States Increasingly Implementing Innovative Policy Approaches to Quell the E-Cigarette Use Epidemic Among Kids

Will Arizona Join In?

Electronic cigarette use among kids is a growing concern among some state and federal elected officials, appointees and other policymakers.  E-cigs are the most commonly used tobacco products among kids and young adults.  Nationally, e-cigarette use has grown 900% among middle and high school students from 2011 to 2015.

It’s happening in Arizona too.  Last year’s Arizona Youth Survey found that e-cig use was up dramatically across all three age groups:

  • 8th -graders: 21% reported using e-cigarettes in 2016- that’s up to 28% now

  • 10th-graders: 29.4% 2016, now it’s 39%

  • 12th-graders: 35% 2016, now it’s nearly half- at 46%.

Flavored e-cigs are far and away the most popular kind of e-cig for kids- and the data are clear that flavored e-cigs are attracting (and addicting) kids.  The data are striking.  

According to FDA, 96% percent of kids who started using e-cigs between 2016 and 2017 started with a flavored e-cig. The 2018 National Youth Tobacco Survey data found that 68% of current high school e-cig users used a flavored e-cig.

Those data are compelling- and it’s easy to see why some elected officials and appointed public health officials see regulating the sale of flavored e-cigarettes as  an important strategy to reduce youth e-cigarette use.

Regulating Flavored E-Cigarettes

As I mentioned in my policy update a few weeks ago, the HHS issued a press release announcing that they “intend” to remove all flavored e-cigarette products from the market until manufacturers of those products file premarket tobacco product applications with FDA.

Some Governors and state health officials have also taken executive and regulatory action to regulate flavored e-cigarettes. Last month Michigan became the first state to announce a ban on the sale of all flavored e-cigarettes. She based her decision on leadership from their state health department with their issuance of an emergency finding, and Governor Whitmer directed the agency to issue emergency rules banning the sale of vaping products.

New York's Governor Cuomo has instructed their state health department to convene an emergency session of their Public Health and Health Planning Council to consider banning flavored e-cigarettes. The Council adopted rules banning sales of most flavored e-cigarettes.

In Massachusetts, Governor Baker declared a public health emergency, and their state health department commissioner issued an order prohibiting the sale or display of all vaping products.

Some state legislatures are taking action on flavored e-gigs as well.

North Dakota’s governor signed HB 1477 prohibiting the sale of any flavored e-cigs.  Maine’s governor signed LD 1190 which penalizes the sale of flavored tobacco products, including e-cigarettes and flavoring, to anyone under 21.

The California legislature is considering matching bills (AB 739 and SB 38) that would prohibit tobacco retailers from selling flavored tobacco products including e-cigs.  

A similar Illinois bill (HB 3883) would create the Flavored Tobacco Ban Act which would prohibit the sale of any flavored tobacco product.

Massachusetts introduced companion bills (H 1902 and S 1279) that would prevent the sale of flavored cigarettes (and e-cigs).

Public Health advocates like ourselves can play an important role in building the evidence base and conducting the advocacy necessary to move elected and appointed officials to take action. 

Our administrative advocacy can take several forms- from collaborating with elected officials to develop legislation to take action- to working within state and county health departments to urge appointed officials to take action.  State health departments play a key role in catalyzing a response as well, if they take action.

So far, our Governor doesn’t appear to be supportive of banning the sale of flavored e-cigs in AZ.  He’s quoted in this article in the Arizona Capitol Times as saying “What I don’t want to do is take someone who is addicted (to nicotine), restrict them from finding a product and push them to the black market, so we’re going to have a measured approach.”

Perhaps if he knew that 96% percent of kids who started using e-cigs start with a flavored e-cig and that 68% of current high school e-cig users used a flavored e-cig  it would change his mind?