The AMA cited the lack of evidence about the short- and long-term health impact of e-cigarettes and vaping products in making the call for a total ban. The doctors’ group said a separate health issue also prompted its action — the recent U.S. outbreak of lung illnesses linked to vaping. Most of those sickened said they vaped THC, the high-inducing ingredient in marijuana, not nicotine. Officials believe a thickening agent used in black market THC vaping products may be a culprit.
About 2,100 people have gotten sick; 42 have died.
“It’s simple, we must keep nicotine products out of the hands of young people.” Dr. Patrice Harris, AMA’s president, said in a statement.
The AMA has previously sought bans on e-cigarette flavors and ads. At the same time, some states, municipalities and corporations are seeking to limit the products, with Massachusetts lawmakers set to vote on Wednesday on a bill that would ban flavored tobacco. That measure is aimed at reducing vaping among teens, with researchers finding that 5 million children and teens are now using the products.
Yeah, I’m thinking the AMA position might be a bit overly strong. I’m all for banning or at least regulating ecig advertising and banning the sugary flavours. But a total ban would leave millions of vapors, many of whom legitimately use vaping to get off cigarettes, with no other option but to run back to cigarettes for their nicotine fix.
“Doctors at Henry Ford Health System in Detroit, where the teen was treated, said they had never seen such scarring on someone’s lungs from vaping.”
“‘This is an evil that I haven’t faced before,” Dr. Hassan Nemeh, a thoracic specialist at Henry Ford Health System, said during a news conference.”
Wow, that’s some pretty hairy quotes. It really brings it home just how destructive the vaping illnesses have been. More than 40 people have died now and more than 2,000 have been sickened. Nemeh urges kids to stop vaping all products, not just THC products.
According to the story, vaping of both nicotine and THC products has caused the thousands of deaths around the country from vaping (and a few dozen deaths). I do believe it is mostly THC products being sold on the street.
Here’s an interesting aspect to the story. Scientists think they might have tracked down the cause of the illnesses — at least one of them. It’s Vitamin E acetate, which is being used as a diluting agent in THC vapes. Vitamin E acetate, a synthetic form of Vitamin E, has been found in half of the 419 THC vaping fluids tested by the Food and Drug Administration.
CDC recommends that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers. Until the relationship of vitamin E acetate and lung health is better understood, vitamin E acetate should not be added to e-cigarette, or vaping, products.
“First of all, I’d tell them that I’m sorry that their child’s using the product,” said Kevin Burns, who joined Juul in late 2017. “It’s not intended for them. I hope there was nothing that we did that made it appealing to them. As a parent of a 16-year-old, I’m sorry for them, and I have empathy for them, in terms of what the challenges they’re going through.”
Oh, baloney, Kevin Burns, especially his bullshit about “I hope there was nothing that we did that made it appealing to them.”
Juul was one of the vaping companies that most aggressively and successfully used social media to advertise its products, including Instragram “influencers.” Jull very quickly came to dominate the e-cig industry, gaining control of over 70 percent of the industry. This guy Burns is so full of it. He apologized because he got called to testify before congress and because lawsuits are piling up against Juul over addicting kids to nicotine (it turns out Juul pods are considerably more powerful with higher amounts of nicotine than other e-cig companies). This really takes the cake as one of the phoniest “apologies” I’ve ever seen. The L.A. Times even wrote an op-ed piece called, “Let’s call it a Juuling epidemic.”
Yet Juul’s critics point to the company’s initial advertising campaign, which featured bright colors and young looking models, as evidence that Juul fueled the surge in teen vaping. Co-founder Adam Bowen said in retrospect the ads were “inappropriate.”
“When we launched Juul, we had a campaign that was arguably too kind of lifestyle-oriented, too flashy,” he said. “It lasted less than six months. It was in the early days of the product introduction. We think it had no impact on sales.”
The Campaign for Smokefree Kids thought the same of Burns’ apology as I did.
Once again, Juul is following the tobacco industry’s playbook: Proclaim loudly that they don’t want kids to use their product, while never admitting that their marketing targeted and attracted kids. Like its partner Altria, Juul still refuses to admit that the company’s marketing targeted kids or has played a major role in youth use of its e-cigarettes – despite overwhelming evidence to the contrary.
