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August 9th, 2016:

It’s now illegal to sell e-cigarettes, cigars, hookah tobacco to minors

Federal officials are hopeful that a new law that took effect Monday which expands the types of tobacco products it’s illegal to sell to minors will help curb tobacco use.

The new law prohibits retailers from selling e-cigarettes, hookah tobacco or cigars to people under 18, Mitch Zeller, director of the U.S. Food and Drug Administration’s Center for Tobacco Product said.

For years, it has been illegal under federal law to sell cigarettes and smokeless tobacco to minors. Now all tobacco products are covered except for accessories.

Retailers are required to check photo ID of anyone under age 27, and are not be allowed to give away free samples of newly deemed tobacco products.

In addition, retailers will not be allowed to sell cigars, hookah tobacco, and e-cigarettes in a vending machine where anyone under age 18 has access at any time.

“While there has been a significant decline in the use of traditional cigarettes among youth over the past decade, their use of other tobacco products continues to climb — putting a new generation of kids at risk of addiction. E-cigarette use, for example, skyrocketed from 1.5 percent in 2011 to 16 percent in 2015 (an over 900 percent increase) among high school students; and hookah use also increased significantly. And every day, more teenage boys try a cigar than try a cigarette,” Zeller said in a blog post.

The 2009 Family Smoking Prevention and Tobacco Control Act into law, Zeller added, gave the FDA the authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco.

“But cigar, hookah tobacco and e-cigarette markets remained unregulated, creating a market environment I have equated in the past to the Wild, Wild West,” Zeller wrote.

In addition to restricting youth access to tobacco products, FDA will now be able to review new tobacco products not yet on the market, prevent misleading claims and help better provide consumers with information to make informed decisions about their tobacco use. This means tobacco product manufacturers will be required to register and list their products with FDA. Manufacturers will also be required to report ingredients and harmful and identify potentially harmful ingredients in their products.

Ann Arbor raises tobacco purchase age to 21

In a move that has been lauded by some and criticized by others, Ann Arbor became the first Michigan city last week to raise the minimum age to purchase tobacco products from 18 to 21.

The Ann Arbor City Council approved the ordinance to raise the minimum age last Thursday in a 9-1 vote, which was in support of Tobacco 21 — a national movement that has gained traction across the country. The amended ordinance becomes effective Jan. 1.

The ordinance is the latest crackdown against tobacco users in the state. Although Ann Arbor is the first city to enact an ordinance banning tobacco purchases for those under the age of 21, similar moves have been made on college campuses across the state.

Last year, Michigan State University’s Board of Trustees approved a tobacco-free ordinance that goes into effect in just a few days on Aug.15.

MSU’s ban includes the entire spectrum of tobacco products; from cigarettes and chewable tobacco to vaporizers, E-cigarettes and hookahs. It also prohibits tobacco use in buildings, on the lawns and sidewalks, even in personal vehicles on MSU property, according to the university.

Local supporters of Tobacco 21, including Washtenaw County Public Health and Saint Joseph Mercy Health System, have stated they believe raising the legal purchase age will help prevent early tobacco addiction and adverse health effects.

According to a news release from the City of Ann Arbor, tobacco use among youths “continues to be a significant public health concern.” The city said 9.2% of Washtenaw County high school students reported that they had smoked a cigarette.

The ordinance also repeals the penalties for underage possession of tobacco products and instead limits violations and penalties to retailers.

“The passage of this ordinance demonstrates the Ann Arbor City Council’s commitment to the health and well-being of the community,” said Michael Miller, regional chief mission officer of Saint Joseph Mercy Health System, in a statement. “I look forward to other Michigan municipalities following the council’s courageous leadership.”

But not everyone was happy with the move.

More than 50 gas station and convenience store owners signed a petition opposing the move, saying it unfairly targets business owners and makes it hard for them to compete against businesses in neighboring communities with no similar age restriction.

“We should be allowed to offer legal tobacco products to our adult customers,” the petition said. “Raising the legal age to purchase tobacco products to 21 is unnecessary given efforts by responsible retailers to prevent underage individuals from buying tobacco products. The majority of individuals under age 18 obtain tobacco products from ‘social sources’ and not from law-abiding retailers.”

State Rep. Adam Zemke, D-Ann Arbor, wrote a letter in support of the ordinance, saying it was a “worthwhile public health and economic goal for our state.”

“As a lifelong resident of our community and someone whose family has a generational history of heart-related health problems, I am particularly proud that Ann Arbor is willing to take this commonsense, progressive step toward becoming the first locality in Michigan to adopt a Tobacco 21 policy,” Zemke wrote. “I only hope other jurisdictions will see the many benefits of this life-saving policy and do the same.”

Eastern Michigan University also went tobacco-free in 2014, banning smoking and the use of tobacco products in or on all university-owned, operated or leased buildings and facilities, including vehicles.

Vaping flavor: Dangerous trends in youth consumption of e-cigarettes

Currently, we are experiencing a new phenomenon with youth consumption of e-cigarettes all around the United States. New flavors appear to be one of the main reasons why teens are getting hooked on this product, say researchers.

Currently, we are experiencing a new phenomenon with youth consumption of e-cigarettes all around the United States. For the second consecutive year, e-cigarettes were the most popular product among youth. FDA’s newest statistics indicate that more than 3 million middle and high school students were users of e-cigarettes in 2015, representing 540,000 more consumers than in 2014. New flavors appear to be one of the main reasons why teens are getting hooked on this product. In 2013-2014, 81% of the current e-cigarette youth users, pointed to the appealing flavors of e-cigarettes as one of the main reasons of why they started using them, stating that they used e-cigarettes “because they come in flavors I like.” This is even more concerning when we see how quickly this market is growing. In a report released in January 2014, researchers found that every month, an average of 240 new flavors are added to the e-cigarette market.

