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Why did Marty Makary resign as FDA chief? Clash over flavored vape decision explained

Marty Makary has resigned as Commissioner of the US Food and Drug Administration following a high-stakes policy clash with the Trump administration over the approval of flavored e-cigarettes, according to The New York Times.

Dr. Marty Makary, Food and Drug Administration (FDA) commissioner, attends an event on health care affordability in the Oval Office at the White House, April 23, 2026, in Washington. (AP)

His departure on Tuesday comes after weeks of internal pressure and growing tension inside the agency, with officials reportedly anticipating a possible firing or forced exit before Makary ultimately stepped down.

Flavored vape approval dispute

The key trigger behind Makary’s resignation was a disagreement over the administration’s decision to authorize fruit-flavored vaping products, a move he privately opposed.

People familiar with the matter said, as per NYT, that Makary believed flavored e-cigarettes posed a significant risk to young people due to their appeal and addictive nicotine content. He reportedly told close associates he could not support the decision in good conscience and would not approve a policy he fundamentally disagreed with.

The White House, however, moved ahead with the authorization despite his objections. The decision reportedly became the point of conflict between Makary and senior administration officials in his final weeks.

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FDA tensions

Makary’s resignation also follows months of broader friction within the FDA over regulatory direction under the current administration.

According to The New York Times, his tenure was marked by clashes over drug approvals, vaccine policies and food regulation, placing him at odds at various points with both industry groups and political stakeholders.

He was also criticized by some public health experts over controversial policy decisions, including earlier messaging on COVID-19 vaccines and support for alternative treatment approaches, which critics said lacked sufficient scientific backing.

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President Donald Trump acknowledged Makary’s resignation while speaking to reporters, offering a brief comment on his departure. “Marty’s a terrific guy, but he’s going to go on and he’s going to lead a good life,” Trump said, according to The New York Times. “He’s a great doctor, and he was having some difficulty.”

Following his exit, FDA food regulator Kyle Diamantas was named acting commissioner as the agency prepares for a permanent replacement.