By Jonathan Samet
As a Boulder resident and public health physician, I urge the Boulder City Council to take an action needed to protect Boulder’s youth — pass a policy that bans all flavored nicotine products in all locations. While the Food and Drug Administration took jurisdiction over electronic cigarettes in 2016, action at the national level will likely be delayed for years, and in the meantime communities can take steps to protect youth, as proposed for Boulder.
E-cigarettes are not safe; they deliver one of the most addicting drugs there is — nicotine. And, in recent weeks, vaping teenagers in Illinois, Wisconsin and Minnesota have been hospitalized with a serious, acute lung disease. One purported benefit of e-cigarettes — that they aid smoking cessation — remains to be conclusively proven, and e-cigarettes cannot be legally marketed as an aid to cessation of cigarette smoking. There are already FDA-approved therapies, including nicotine replacement, for that purpose.
The vaping epidemic has caught public health by surprise. The epidemic rise of Juul and other new products comes from the technological innovation that makes these devices so effective in delivering nicotine, coupled with updated marketing strategies. The result? Vaping surged 78% among high school students from 2017 to 2018, according to the U.S. Centers for Disease Control and Prevention, a spike driven largely by flavored vaping products. The epidemic is worse here in Colorado, where we have the highest e-cigarette use among youth in the country. Of the high-schoolers using e-cigarettes, more than two-thirds (67.8%) are using flavored e-cigarettes. Sadly, Boulder is among the state’s leaders, with the most recent data showing that 33% of Boulder County high school students are current users of e-cigarettes or other vaping products.
Tobacco products are flavored for a reason; the flavorings mask the harshness of nicotine and enhance appeal to youth. Menthol, still allowed in cigarettes, cools and anesthetizes the airways of the lung. I was the first chair of the FDA’s Tobacco Product Scientific Advisory Committee. In 2011, our first report concluded that menthol in cigarettes increased youth use, likely made it more difficult to quit, particularly for African-Americans, and overall harmed public health. The report also concluded that removing menthol would benefit public health. The health risks of the many other flavors in e-cigarettes have yet to be assessed and one is known to cause a serious lung disease. Banning flavored products will protect youth from the known danger of nicotine addiction and the unknown harms that these flavorings may cause.
There should be no loopholes. Allowing for adult-only stores to sell flavored tobacco and vape products weakens protection of youth and allows more opportunity for these insidious products to reach Boulder’s youth. A study conducted in June in California found that 45% of tobacco and vape shops sold e-cigarettes and vaping supplies to researchers posing as underage shoppers. These findings, as well as real world experience in Colorado, challenge industry assurances that by limiting the sale of flavored tobacco and vape products to adult-only tobacco and vape shops youth access will somehow be reduced.
The Boulder City Council has the opportunity to proactively protect the city’s youth and to help end an epidemic that has been particularly aggressive in Boulder. The scientific evidence firmly supports the measures included in the proposed regulations. The epidemic warrants the strongest measures possible without any exemptions or carve outs. Boulder should not allow the health of its youth to be sacrificed so that the tobacco and vaping industries can continue to make ill-gotten and immoral profits.
Jonathan Samet, dean and professor at the Colorado School of Public Health, has been engaged in tobacco control research and policy for decades.
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