Although tobacco companies claim that new flavors are simply a response to adult users’ demand for variety, flavored tobacco products primarily serve to attract new users, particularly kids, and to get them addicted. As shown by the Campaign for Tobacco Free Kids, an industry publication stated, “While different cigars target a variety of markets, all flavored tobacco products tend to appeal primarily to younger consumers.” Even the industry leader Lorillard, which sells flavored e-cigarettes such as kool-aid and gummy bears, has admitted that “kids may be particularly vulnerable to trying e-cigarettes due to an abundance of fun flavors such as cherry, vanilla, pina-colada, and berry.”

Previous bans on flavored tobacco

Cigarettes with specific characterizing flavors were prohibited by the FDA in 2009, with the goal of halting the tobacco industry’s strategy and reducing the number of children who start to smoke and become addicted to different tobacco products. It was no secret that before this ban, tobacco companies marketed cigarettes with flavors, images and names in order to appeal to a younger audience. The flavored cigarette ban not only occured in the US but has been a trend in various parts of the world. For instance, in 2012, Brazil became the first place to ban all tobacco flavors. Likewise, in 2014, the European Union passed theTobacco Products Directive, which took effect on May 20, 2016, prohibiting flavored cigarettes, except for menthol, where the ban is delayed till 2020.

Almost seven years have passed since the FDA’s prohibition, and the results have been favorable. In 2006, the National Youth Tobacco Survey (NYTS) indicated that 30.2% of male high school students and 21.3% of female smoked cigarettes, while the NYTS in 2013 showed that the smoking prevalence in male students had dropped to 14.1% and to 11.2% in females. The statistics appear to show that the ban on flavored cigarettes has been helpful in reducing prevalence. However, it is important to take into consideration that the ban was not the only change in tobacco regulation. In the last couple of years, there were other policies which could have also been helpful, such as taxation and the restrictions on tobacco sales, labeling, advertising and promotion.

E-cigarette consumption increases overall consumption

The FDA’s ban on flavored cigarettes did not apply to e-cigarettes, which still can come in different flavors such as cotton candy, fruit punch, and chocolate. This is considered to be one of the main reasons why e-cigarette consumption has had such a huge increase. Indeed, studies regarding youth expectations about other flavored tobacco products such as bidis and hookahs, have found that young consumers prefer flavored tobacco over the regular tobacco because they consider flavored tobacco to taste better and be safer. So even though the ban on flavored cigarettes seemed to help in the reduction of youth use, the tobacco industry quickly found another product to replace it and keep targeting kids. This growing use of e-cigarettes can add to the problem by keeping overall youth tobacco use on the rise. A new study from the American Academy of Pediatrics shows that there are more young tobacco consumers than before, if we include e-cigarettes. The study published in July 2016 states that among 12th grade students in Southern California, the combined current cigarette and e-cigarette use in 2014 was 13.7%, which was greater than 2004, were cigarette use was 9% (before e-cigarettes were available).
New FDA Measures
This year, the FDA issued a final rule that includes e-cigarettes regulation, and which takes effect today (August 8). It regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of e-cigarettes. Among the restrictions to e-cigarettes are the prohibition to sell them to all of those under 18 years of age and to give away samples of e-cigarettes including their components and parts. However, the FDA did not ban the different flavors of e-cigarettes, and its spokespeople said that they would consider future regulation related to flavors based on a further study about the health risks and benefits of vaping.
Beyond the health risks and benefits of e-cigarettes, it would be important to consider the ban of all flavors given that the statistics show that a high percentage of young people who use e-cigarettes started because of their attraction to these. Even though the FDA wants further studies, the ban of flavored e-cigarettes has already been proposed by various international health authorities, such as the World Health Organization, which suggested the prohibition in its recommendations for regulating e-cigarettes.
What to consider in flavored e-cigarette banning?
In order to regulate flavored e-cigarettes, it is important to take into account that even when they are seen as a new way to introduce young people to tobacco use, e-cigarettes can also be considered less harmful than cigarettes and thus, as a new way to help older smokers quit cigarette smoking. Several authors have marked this duality and have proposed different ways to regulate them. For example, O’Neill Institute Senior Scholar Eric N. Lindblom in his article “Effectively Regulating E-Cigarettes and Their Advertising — and the First Amendment,” states that one way to stop young people’s use of e-cigarettes is by banning the flavors which attract youth, which can help discourage them from trying “e-cigs” and not affect its use as an alternative to smoking by current cigarette users. Lindblom, like others, propose the ban of flavors that appeal to youth in order to protect children’s health. Others argue against this stating that a ban on flavors limits adult choice and eliminates products that adults may prefer. Additionally, they argue that flavor options exist for different age restricted consumer products and therefore they shall be allowed in e-cigarettes as well. While it is true that adults should be allowed to decide what they want to consume, the government needs to take appropriate measures to ensure the well-being of children when their health is at stake. Similar arguments were made by the tobacco industry and other groups when the government was looking to ban cigarette flavors and yet the government went through with the prohibition of flavors in cigarettes. What is to come?
This year has been important for e-cigarette regulation with the FDA finally publishing a series of rules which can be applied to these products. It will be interesting to see the impact of the new policies on the e-cigarettes market, particularly in youth consumption. The ban of e-cigarettes for those under 18 years of age could be enough to curb the growth in consumption but that still remains to be seen. If in the years to come there is no substantial decrease, it may be necessary to start thinking on banning flavored e-cigarettes, just like it was done with cigarettes.