of #aihf is amended by redesignating subsection 7h7 as subsection 7i7 and by inserting after subsection 7g7 the following new subsection3 7h7 ,nicotine ,on taxable nicotine1 manufactured in or imported into the ,united ,states1 there shall be imposed a tax equal to the dollar amount specified in section #egja7;b77#a7 7or1 if greater1 #ej4cc7 per #a1haj milligrams of nicotine 7and a proportionate tax at the like rate on any fractional part thereof74 4 7b7 ,taxable nicotine ,section #egjb of such ,code is amended by adding at the end the following new subsection3 7q7 ,taxable nicotine 7#a7 ,in general ,except as otherwise provided in this subsection1 the term taxable nicotine means any nicotine which has been extracted1 concentrated1 or synthesized4 7#b7 ,exception for products approved by ,food and ,drug ,administration ,such term shall not include any nicotine if the manufacturer or importer thereof demonstrates to the satisfaction of the ,secretary of ,health and ,human ,services that such nicotine will be used in-- 7,a7 a drug-- 7i7 that is approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act or licensed under section #cea of the ,public ,health ,service ,act2 or 7ii7 for which an investigational use exemption has been authorized under section #eje7;i7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act or under section #cea7;a7 of the ,public ,health ,service ,act2 or 7,b7 a combination product 7as described in section #ejc7;g7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act71 the constituent parts of which were approved or cleared under section #eje1 #eaj7k71 or #eae of such ,act4 7#c7 ,coordination with taxation of other tobacco products ,cigars1 cigarettes1 smokeless tobacco1 pipe tobacco1 and roll-your-own tobacco shall not be treated as containing taxable nicotine solely because the nicotine naturally occurring in the tobacco from which such product is manufactured has been concentrated during the ordinary course of manufacturing4 4 7c7 ,taxable nicotine treated as a tobacco product ,section #egjb7;c7 of such ,code is amended by striking and roll-your-own tobacco and inserting roll-your-own tobacco1 and taxable nicotine4 7d7 ,manufacturer of taxable nicotine ,section #egjb of such ,code1 as amended by subsection 7b71 is further amended by adding at the end the following new subsection3 7r7 ,manufacturer of taxable nicotine 7#a7 ,in general ,any person who extracts1 concentrates1 or synthesizes nicotine shall be treated as a manufacturer of taxable nicotine 7and as manufacturing such taxable nicotine74 7#b7 ,application of rules related to manufacturers of tobacco products ,any reference to a manufacturer of tobacco products1 or to manufacturing tobacco products1 shall be treated as including a reference to a manufacturer of taxable nicotine1 or to manufacturing taxable nicotine1 respectively4 4 7e7 ,effective date 7#a7 ,in general ,the amendments made by this section shall apply to articles manufactured or imported in calendar quarters beginning more than #ij days after the date of the enactment of this ,act4 7#b7 ,transition rule for permit and bond requirements ,a person which is lawfully engaged in business as a manufacturer or importer of taxable nicotine 7within the meaning of subchapter ,a of chapter #eb of the ,internal ,revenue ,code of #aihf1 as amended by this section7 on the date of the enactment of this ,act1 first becomes subject to the requirements of subchapter ,b of chapter #eb of such ,code by reason of the amendments made by this section1 and submits an application under such subchapter ,b to engage in such business not later than #ij days after the date of the enactment of this ,act1 shall not be denied the right to carry on such business by reason of such requirements before final action on such application4 ,,vi ,further health investments #fja4 ,waiving ,medicare coinsurance for colorectal cancer screening tests ,section #ahcc7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77 is amended-- 7#a7 in the second sentence1 by striking section #ahcd7j7 and inserting section #ahcd7o72 7#b7 by moving such second sentence #b ems to the left2 and 7#c7 by inserting the following third sentence following such second sentence3 ,for services furnished on or after ,january #a1 #bjbd1 paragraph 7#a77,y7 shall apply with respect to a colorectal cancer screening test regardless of the code that is billed for the establishment of a diagnosis as a result of the test1 or for the removal of tissue or other matter or other procedure that is furnished in connection with1 as a result of1 and in the same clinical encounter as the screening test44 #fjb4 ,safe harbor for high deductible health plans without deductible for certain inhalers 7a7 ,in general ,section #bbc7;c77#b77;,c7 of the ,internal ,revenue ,code of #aihf is amended-- 7#a7 by striking for preventive care and inserting for one or more of the following3 7i7 ,preventive care 1 and 7#b7 by adding at the end the following new clause3 7ii7 ,inhalers or nebulizers for treatment of any chronic lung disease 7and any medicine or drug which is delivered through such inhaler or nebulizer for treatment of such disease74 4 7b7 ,conforming amendment ,the heading for section #bbc7;c77#b77;,c7 of such ,code is amended by striking preventive care deductible and inserting certain deductibles4 7c7 ,effective date ,the amendments made by this section shall apply to months beginning after the date of the enactment of this ,act4 ,passed the ,house of ,representatives ,february #bh1 #bjbj4;,clerk4