This is a deceptive, self-serving gesture by Juul given their complete refusal to take responsibility for creating the youth e-cigarette epidemic. It is a blatant attempt to deflect attention from the company’s wrongdoing while it opposes meaningful government regulation to prevent it from continuing to addict kids. There can be no doubt about Juul’s role in the current youth epidemic: It marketed a sleek, cool, high-tech product that comes in sweet flavors that appeal to kids, delivers a massive dose of nicotine that can quickly hook kids and was launched with social media marketing that a Stanford study found was patently youth-oriented.
This is one more example that Juul is more interested in repairing its image and expanding its sales than preventing youth use. Juul is following the tobacco industry’s playbook to the letter: Addict kids, deny responsibility for doing so, run slick PR campaigns to fool policy makers and the public, and fight real solutions to the problem.
Long time since an update. I have been very busy and spend most of my spare time outdoors, hiking and trying to get back in shape this summer.
So, there’s a TON to catch up on. I will try to do this over the next few days.
First things first
Mysterious vaping illnesses
At least 150 teenagers around the U.S. have been admitted to emergency rooms with some mysterious lung disease caused by vaping.
They weren’t necessarily vaping tobacco; some of the teens were vaping marijuana.
The one common thread between all the illnesses. All of the victims were vaping. The other common thread, most of them appeared to have bought their vaping products on the street rather than legally through a store.
“One patient came in with full respiratory collapse and essentially had to be on life support,” said Dr. Jacob Kaslow, a pediatric pulmonary fellow at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville.
Kaslow told NBC News that his hospital has treated four cases of vaping-related respiratory illness over the past six months. Tracking the cases has been tricky, as patients tend to have a variety of symptoms, including severe pneumonia and coughing up blood.
“We’re only discovering this now because we’re asking, ‘is there any history of vaping or electronic cigarette use?'” said Kaslow.
No deaths have been reported. But some patients have developed severe, progressive lung disease, and have required ongoing mechanical breathing assistance.
The Centers for Disease Control and Prevention is working with states to try to pinpoint an e-cigarette ingredient, e-liquid, device or purchase method linking all of the cases.
It’s unclear whether there was some kind of contamination of the devices or e-liquids that led to the 149-plus cases.
Some patients reported buying their vapes off the street.
“The evidence continues to point to street-bought vaping cartridges containing THC or synthetic drugs as being the cause of these illnesses,” Gregory Conley, president of the American Vaping Association, wrote in a statement to NBC News.
So, again, lots of questions about vaping and the contaminants that are found in vaping fluids. This isn’t the first illness tied to vaping. Vaping is already believed to be tied to a disease known as “popcorn lung” (the name comes from the fact that it was first tied to workers in popcorn factories).
FDA Administrator Scott Gottlieb announced this week that he is resigning his position to… get this … spend more time with his family.
Yup, that really actually is his excuse. And this came a couple of weeks after he insisted he wasn’t going anywhere … which was a pretty big clue that he was on his way out.
And he was totally not forced out by Republicans or by the tobacco industry because … he insists he was not forced out by Republicans or the tobacco industry. Repeatedly. So, that’s the end of discussion.
Gottlieb was a total anomaly in the Trump Administration, someone who actually was doing his job. Someone who wasn’t terribly controversial and who didn’t completely dismantle the agency he was put in charge of.
Honestly, for two years, I’ve been scratching my head at it. Trump has clearly put pro-industry, pro-business, anti-regulatory shills in charge of many federal agencies. And it’s clear that their role is to simply dismantle that agency.
Gottlieb was the outlier. He actually was fairly anti-tobacco industry and he was particularly anti-vaping industry (and I don’t differentiate much between the vaping and tobacco industry because the tobacco industry has a controlling interest about 75-80 percent of the vaping industry) was using the FDA to crack down pretty harshly on the vaping industry, mostly over the huge increase in recent years in teen vaping.
