Teen vaping is surging, with more than a quarter of U.S. high school students now saying they are current users of electronic cigarettes, up from about one in five last year. As it typically does, technology has outpaced public policy, leaving policymakers scrambling to respond.
The Centers for Disease Control and Prevention’s 2019 National Youth Tobacco Survey found that 27.5% of high school students said they used e-cigarettes at least once in the past 30 days. That’s a significant jump from 20.8% in 2018, and it’s more than double the rate of users just two years ago, 11.7%. Among middle school students (grades five through eight), 10.5% are current e-cigarette users, up from 7.2% in 2018 and 5.6% in 2017.
In Arkansas, a growing number of teens have tried e-cigarettes. The 2018 Arkansas Prevention Needs Assessment survey found that 44.3% of Arkansas high school seniors said they had used an e-cigarette at least once in their lifetime, up from 39.3% in 2017. The devices have even found their way into the hands of Arkansas sixth graders, 7% of whom have tried vaping. Parents of teenagers should assume their children frequently see others vaping and should have conversations with them about it.
These numbers are especially frustrating in light of the gains that have been made in reducing cigarette smoking among young people. Only 5.8% of U.S. high school students, and 2.3% of middle school students, are current cigarette smokers, according to the CDC. But through products and marketing carefully crafted to appeal to young people, makers of e-cigarettes are recruiting a new generation of nicotine addicts. Young people’s brains are still developing, so they are especially susceptible to nicotine addiction and the harms of nicotine. Also, studies have shown that young people are more likely to move on to cigarettes after vaping.
The CDC is investigating more than 2,400 cases of vaping-related lung injury and nearly 50 vaping-related deaths. The causes of the injuries and deaths are unknown, but products containing THC, the psychoactive ingredient in marijuana, were involved in more than 80% of the cases. Among patients for whom the CDC has age information, 16% were younger than 18.
In the absence of federal action, many states and cities across the country are enacting restrictions aimed at reducing teen vaping. I applaud our elected officials in Arkansas for raising the minimum legal age to purchase tobacco or vaping products from 18 to 21 this year. Unfortunately, that same law also removed the authority of local governments to protect their communities through regulation of tobacco products, echoing a 2015 law that did the same for vaping products.
That leaves the responsibility for any further policy action on teen vaping in the hands of the state. Here are five actions that I urge our representatives at the state Capitol to take:
· Increase enforcement efforts to ensure retailers are complying with the new age restrictions for tobacco and vaping product purchases.
· Prohibit advertising for vaping products that targets young people.
· Include e-cigarettes and other vaping products in the definition of “tobacco products” ― consistent with the Food and Drug Administration’s definition ― for purposes of the Arkansas Clean Indoor Air Act, which prohibits their use in most workplaces and public spaces.
· Ban flavored vaping liquids, especially sweet or candy-themed flavors. This would be consistent with the law for conventional tobacco products, which has banned flavors for more than a decade.
· Levy a tax on e-cigarettes that is no less than the tax on tobacco products and based on nicotine content. Such taxes have been shown to have an impact in reducing the use of e-cigarettes among young people.
It took several decades for scientists, public health officials and policymakers to understand and respond to the health risks posed by tobacco. The makers of e-cigarettes have been effective in getting young people ― many of whom have never smoked ― hooked on a product that has only been on the market for about a decade. We should do all we can, as soon as we can, to protect our kids.
Editor’s note: Joe Thompson, MD, MPH, is president and CEO of the Arkansas Center for Health Improvement and was Arkansas’ surgeon general under Govs. Mike Huckabee and Mike Beebe. The opinions expressed are those of the author.