Consumers soon may need to be 21 or older to buy burning tobacco cigarettes or e-cigarettes, the key component of the national health nightmare of “vaping.”
Both the House and Senate have passed the higher age requirement and President Trump is expected to sign it, joining hundreds of states (including Maryland, as illustration shows) and cities that have sought to make it tougher for Americans to damage their health with the popular products.
The damage caused by smoking have been well proven for decades now, with the American Cancer Society reporting the nasty habit’s persistent toll:
“Each year more than 480,000 people in the United States die from illnesses related to tobacco use. This means each year smoking causes about 1 out of 5 deaths in the U.S. Smoking cigarettes kills more Americans than alcohol, car accidents, HIV, guns, and illegal drugs combined. Cigarette smokers die younger than non-smokers. Smoking shortens male smokers’ lives by about 12 years and female smokers’ lives by about 11 years. Smoking not only causes cancer. It can damage nearly every organ in the body, including the lungs, heart, blood vessels, reproductive organs, mouth, skin, eyes, and bones.”
But even as cigarette smoking has waned, e-cigarette use and vaping have burgeoned. Under the Trump Administration, and notably under federal Food and Drug Administration head Scott Gottlieb, regulators heeded manufacturers’ bleating and postponed a crackdown on e-cigarettes that public health advocates campaigned for in the Obama Administration. Gottlieb, instead, said he wanted more research on nicotine’s addictive powers and e-cigarettes’ potential as a less harmful alternative to burning tobacco use. (That latter issue remains not only unresolved but hotly disputed).
During the regulatory stall, e-cigarette makers — led by Juul, a Silicon Valley firm — stormed the youth market with social media and other advertising and promotions that went all but undetected by adults. Suddenly, parents, teachers, doctors, hospitals, and public health officials found themselves swept up in first huge concern, then later medical cases of significant harms involving vaping, the catalyzing in specially designed devices of liquids to produce smoke-like vapors.
Teenagers went wild for e-cigarettes’ sweet, candy-like flavors. They spent big to buy vaping devices and to intoxicate themselves with the powerful wallop that e-cigarettes could deliver of addictive and damaging nicotine (equivalent to smoking a pack of cigarettes) and of tetrahydrocannabinol, aka THC, the high-producing chemical in marijuana.
As locations throughout schools and other spots where young people frequent turned into vaping dens, anti-tobacco advocates looked with alarm at respected surveys and other measures showing that a generation was getting hooked on nicotine — likely leading them to burning cigarettes’ harms.
And drug abuse foes saw a sharp and troubling rise in problematic THC vaping, not only with the young but also with older users. While few in this day would seek to stigmatize marijuana as “devil weed” and exaggerate harms of its use, evidence has mounted that grass consumption should not be seen as harm free but rather as accompanied by real risks (which also need much more study).
The New York Times reported disturbing data on vaping as a means of young people getting stoned:
“Teenagers are drinking less alcohol, smoking fewer cigarettes and trying fewer hard drugs, new federal survey data shows. But these public health gains have been offset by a sharp increase in vaping of marijuana and nicotine. These diverging trend lines … are among the findings in the Monitoring the Future survey — a closely watched annual study by the National Institute on Drug Abuse, or NIDA, of eighth, 10th and 12th graders. The survey shows that youth drug use and experimentation continue to undergo significant evolution. Most troubling to public health experts in this year’s report were sharp increases in marijuana vaping. Of 12th graders surveyed, 14% said they had vaped marijuana in the last month, nearly double the 7.5% reported a year ago. The percentage of teenagers who said they had vaped marijuana once or more over the last year essentially doubled during the past two years as well, rising to 7% for eighth graders, 19.4% for 10th graders and 20.8% for 12th graders.”
As vaping’s popularity has skyrocketed, young people also apparently have turned with increasing frequency to street or bootleg products, particularly for varied flavorings and for liquids with higher THC or nicotine potency. The illicit items, however, have become the focus of a deepening public health investigation.
That’s because the federal Centers for Disease Control and Prevention has as of mid-December recorded more than 50 deaths and in excess of 2,500 confirmed cases of lung injury — these cases all are blamed on e-cigarettes and vaping.
Authorities have not concluded why, since the summer, so many vapers have suffered such damage. But their leading suspect is Vitamin E acetate, an additive or chemical taint, in e-cigarette liquids, particularly bootleg varieties. Experts have said that exposing sensitive lung tissues to Vitamin E acetate may be the equivalent of inhaling grease.
Although public health officials pressed lawmakers to not only increase the legal age for cigarettes and e-cigarettes but also to ban flavorings — especially menthol tobacco products (of great harm to minority group members who smoke) and sweet and candy vaping liquids — Congress declined to do so.
Juul and other e-cigarette makers have been subject to investigation and crackdowns on their marketing, advertising, and product sales, particularly to the young. Their wares already in many jurisdictions could not be sold in the open, as before. And the makers have pulled some flavorings. Big Tobacco — which had bought into Juul or pushed its own versions of vaping products — joined with the e-cigarette makers in supporting the higher purchase age. One of its leading advocates was Mitch McConnell, the Senate Majority leader from Kentucky, a leading tobacco-producing state. Makers feared even more draconian measures might be taken, if officials could not show the public some evidence of more action against smoking and vaping.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the high value in their staying healthy and as far from the U.S. health care system as possible. It is fraught with medical error, preventable hospital acquired illnesses and deaths, and misdiagnoses. An important and common-sense way to stay out of the staggering costs and potential injuries of medical care, of course, is by stopping smoking or vaping if you do so now. Please don’t start either practice if you haven’t already. Vaping, by the way, also generates a lot of polluting waste products.
We’ve got a lot of work to do to knock out the damage that smoking and vaping can and will do, and we need to ensure that lawmakers and regulators don’t succumb to Big Tobacco and that they do all they can to protect this generation and those that follow from us all from products that injure and kill.