Gottlieb had gone so far as to threaten to completely ban vaping products completely. He didn’t follow through with that threat, but he did propose a bunch of new regulations toward vaping products, including rules that vaping products can only be sold in areas completely closed off to minors. He also proposed banning menthol cigarettes.
So, I wasn’t surprised when he suddenly announced this week he was resigning.
Hah, the kicker? He actually boldly announced two months ago he wasn’t going anywhere. That told me right there that there was political pressure coming down on him because he was too anti-industry for Republicans’ taste.
This New York Times article goes to great length to highlight Gottlieb and the Trump Administration’s denials that he was forced out by Big Tobacco and Republicans. He denies it a little too much, frankly. Yeah, because the Trump Administration ALWAYS tells the truth about these things, right? And the “I wanted to spend more time with my family” is the oldest excuse in the book.
Dr. Gottlieb has been subject to increasing pressure from some Republicans in Congress and his former associates in the conservative movement for his tough stance against youth vaping and traditional cigarettes. A coalition of influential conservative groups recently asked the White House to block some key parts of the F.D.A.’s strategy to prevent youths from vaping. Republican Senator Richard Burr blasted the commissioner on the Senate floor for his proposal to ban menthol cigarettes.
Dr. Gottlieb said these protests had no role in his departure.
“There’s no intrigue here,” he said in an interview. A senior White House official said Dr. Gottlieb was not pressured to leave and that the President was “very fond” of him.
Dr. Gottlieb said these protests had no role in his departure.
“There’s no intrigue here,” he said in an interview. A senior White House official said Dr. Gottlieb was not pressured to leave and that the President was “very fond” of him.
Gottlieb’s proposed regulations were in the “pending” stage. Expect them to remain there … or to be dropped entirely. From the article:
Dr. Gottlieb said he planned to advance the F.D.A.’s pending tobacco regulations before he leaves. And he was confident, he said, that the agency’s guidance on restricting flavored e-cigarettes would be issued before he left. He acknowledged, however, that he could not predict the fate of his proposals to ban menthol in cigarettes and reduce nicotine to nonaddictive levels in cigarettes.
Industry analysts expressed optimism that those initiatives would, in fact, now end.
“We think this major development will be broadly viewed as a positive for the tobacco industry, although this introduces some uncertainty,” Bonnie Herzog, a managing director of equity research at Wells Fargo Securities, wrote in an email to clients. “We believe his resignation calls into question whether or not the FDA will in fact enforce harsher regulations around youth e-cig usage/access, cig nicotine limits and a cig menthol ban given he was the champion behind these initiatives.”
So, I expect little or nothing to be done about vaping, teen vaping, menthol cigarettes for the next two years. Gottlieb was the wrong guy, in the wrong administration, to make it happen.
Well, this is progress, I wonder if it will have any effect.
The FDA announced that it will soon ban the sale of e-cig flavourings at minimarts. This is in response to the rapid rise of e-cig use by teenagers. The FDA warned a few weeks ago that it was cracking down on e-cigs because of the epidemic of teen e-cig use. So, this is apparently step one.
Also, cartridge-based e-cig products like Juuls will no longer be allowed to be sold at convenience stores. Sales will be limited to tobacco and vaping shops. Juuls are relatively news, they’ve only been around a year or two, but their use has exploded (not literally) among teens.
That seriously limits the venues that e-cig flavours and Juuls will be sold at — basically from millions of convenience stores around the country to about 10,000 estimated tobacco and vaping stores. It won’t stop kids from trying to buy them, but will make it harder. And tobacco and vaping stores are more regulated than convenience stores.
The FDA, and this is a big one I think, is also going to impose more rules and regulations on online sales of vaping products, requiring stricter standards for age verification. Today, any kid with their own debit card can just click on “yes, I’m 18” on most of these sites.
Will these be enough to stop the epidemic of kids using e-cigs? Only time will tell, but the FDA suggested this is just the beginning of the steps that it plans to crack down on the industry and its lax attitude toward teen vaping.
