More tobacco regulations needed to curb teen e-cigarette use, ETSU professor says


JOHNSON CITY, Tenn. (WJHL) – Cigarette smoking among high-school students has been sinking over the years, but the would-be victory is overshadowed by the rise of e-cigarette use in teenagers across the nation.

The Food and Drug Administration bumped the federal age to buy tobacco products to 21 last month.

Previous story: Stores enforce new tobacco age restriction after FDA announces ‘immediate’ implementation

But local experts say it isn’t enough.

Dr. Hadii Mamudu, an associate professor of public health at East Tennessee State University, listed several recommendations for regulation of e-cigarettes and vaping products in an editorial to the American Journal of Public Health.

The editorial, published about a month before the new age restrictions went into effect, recommends several federal policy changes including:

  • Require childproof packaging and warning labels on e-cigarettes and nicotine solution cartridges
  • Prohibit flavored e-cigarettes
  • Prohibit internet distribution of e-cigarettes through the U.S. Postal Service.
  • Extend restriction on advertising, marketing and promotion of tobacco to e-cigarettes and vaping products.
  • Increase the prices of e-cigarettes by limiting rebates, discounts and coupons
  • Fund research for the short and long-term health consequences of e-cigarette use.

What’s happening

Mamudu writes in the editorial that studies suggest e-cigarettes are more effective than nicotine-replacement therapy for smoking cessation among current smokers.

But the problem, he said, is that it appears to come at the cost of more teenagers and young adults being exposed to nicotine because of e-cigarettes.

“Among high school students, it was about 1 in 2 (who have tried e-cigarettes),” Mamudu said. “It is a big national issue compared to tobacco use, which nationally is around 17%, so is about 1 in 7 or 1 in 6 people (who) currently smoke.

“It is a big issue and especially when you look at the issue from a youth level.”

Read more: Vape debate: Are e-cigarettes wiping out teen smoking?

Mamudu said that e-cigarettes are acting as a gateway for teenagers and young adults who may have never started smoking in the first place.

“People who initiate the use of e-cigarettes, they transition to the use of regular cigarettes,” he said.

He further explained that it’s important to acknowledge that the conversation is different when talking about teens and young adults versus longtime smokers. According to the Centers for Disease Control, 9 out of 10 cigarette smokers report trying a cigarette by the time they’re 18, and 98% of smokers first try cigarettes by the age of 26.

While raising the minimum age to buy tobacco products was on the list of recommendations, he said policies shouldn’t stop there.

He said numbers from the National Youth Tobacco Survey pinned the four most common reasons adolescents start smoking as curiosity, friends and family, flavoring and marketing.

Mamudu said 68% of teens reported they started using e-cigarettes because of the flavors.

The Trump administration announced an anticipated ban on flavored e-cigarette pods, but critics pointed out that the ban doesn’t include refillable liquid flavors that smokers can refill themselves.

READ MORE: President Trump expected to ban some flavored vaping products

When it comes to crafting effective policy, Mamudu pointed to the policies that put a leash on cigarette smoking that curbed use from 1 in 2 Americans in the 1960s to 1 in 7 smokers today.

“When you look at the enactment of tobacco control . . . How were they successful?” he asked. “They came out with what the CDC called a comprehensive approach, and within that comprehensive approach are a myriad of policies that enforce each other.”

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