FDA Commissioner Martin Makary has resigned, following numerous reports that President Trump and Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. had agreed to fire him. According to POLITICO, it was Kennedy who made the final decision.
Until a permanent replacement is nominated, FDA food regulator Kyle Diamantas will serve as acting commissioner.
Makary, formerly a Johns Hopkins University pancreatic surgeon and professor, was chosen by Trump for his outspoken criticism of the medical establishment. He spoke and wrote on many topics, including overtreatment in the United States, medical education reform, and overuse of antibiotics.
During the COVID-19 pandemic, Makary appeared on Fox News to criticize vaccine policy and mask mandates, and gained followers from the Trump camp and from fans of Kennedy, who was eventually tapped to lead Trump’s health agencies. Makary was considered a natural fit for the Trump administration.
In the end, however—in just over 13 months on the job—Makary managed to disappoint or offend nearly every FDA employee, industry stakeholder, special interest group, and Trump administration official associated with food, drug and tobacco regulation.
The FDA commissioner who trusted anecdotes over data
In the vaping world, Makary quickly transformed from a complete unknown to public enemy number one.
In a Senate confirmation hearing on March 6, 2025, Makary told the Health, Education, Labor and Pensions (HELP) Committee that the U.S. has been “flooded” with Chinese vaping products.
“We have no idea what’s in these products,” Makary said, “and public health isn’t even going to be able to study them because it takes so long for public health research to catch up. But it’s very concerning, and it’s not right that products are banned in China, and yet they’re manufacturing them and sending them to the United States.
“There are a few things the FDA can do to try to address this problem,” he continued. “First of all, the Office of Inspections and Investigation has a lot of people with guns, and they do enforcement and raids, and we need—in collaboration with [the Department of Justice] and other areas of law enforcement—to try to address this problem of illegal products on our market.”
Following his confirmation, Makary did in fact encourage the “people with guns” to get involved. The FDA seized imported products in unprecedented numbers, and teamed up with the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) and the U.S. Marshals Service to conduct armed raids on vape distributors across the country last September.
Between Trump’s Jan. 20 inauguration and August 19, 2025, the Trump/Makary FDA issued more than 40 new marketing denial orders (MDOs) for U.S.-made vaping products, and eventually ended the practice of publicly listing new MDOs—leaving us without an accurate count of the products ordered off the market between then and now.
One of Makary’s most-bizarre anti-vaping actions was his public questioning last September of the venerable National Youth Tobacco Survey, the joint FDA-Centers for Disease Control and Prevention (CDC) annual survey of middle and high school students.
The accuracy of the survey is widely trusted—by both vaping and anti-vaping advocates, but Makary said the survey methodology used by the “Biden CDC” was flawed, and we’d get more scientifically believable numbers by asking parents and students what they think.
“When I talk to parents and teachers and kids in high schools,” said Makary, “I'm hearing 20 percent…40 percent of the kids in high school…50 percent of the kids in high school.
This is an epidemic that we have yet to fully understand.”
An FDA commissioner who finds anecdotes more believable that FDA and CDC data is surely something new under the sun.
Was vaping policy Makary’s undoing?
In the end, it may have been his opposition to vaping that did him in—or at least pushed his already shaky position with the administration to the breaking point.
FDA Center for Tobacco Products (CTP) scientists had recommended authorization of the Glas G2 age-gated pod vape and several pods, including two in blueberry and mango flavors. But Makary blocked marketing orders for the flavored pods, despite all evidence showing the products would pose no serious risk of youth uptake.
White House staff, eager to help keep Trump’s promise to “save vaping,” pushed the issue, and advised Trump that Makary had become “a problem for the administration,” according to the Wall Street Journal. Eventually Trump apparently got involved, Makary backed down, and the Glas flavors were authorized for sale last week.
Dying on a cross of mango vapes will nicely set up Makary for a post-FDA career in tobacco control if he chooses to do that, but few outside that prohibition cult will regret his passing from the FDA.
“He will not be missed by a single career person,” an FDA staffer told POLITICO last Friday. “And we will only regret it when they manage to find someone worse.”