From an NBC News article on the FDA’s move:
The Centers for Disease Control and Prevention reported Thursday that adult smoking rates have dropped to their lowest level yet, at 14 percent. But the CDC found that 47.4 million U.S. adults , or 19 percent of the adult population, uses any tobacco product, including cigarettes, cigars, or e-cigarettes.
Public health experts have been complaining that the fruity, candy-like flavors found in e-cigarettes are targeted directly at children and teenagers, and rates of teen cigarette use have soared.
The FDA has also expressed concern about online sales to teens. In September, the FDA made an unannounced visit to Juul headquarters to look for evidence about the company’s marketing practices. In April, the agency launched what it called a “blitz” to stop retailers from selling vaping products to underage children. And it has warned several online sites about sales.
Next week, the FDA will do more, the official said.
“We’re also going to restrict online sales only to sites that put in place specific age verification measures and limit access to kids that we are going to specify in guidance,” the official said.
“This is just the first step. We will consider other steps if use doesn’t come down, and sharply.”
Tobacco advocates question if the FDA is going far enough.
Public health groups including the American Heart Association, American Lung Association, American Academy of Pediatrics, the Campaign for Tobacco-Free Kids, Truth Initiative and the American Cancer Society Cancer Action Network, have been urging the FDA to move faster and to remove Juul from the market until it undergoes an FDA review.
“To reverse the epidemic of youth e-cigarette use, the FDA needs to stop the sales of all flavored e-cigarette products that have not been subject to public health review by the FDA as the law requires,” the Campaign for Tobacco-Free Kids, American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association and Truth Initiative said in a joint statement.
“There is nothing to prevent the number of vape shops from rapidly expanding and there is no solid evidence that vape shops do a good job of preventing illegal underage sales. In addition, youth use of e-cigarettes is not limited to Juul and other pod-type products. Even before the introduction of Juul, e-cigarettes had become the most commonly used tobacco product among kids and research found that 81 percent of youth who ever tried e-cigarettes started with a flavored product.”
A couple of contradictory articles here about what appears to be the same survey. Took some research, but I got to the bottom of what these numbers really mean. This CDC graphic is REALLY helpful. I recommend clicking on it to see it full size.
According to U.S. News and World Report, a new Centers for Disease Control survey showed that teen smoking rate has dropped to 9 percent, while teens are also doing fewer drugs, having less sex and … drinking less milk?
OK, the milk part was weird. The point being more kids are drinking sodas and energy drinks.
However, a story from NBC News, which appears to cite the same CDC study, says that teen use of tobacco products has dropped from 24 percent in 2011 to 20 percent today — but that 13 percent of that is from cigarettes, with the rest vaping.
This is mostly good, if not confusing news. Well, more good than bad. I see a glass half-full from the fact that when I started looking at these CDC surveys 10-12 years ago, the teen smoking rate was pushing 30 percent. Now, it’s somewhere between 9-13 percent.
The glass half-empty is that there are still kids getting addicted to nicotine, just from a different delivery system. E-cigs aren’t as bad as cigarettes, but they aren’t 100 percent benign either. It’s best if kids don’t get addicted to nicotine … period. Regardless of the delivery system.
So, I decided to look at the CDC survey directly. I HATE contradictory information like this when different reporters see different results when they look at different part of the same study.
Here’s MY take on the CDC survey (these surveys are done every two years, by the way). A little more in-depth and a little more carefully worded than the two articles:
There is something there that says 8.8 percent of teens have smoked a cigarette in the past 30 days, so that’s where they got 9 percent.
Total number of teens using a tobacco product is 19.6 percent. That’s e-cigs, smokeless tobacco, cigarettes, cigars and hookahs combined.
percentage of kids using e-cigs is 11.7 percent
There is something that says total percentage of “combustible” tobacco products — that’s cigarettes, cigars and hookahs — is 12.9 percent. I’d be willing to bet most “cigars” being smoked by kids are those Swisher Sweets.
So, it appears that both articles are right. It also showed to me that there’s some overlap between kids who smoke and kids that vape — that’s why 11.7 percent + 12.9 percent = 19.6 percent. The articles aren’t clear about that. There is a category in the study that says, “more than two types” of tobacco products. That’s roughly about 10 percent of teens. And that’s why 11.7 + 12.9 = 19.6.
