Note to readers: Each week through November 2019, a selection of our 101 California Influencers answers a question that is critical to California’s future. Topics include education, healthcare, environment, housing and economic growth.
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California Influencers this week answered the following question: How can we best confront the rapid spread of vaping among young people? Below are the Influencers’ answers in their entirety.
“California will not stand by as a new generation falls victim to the dangers of big tobacco”
Mark Ghaly - Secretary of the California Health and Human Services Agency
Vaping devices are the most commonly used tobacco product in California. From 2016 to 2018, vaping among California high school students rose 27% and a 2017 study found that 86% of youth who vape are using flavors. As a father and a pediatrician, I understand the urgent need to confront this epidemic as well as anyone. I can assure you California will not stand by as a new generation falls victim to the dangers of big tobacco. This extends to cannabis consumption as well – vaping of cannabis products among youth rose by 58% in a single year. In mid-September, Governor Newsom signed an Executive Order to confront the youth vaping epidemic and vaping-related illness. The order calls for a statewide public awareness campaign to educate youth, young adults and parents about the health risks of vaping as well as the development of recommendations to reduce smoking among young adults and teens by establishing warning signs with health risks where vaping products are sold and on product advertisements.
I also believe parents, schools and communities should make coordinated and concerted efforts to educate our young people across the state to curb the rise in vaping we have seen over the last decade. I know I’ve been speaking about the potential impact of vaping on my children’s health, sports, social interactions and finances. I’ve also been encouraging friends to talk to their kids about the same issues. Just like campaigns to curb drinking or even use of smart phone technology to keep kids safe, we must begin to focus on vaping as an important negative challenge to contend with in all communities.
“Vaping is a crisis that has been a decade in the making”
Jeannine English - Former National President of AARP
It’s important to learn from the success of California’s Tobacco Control experience. In 1988, voters passed a ballot initiative creating the single largest anti-tobacco public health intervention of its kind. The initiative and a follow-up act provided for taxation of tobacco products. The initiative earmarked funding to help prevent youths from smoking and to help smokers overcome their addiction. The program was broad based and sweeping involving multiple state agencies with funds for health education including a media campaign, programs for city and county health departments and grant programs for school districts.
Implementation of the initiative wasn’t perfect and we can learn from the imperfections, as well. The legislation to implement the initiative was watered down and some of the funds were diverted in an effort to appease the tobacco lobbying effort.
But even with serious deficiencies in implementation the initiative was considered the “most innovative public initiative ever designed to change long-term health of a state’s population and improve the public health capacities of state and local government”. Vaping is a crisis that has been a decade in the making and elected officials need to respond immediately. The tobacco industry spends nearly $1 million per hour to market their deadly, addictive products. Legislation needs to be enacted to develop and fully fund a multifaceted public health intervention program and outlaw the tobacco industries predatory marketing.
It’s a matter of life and death.
Vigilance and education are key to preventing teen vaping
Carmela Coyle - President and CEO of the California Hospital Association
Given how little we know about vaping-related deaths, this is like watching children play in traffic. Last month, state health officials issued an advisory urging everyone to stop vaping until the link to serious health issues is understood.
Since June, 126 Californians have been hospitalized for vaping related illnesses, and three have died. Federal health officials now consider teenage vaping an epidemic that must be stopped.
The best answer is prevention – we must all do what we can to stop teens from vaping through vigilance and rapid education.
Vigilance? Each of us, as parents, grandparents, teachers, coaches, neighbors, and friends must engage. If you see a teen vaping, say something. Are you texting the daily headlines about vaping to your teenagers? You should be.
Education? We need messages specifically targeted to teens – similar to the 1980s anti-drug campaign of an egg frying in a sizzling hot skill with the tag line “This is your brain on drugs.” And, we need widespread education for adults – with pictures – as vaping tools are easily concealed as other electronic devices.
Our children are a community asset and our hope for the future. We must work together to impress upon them the harm of vaping.
It’s time to tax vaping like cigarettes
Dustin Corcoran - CEO of the California Medical Association
The vaping industry has followed in the footsteps of its Big Tobacco predecessors, using predatory marketing tactics to get kids hooked on their dangerous products. In the wake of vaping-related illnesses reported across the country, California has lagged behind other states in taking the necessary steps to protect kids. The first should be a ban on flavored vape products that are clearly designed to appeal to teens and young users. The other tool we have is taxation. Proposition 56 intend to ensure that the taxation of vaping products was equal to the taxation of traditional cigarettes. Unfortunately, the formula for taxing vaping products is far lower than cigarettes. The current tax on a pack of cigarettes is about $2.87. The tax on one Juul pod is about $1.48. We know that tobacco taxes are the most effective way to reduce tobacco use, and that kids in particular are sensitive to price point. By simply taxing vaping products the same way we tax cigarettes, we can make it harder for kids to get access to these dangerous products which have hooked a new generation of young users.
