Study shows e-cigs don’t keep teens from smoking cigs; health foundation calls for smoke-free schools; FDA to act on e-cigs

Coalition for a Smoke-Free Tomorrow chart

By Melissa Patrick
Kentucky Health News

Teens who use electronic cigarettes end up smoking traditional cigarettes at about the same rate as teens who first start with the traditional smokes, according to a recent study based on surveys in California and Connecticut.

“The findings show that e-cigs do nothing to deter the amount of combustible smoking in youth,” Jessica Barrington-Trimis, an assistant professor of preventive medicine at the University of Southern California and the study’s lead author, said in a news release. “On the contrary, they increase the likelihood that vaping teens will start smoking.”

The study, published in the medical journal Pediatrics, is based on surveys of 6,258 high-school students in three studies, including two from the Children’s Health Study and Happiness and Health Study in Southern California and a Yale University survey in Connecticut. Participants were re-surveyed again six to 16 months later.

During the study period, 7 percent of the students initially identified as never-smokers, and 21 percent of those who were using e-cigs, began smoking traditional cigarettes. And once they started smoking them, the amounts the two groups smoked were similar.

The study also found that students who only smoked cigarettes, or used both products, were more likely to continue using cigarettes than they were to switch to e-cigs only, or to quit smoking altogether.

The report notes that numerous studies show that young people who use e-cigarettes are more likely to start smoking.

“Because e-cigarettes are used by at least some youth who likely would not ever have begun smoking without having been exposed to e-cigarettes, the potential negative impact of e-cigarettes on the health of youth via the effect of e-cigarettes on smoking uptake is concerning,” the report says.

It called for policies to reduce teen use of both products “to prevent progression to more frequent tobacco-use patterns, and to reduce combustible cigarette use (with or without concurrent e-cigarette use) to lessen the adverse public health impact of e-cigarettes.”

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a news release that it’s time to make local and state tobacco controls include e-cigarettes and other vaping products, since research continues to show e-cigarettes are a “gateway to smoking for youth and young adults.”

“Our tobacco-control policies at the national, state and local levels must be updated to reflect that youth e-cigarette use has risen to epidemic levels, potentially reversing all the progress we’ve made in reducing smoking rates over the past 50 years,” Chandler said. “At a minimum, that means enacting tobacco-free school policies that prohibit the use of all tobacco products — including combustible cigarettes as well as vapes, e-cigarettes and other electronic nicotine delivery systems, or ENDS — on or in school property. And it means including these products in smoke-free community policies.”

The latest Kentucky Health Issues Poll showing 87 percent of Kentucky adults support 100 percent tobacco-free schools, but state legislation to do that has failed, and as of July, only 42 percent of the state’s 173 school districts were covered by 100 percent tobacco-free policies.

About the same number of Kentucky high-school students smoke cigarettes as use e-cigs, 14 percent. Nationally, 8.8 percent of teens smoke and 13.2 percent use e-cigarettes.

FDA action coming

The U.S. Food and Drug Administration has been cracking down on the sale of e-cigarettes and other vaping products to minors, and is expected to impose severe restrictions on their sale as early as next week, Laurie McGinley reportsfor The Washington Post.

Citing senior agency officials, the Post says FDA Commissioner Scott Gottlieb is expected to announce a ban on the sale of most flavored e-cigs in convenience stores and gas stations, impose age-verification requirements for online sales, and propose banning menthol in regular cigarettes.

“The FDA’s initiatives on vaping are spurred by preliminary government data that show ­e-cigarette use rose 77 percent among high schoolers and nearly 50 percent among middle schoolers in 2018. That means 3.5 million children were vaping in early 2018, up 1 million from 2017,” McGinley reports.

Six organizations that have been on the front lines in the fight against tobacco asked Gottlieb in a letter Nov. 10 for “action that will ensure that we don’t addict another generation of American youth.” The letter from the American Academy of Pediatrics, the American Cancer Society, the American Heart Association, the American Lung Association, the Truth Initiative and the Campaign for Tobacco-Free Kids lists “core principles essential to reducing tobacco use:”

Voluntary action by the industry, including the electronic cigarette industry, is insufficient. Industry-wide regulatory action is essential; FDA’s approach must be comprehensive and not be limited to sales restrictions to prevent illegal sales to youth. and it is essential to address the problem of youth use of other tobacco products as well as e-cigarettes.

The groups called for FDA to take specific actions, including immediate removal of all flavored tobacco products that have not been thoroughly vetted in advance by FDA to assess their public health impact; restrictions on e-cigarette marketing, including on social media, that are at least as stringent as those applied to cigarettes; restriction of online sales and continued aggressive enforcement of the law against sales to minors; and enforcement of the legal requirement for pre-marketing review of products that were not commercially marketed as of Aug. 8, 2016.

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