Anyway, the graphic I included with this post makes it MUCH clearer. According to that graphic, the news is generally good, though it could be better.
Teen vaping has actually dropped since it hit its peak in 2014. Yayy, I’m actually heartened by that, though I’d like to see it drop faster. Total nicotine use via either e-cigs or cigarettes has dropped since 2014.
In 2014, roughly 17 percent of teens were using e-cigs, that’s now down below 12 percent.
Total nicotine uses by teens in 2014 was just above 25 percent. That figure is just under 20 percent in 2017. Smoking is down a ton, from about 18 percent (any combustible) in 2014 to 13 percent in 2017. Cigarettes are down from about 11 percent in 2014 to just under 9 percent in 2017.
I don’t know if the CDC broke down the difference between cigarettes and cigars before. I never noticed it before this year’s survey, and I’ve been perusing these CDC survey reports for a decade. But, it’s good to have the whole story. A lot more teens smoking cigars and cigarillos than I thought.
Resembling a flash drive, Juul conveys a sense of industry — you’re Juuling into your MacBook Air while you are cramming for your test on Theodore Dreiser and thinking about trigonometry — and it is so easy to conceal that, as one mother explained to me, she failed to notice that her daughter was vaping in the back seat of the car as she was driving.
It’s basically just the latest “hip” e-cig. And this is one of the issues I have with e-cigs … is they keep trying to pass themselves off as “hip” and the “latest thing.” And kids love stuff that’s “hip” and the “latest thing.”
The company’s position that Juul is intended strictly for “adult” smokers as its website repeatedly indicates, is belied by the menu of flavors in which the nicotine pods are offered. These include Mango, Cool Mint, Fruit Medley and Creme Brulee. As Anthony Charuvastra, a child psychiatrist and assistant professor at New York University’s Medical Center put it, “Who over 25 is looking for creme brulee as part of a smoking experience?”
Like all modern tech companies that attract tens of millions of dollars in venture capital funding, Juul believes it is doing something globally valuable, acting as “part of the solution to end combustible smoking,’’ as its marketing material proclaims. A “Mission & Values” statement on the company’s website declares that no minor should be in possession of Juul and argues that the company is working to combat underage use. In August, it instituted an age-verification system on its e-commerce site to try and prevent anyone under 21 from buying Juul products.
“James and Adam recognized a groundbreaking opportunity to apply industrial design to the smoking industry, which had not materially evolved in over one hundred years,” the Juul website also declares, indicating how little Silicon Valley can distinguish between what needs to be disrupted and what simply needs to go away.
When asked about Juul’s use by teenagers, the company said in a statement, “We condemn the use of our product by minors. We are fully committed to dramatically reducing the incidence of young people using Juul.”
Yeah, the “we here at Juul are very concerned about teen vaping” sounds pretty lame and vapid (They gave a similar statement to Women’s Health), especially when it sounds EXACTLY like the Tobacco Industry excuses for their products being blatantly marketed to teens for decades. So, colour me seriously unimpressed with the owners of Juul and their milquetoast response about teens using their product.
Teen vaping use had increased dramatically from 2011 to 2015 (from less than 2 percent to 16 percent in just four years). Why? Kids were seeing lots of advertising in teen magazines and on TV making e-cigs look cool and hip … and harmless. In the long run, despite an initial investment, they’re cheaper than cigarettes. And most of all, they used to be really easy to buy — and still are pretty easy to buy online.
From 2015 to 2016, teen vaping actually dropped a bunch, from 16 percent to 11.3 percent. That’s roughly a 30 percent decrease.
Meanwhile, teen smoking dropped to an all-time low of 8 percent (high school students). Man, when I first started this blog over on blogspot 10-12 years ago, the teen smoking rate was still 22.5 percent. It frustrated the crap out of me because year after year, it refused to drop.