Education and enforcement is needed to help people quit while preventing new smokers
Marie Waldron - California State Assemblywoman (R-Escondido)
While vaping products were created to help people break the smoking habit, we need to balance that potential with the risk. Most importantly, we need to realize this is an epidemic. In 2018, more than 3.6 million children used e-cigarettes, an increase of 1.5 million from 2017. Contributing to the rise is the perception that vaping is a cool alternative to cigarettes and the ease with which young people can get their hands on fun flavors like mango and cotton candy.
Our first step needs to be educating kids about the dangers of e-cigarettes. I supported proposals this session to help school employees and parents recognize e-cigarettes that often look like other products, such as USB drives, prohibit packaging that is attractive to kids and require cartridges containing cannabis to bear a recognizable symbol.
Next, we need to look at where kids are getting these products. There’s a bipartisan effort in the Capitol to increase penalties for retailers who sell to minors and prohibit e-cig manufacturers from advertising to children. Ensuring that law enforcement has the tools to crack down on illegal sales and educating children, parents and school employees about vaping will help ease the epidemic and save lives.
“The vaping industry is using the same Big Tobacco marketing playbook”
Anthony Wright - Executive Director of Health Access California
The huge drop in smoking rates is one of California’s greatest public health achievements of the last half century – a victory vaping threatens to undo. Tobacco control laws and public health campaigns were key to this marked reduction, and will be vital again to address the vaping crisis.
The vaping industry is using the same Big Tobacco marketing playbook, while making claims that vaping is safer than smoking – an exceedingly low bar, given how harmful cigarettes are. Young people should know vaping puts your health and your life at risk.
The industry is working hard to hook our kids, particularly from marginalized groups, such as LGBTQ youth and people of color. California must work as hard to make vaping as unattractive as possible by passing local, state, and federal policies. Actions we can take include: banning the sale of all flavored products; licenses that limit the number of tobacco retailers in a community, further proximity to schools and parks, cracking down on online retailers, and more.
However, these steps should not further criminalize the purchase of vaping products by minors. Ordinances punishing youth for purchasing, using, or possessing tobacco products contribute to the school-to-prison pipeline and further exacerbate health disparities.
“Vaping is yet another, more creatively evil form of the nation’s adolescent smoking crisis”
Robert Ross - President and CEO of The California Endowment
From the standpoint of a public health purist, I am reminded of the Hollywood thriller films, like “Friday the 13th”, where the evil Jason appears in series after series despite efforts to put him away.
Vaping is yet another, more creatively evil form of the nation’s adolescent smoking crisis – which California successfully confronted the tobacco industry about over the past couple of decades. While most vaping products don’t contain the thousands of toxic chemicals that are found in tobacco smoke, they have been found to routinely contain the highly addictive nicotine, volatile organic compounds, heavy metals like lead, and other cancer-causing agents.
The efforts by industry to market these products to adolescents and communities of color by utilizing candy-like flavors are outrageously irresponsible, and is a page right out of the tobacco industry playbook. The science tells us that legislators and regulators are justified in taking every reasonable and assertive step to protect consumers and young people from being guinea pigs-for-profit by these companies.
Cotton candy vaping, meet Joe Camel
Robin Swanson - Swanson Communications
In the nineties, when children were able to identify Joe Camel as quickly as they could the Disney logo, the jig was up on the idea that the tobacco industry was marketing their product to children. Eventually, Camel had to “rebrand” their advertising and morphed their mascot into a more adult-looking creature.
But the aggressive advertising of tobacco and vaping products to youth is more pervasive than ever. As a result, if we want to confront the spread of vaping among young people, we need to start by intercepting the ads, social media and concert promotions that attempt to market this dangerous product as “cool.” We also simply can’t allow this industry to produce products that are designed to addict our children in flavors like “Cotton Candy” and “Gummy Bear.”
According to the Campaign for Tobacco Free Kids, vaping products are being marketed and distributed to young people at alarming rates, and our high schoolers are falling prey to resulting nicotine addiction. Data shows that one out of nine high school seniors report that they vaped nicotine nearly daily. Students who do so report feeling “trapped” once they are hooked on the product. And we’ve now learned that this product can kill users more quickly than ever, with resulting lung and other acute respiratory diseases taking lives.
