In recent years, health officials have touted decades of progress since the mid-1960s release of the first Surgeon General’s report warning of hazards tied to smoking. Now, the outlook for further gains — especially in the teenager bracket — is clouded by the soaring popularity of vaping.
The Surgeon General, along with Food and Drug Administration, is calling electronic cigarette use among youth an “epidemic.” Pitched as a helpful — albeit unregulated — product for adult smokers trying to kick a tobacco habit, electronic smoking devices (ESDs) seem to hold potential to create a new generation of nicotine addicts.
In Hawaii, the state Health Department points to data that shows from 2011 to 2015, vaping experimentation among middle-school students increased six-fold; among high schoolers, four-fold. On the heels of that, the Hawaii 2017 Youth Risk Behavior Survey found that in our public schools, about 1 in 4 high schoolers and 1 in 6 middle schoolers used e-cigs that year.
Here, and on the mainland, it’s clear that vaping may be something worse than a frightening fad. Last month, FDA Commissioner Scott Gottlieb announced that the most recent National Youth Tobacco Survey found that from 2017 to 2018, there was a 78 percent increase in e-cigarette use among high school students and a 48 percent increase among middle schoolers.
So, the total number of tween and teen students vaping rose to 3.6 million — that’s 1.5 million more students using these products than the previous year.
In response to the apparent health threat, at the federal level, Gottlieb has been conducting a months-long kids-focused campaign that has included rightly putting makers of in-demand ESDs on notice that they must prove they can keep their devices away from minors. Federal law prohibits selling e-cigarettes and tobacco cigarettes to anyone under age 18.
In Hawaii, the age limit for both sorts of cigarettes is 21, and the Legislature is now weighing bills that aim to further discourage vaping among youth.
>> Twin bills, House Bill 276 and Senate Bill 1009, would ban the sale and distribution of flavored tobacco products. Hawaii’s Health Department has pointed out that these products — including chemical solutions with nicotine-infused “e-juices” with names like “Bubble Pop” and “Peanut Butter Cup” — are likely a main reason why kids start vaping.
Among responders to the 2017 Hawaii Youth Tobacco Survey reporting ever using ESDs, one quarter said availability of “flavors such as mint, candy, fruit, or chocolate” was their top reason for vaping. Further, 1 in 4 did not believe ESDs to be dangerous. That’s alarming, given that nicotine use is known to be harmful to neurological development in youth.
The Health Department should be commended for taking a strong stand on the matter, stating in bill testimony that “ending the sale of flavored tobacco products is an issue of both health and social justice.” Further, it asserted the products are marketed to youth “intentionally as a way of replacing adult smokers of traditional cigarettes” as those using flavored tobacco products are “more likely to progress to regular smoking.”
It should be noted, though, that not all vaping involves nicotine. For example, in July, Hawaii’s marijuana dispensaries started selling cannabis oil cartridges so that patients can legally take the drug through vaping. A battery-powered device heats the liquid into a vapor that’s inhaled.
Also, it’s possible, as e-cig advocates and others claim, that vaping is less harmful than cigarettes and can help smokers quit tobacco. A study published last week in the New England Journal of Medicine found that e-cigarettes were nearly twice as effective as conventional nicotine replacement products, like patches and gum, for quitting smoking.
E-cigarettes provide the craved nicotine without the toxic tar and carcinogens linked to inhaling burning tobacco. Still, regulators have not approved them as smoking cessation tools. The current deadline for makers to comply with federal guidelines, which, among other things, require proving that e-cigs are beneficial to public health, is set for 2022.
In testimony opposing anti-vaping bills, the Hawaii Food Industry Association echoed the sentiments of vendors, maintaining that they “unfairly target and penalize” both those who choose to use products that are not illegal, and the businesses serving them. A valid point, from a marketplace perspective.
Outweighing that, however, is escalating public health concern about the aerosol-producing device’s underground gains among our kids. And that’s why state lawmakers, in addition to supporting the flavor ban, should back a measure that would tax and regulate vape products in Hawaii.
>> House Bill 1574 (Senate Bill 1405) would apply an excise tax to disposable ESDs and vape liquids; require licensing and permitting for wholesalers and retailers; and create online shipment restrictions to consumers. Also, it would also tag a slice of the tax revenues for Hawaii Tobacco Prevention and Control Trust Fund’s health education efforts.