Amazingly, 19 years ago, it was over 35 percent! (Thanks, Joe Camel). Now, it’s down to 8. That is roughly a 72 percent decrease in 19 years. And the combined teen smoking/vaping/chewing rate (essentially any tobacco product) is down to 20.2 percent.
the past couple of years have been frustrating, as well. While it was great to see the the smoking rate among teens dropping dramatically, the teen vaping rate was increasing during that time just as dramatically. What that meant is that roughly the same percentage of kids were still getting addicted to nicotine, but that they had just discovered a new delivery system.
Matt Myers, from the Campaign for Tobacco-Free Kids responds: “This is unimaginable, extraordinary progress. This is a change of a cosmic nature that has the potential to dramatically impact lung cancer, heart disease, asthma and other problems.”
Robin Koval with the Truth Initiative said these latest numbers might be showing that smoking its on its way out for good. Cigarette smoking has really dropped dramatically just in the past five years for a variety of reason — the popularity of vaping, cigarette taxes, the stigma of smoking and smoking bans being the main reasons.
I want to make it clear, I don’t have a problem with adults vaping, especially if it’s helping them quit smoking. I do have a problem with teenagers getting hooked on nicotine to begin with via vaping. And I really have a problem with some of the reckless advertising being done by vaping brands. It’s still nicotine and it’s still one of the most addictive substances on the planet.
Anti-tobacco advocates had a variety of theories behind the dramatic dropoff in teen vaping (one advocate suggested that the experimental allure of e-cigs has worn off). I have a theory that I think more vendors are cracking down on selling vaping products with an ID … and more states are not allowing vaping products to be sold to teens or even to people under 21. This Washington Post article points out that the feds sent out more than 4,000 warning letters to retailers cautioning them against selling e-cigs to minors.
Anyway, it’s looking good for the moment, though the FDA has delayed implementing regulations over e-cigs … and who knows what the Trump administration is going to do on this issue. I have zero trust in them.
California is the latest entity — and the biggest — to raise the age for buying cigarettes and vaping products to 21 (There’s a misunderstanding here, it’s not against the law for 18-year-olds to smoke or vape … it’s against the law to sell products to people under 21 now.).
This is one area where I’m not 100 percent on board with the rest of the tobacco control community. There is a part of me that thinks when you’re 18, you can vote, join the military and go to prison for committing a crime; you’re considered mature enough to vote and do prison time, but not smoke? I’m still struggling with this, though virtually the entire rest of the tobacco control community is in favour of it. The American Heart Association, the American Cancer Society’s Cancer Action Network (the group’s advocacy affiliate), the American Lung Association and the president of the California Medical Association all came in favour of the California law.
Interestingly, I think lawmakers in California listened to some of these concerns. People in the military between 18 and 21 are exempted from the law (though I need to follow up later on a story that the military is cracking down on tobacco sales on its bases.).
California now joins Hawaii and New York City and a few other places that have raised the age for buying tobacco from 18 to 21.
Perhaps this will be effective in stopping kids from not only smoking but vaping. One reason I remain a bit skeptical about how effective this law will be is most kids don’t start smoking or vaping after they turn 18; most of the time they start when they’re 13 or 14 years old. Maybe it will be harder for their 18- and 19-year-old friends or siblings to buy their tobacco products for them. We’ll see. If the teen smoking and vaping rates go down in five years because of these laws, I’ll be more
“[These laws] will save countless lives, reduce astronomical costs to the health care system, and cost very little because it uses existing enforcement mechanisms,” said Senator Ed Hernandez, who authored the bill to raise the age of tobacco products. “Today was an enormous victory for not only this generation, but also for many generations to come who will not suffer the deadly impacts of tobacco.”
One thing I like is that the bills Gov. Jerry Brown signed also prohibit the use of e-cigs in public buildings, even in bars.
The e-cigarette is nothing more than a new delivery system for toxic and addictive nicotine,” State Sen. Mark Leno said Wednesday. “Ensuring that e-cigarettes fall under California’s comprehensive smoke-free laws is critical to protecting public health, especially given the alarming rate at which young people are picking up these devices.”
What I like most about the law is that it actually makes it a criminal offence — a misdemeanor, not a citation — to sell or buy cigarettes or vaping products for underaged users. Basically, the same as alcohol. That should put a dent in retailers selling vaping products to teens.