This isn’t an experiment, it’s an epidemic, and we need to treat it like one. It’s time to quarantine and abolish the source.
“The best way to cut down on youth vaping rates is to significantly reduce access”
Zach Friend - Second District Supervisor for Santa Cruz County
The best way to cut down on youth vaping rates is to significantly reduce access. In Santa Cruz County, the Board of Supervisors voted unanimously to ban flavored tobacco and electronic cigarettes. According to the Centers for Disease Control and Prevention 1 in 5 high school students reported smoking an e-cigarette in the past 30 days and 3.6 million middle and high school students reported vaping in 2018.
Even as conventional cigarette usage is falling middle and high school students are using e-cigarettes at increasing rates. There are significant public health risks associated with vaping and the long term effects of usage are just now starting to be seen. As a state we need to cut down on access. We’ve made great strides in reducing smoking rates but vaping presents a new challenge and an attempt to create a new generation of smokers – reducing access through local or state bans is an important step.
“Kids don’t realize vaping isn’t just flavors and water”
Chet Hewitt - President and CEO of the Sierra Health Foundation
Most Californians probably share my incredulity and anger about the vaping epidemic. Why are 10% of our youth vaping, with 86% using flavored tobacco? Fortunately, the same plan of action we took to decrease smoking—education coupled with enforcement—can be used to fight this new attempt to put profits above health. According to the Truth Initiative, 2/3 of kids don’t realize vaping isn’t just flavors and water. They need to know they’re vaping the same addictive nicotine found in cigarettes, and that vaping presents unique challenges like sudden lung damage. Young people don’t like anyone to make decisions for them; let’s use that newfound independence to push back against the obfuscation. We must allow young people to lead the way and work with them to craft messages and use delivery mechanisms such as social media that they find relevant. We know how to do this effectively, with large scale campaigns and more personalized education in our schools and community spaces. On the enforcement front, California must follow the lead of local governments and enact a ban of flavored vaping products. Smokers needing help in ending addiction can have regulated access through prescriptions.
“Vaping products often contain higher doses of highly addictive nicotine than combustible cigarettes”
Richard Pan - California State Senator (D-Sacramento)
Last week, the CDC reported 1299 lung injury cases associated with vaping with 26 confirmed deaths, underscoring the true danger of vaping. While e-cigarette manufacturers have touted e-cigs as smoking cessation devices and safer than cigarettes, they have not submitted their products to the FDA for approval. In fact, vaping products often contain higher doses of highly addictive nicotine than combustible cigarettes, and vaping is a gateway to initiating cigarette use by teens. Although e-cigarette manufactures deny marketing to teens, the data shows 21% of high school students, an 1286% increase in 7 years, and 4.9% of middle school students, or a 717% increase, used an e-cigarette in the past 30 days; perhaps the most successful “non-marketing” campaign in America. California led in reducing tobacco use, and we must stop this new, insidious form of tobacco and nicotine addiction. Governor Newsom is taking action to raise awareness of the dangers of vaping, but the legislature needs to pass laws to halt marketing to underage youth, including removing all flavored tobacco products including mint and menthol, and vigorously enforce the ban on e-cigarettes for people under 21 years. Our teens are sick and dying of vaping; California must act.
“We should not underestimate the power of prevention”
Joseph Alvarnas - Vice President of Government Affairs and Senior Medical Director for Employer Strategy at City of Hope
Now is the time to learn from history and ensure we do not have additional Californians who needlessly suffer from the preventable consequences of an emerging health threat. We are finally seeing smoking-related cancer and mortality rates decrease based upon the success of public health efforts that began 50 years ago. With the vaping crisis, we have a chance to get this right without sustaining the loss of life and suffering that we have seen in the past with cigarette smoking.
The legacy of permanent injury and cancer-related deaths from smoking should provide a cautionary tale when considering the risks of vaping, particularly in the younger generation who have been particularly attracted through coercive marketing and enticing flavors. In a recent study on the presence of toxic compounds in e-cigarettes, the authors found that carcinogenic and toxic compounds like benzene and acrylamide metabolites were increased in users’ bodies.
We are now seeing emerging data on lung injury and disease related to vaping and now have reports documenting vaping-related deaths in California. We should not underestimate the power of prevention. We should be fully prepared to implement public health policies based upon emerging scientific data on the hazards of vaping.