Food and Drug Administration Commissioner Marty Makary resigned on Tuesday, ending a tumultuous tenure marked by internal clashes with the White House and industry backlash over vaping policy. President Trump announced the news on Truth Social, naming the agency’s top food regulator, Kyle Diamantas, as acting chief. Trump told reporters en route to China that Makary had been “having some difficulty” in the role, adding, “Marty’s a terrific guy, but he’s going to go on and he’s going to lead a good life.”
Makary’s departure caps weeks of speculation about his job security, fueled by reports of tension between him and the administration. In his resignation letter, Makary touted 50 major reforms, including reduced drug review times and new guidance on psychedelics, but critics say his tenure was defined by delays, staff exodus, and a controversial standoff over e-cigarette flavors.
E-Cigarettes: The Breaking Point
The immediate trigger for Makary’s exit appears to be his resistance to authorizing fruit-flavored electronic cigarettes, a move Trump had pushed for months to appeal to young voters in the Make America Great Again movement. According to The Wall Street Journal, Makary tried to block agency scientists from approving the products, prompting an angry reprimand from Trump. Last week, the FDA authorized the first fruit-flavored e-cigarettes, reversing a prior policy that only allowed tobacco or menthol flavors.
Tony Abboud, president of the Vapor Technology Association, which donated over $1 million to Trump’s inauguration, said he met with Makary last week to discuss a “predictable” regulatory framework. Abboud described Makary as “very hostile to vaping products” and preoccupied with a youth vaping epidemic that 2024 federal data shows has declined to its lowest level in a decade. “As a result, he continued the policies of the previous administration, which were hostile to flavors,” Abboud said. “His efforts were too little, too late.”
Democratic Senator Dick Durbin of Illinois praised Makary for resisting Trump’s pressure. “I voted for Dr. Makary to head the FDA based upon his commitment to say ‘no’ if President Trump asked him to do something that would harm America. Dr. Makary kept his word,” Durbin said in a statement. “He resisted Trump’s plan to expose millions of children to the dangers of vaping.”
Broader Turmoil at FDA
Makary’s exit is the latest shakeup at the Department of Health and Human Services, where the White House has sidelined some of Secretary Robert F. Kennedy Jr.’s more controversial allies. The FDA has lost thousands of medical reviewers through voluntary and forced cuts linked to the Department of Government Efficiency (DOGE), as noted by former Commissioner Scott Gottlieb. “I think the continued upheaval at FDA has been detrimental to the agency,” Gottlieb said on CBS’s Face the Nation. “The agency’s lost thousands of medical reviewers, some voluntary through the DOGE cuts, or some forced through the DOGE cuts.”
Makary also faced criticism from anti-abortion advocates who accused him of delaying a review of the abortion pill mifepristone. The acting commissioner, Kyle Diamantas, now inherits an agency with no permanent surgeon general or CDC director. For more on the leadership change, see our report on Trump tapping Diamantas as acting FDA chief.
Trump’s decision to oust Makary mirrors other recent personnel moves, including the firing of the mine safety commissioner and the departure of Acting ICE Director Todd Lyons. The White House did not respond to requests for comment, though its rapid response account shared Makary’s resignation on X.
