The city council in Sheridan, Wyoming, will meet Tuesday, February 21 for their regularly scheduled business meeting instead of Monday due to the President’s Day holiday. According to Sheridan Media, one of the items the Council will consider is an ordinance pertaining to vaping and tobacco use by minors in the City.
Under the proposed ordinance, any minor found possessing tobacco or electronic cigarettes (vaping devices) would be subject to a tiered system of fines through Municipal Court.
There will be a public hearing prior to the Council considering the ordinance on first reading. There will also be a public hearing and subsequent first-reading consideration of an ordinance regarding drug paraphernalia within the City. The City Council will meet Tuesday night at 7 in Council Chambers on the third floor of Sheridan City Hall.
Juul Labs Inc. will pay Indiana more than $15.7 million to settle allegations that the company deliberately marketed its products to minors, Attorney General Todd Rokita announced today. Indiana is one of 32 states participating in a larger agreement under which Juul Labs will pay out nearly $435 million.
“My team and I fight daily to protect Hoosiers from improper business practices that put families at risk,” Rokita said, as reported by am1050. “Wrongful actions that jeopardize children are especially repugnant and shameful. Fortunately, the money we have recovered in this settlement can go toward safeguarding the same young people targeted by the unethical marketing strategies employed by Juul.”
Indiana’s funds are intended to be used in support of prevention, education, harm reduction and mitigation efforts related to youth using electronic nicotine-delivery systems.
Juul Labs has an option to pay over 6-10 years — with the total payout increasing the longer it takes to pay. If Juul Labs chooses a 10-year option, Indiana’s amount would exceed $17.1 million. Juul’s first payment to Indiana will be $1,478,665 — due Dec. 31, 2022. All additional payments are due on Dec. 31 each year.
The idea that e-cigarette flavors hook kids is simple, compelling—and false.
By Clive Bates
In a fact sheet titled “Flavored E-cigarettes Hook Kids,” the U.S.-based Campaign for Tobacco-Free Kids asserts that “Flavored e-cigarettes are undermining the nation’s overall efforts to reduce youth tobacco use and putting a new generation of kids at risk of nicotine addiction and the serious health harms that result from tobacco use.” Let us call this “the activist proposition.”
The challenge with simple but false activist propositions is that refuting them can require a lengthy embrace of more complex arguments. Brandolini’s law, also known as the bullshit asymmetry principle, can be expressed: “The amount of energy needed to refute bullshit is an order of magnitude larger than to produce it.” In this article, we shall demonstrate Brandolini’s law by addressing the simple but false activist proposition about flavored e-cigarettes through a series of questions.
First, do flavors cause youth tobacco or nicotine use? The activist proposition builds in an assumption that flavors cause e-cigarette use. Lots of young people use flavored e-cigarettes. Therefore, it is claimed, flavored e-cigarettes must cause young people to use e-cigarettes. But how likely is that? We know from the past that a high proportion of young people can use tobacco if they choose to, mostly without flavors. According to the Monitoring the Future survey, for most of the 1990s, U.S. 12th-grade past 30-day cigarette smoking prevalence was at or above 30 percent. By 2021, teenage cigarette smoking had fallen around 4 percent, but nicotine vaping had reached 20 percent. Perhaps there is a persistent demand for nicotine or tobacco, regardless of whether it is flavored. Also, let’s look over time. In the United States, high school past 30-day vaping was 11.3 percent in 2016, rose to 27.5 percent in 2019 but fell to 14.1 percent by 2022. Yet there was very little change in the availability of flavored e-cigarettes to explain these swings. There are also countries where flavors are widely available but youth vaping is relatively low. Take the U.K., for example, which takes a positive approach to tobacco harm reduction and vaping. Thousands of flavored products are available, but according to a recent official evidence assessment, youth vaping remains below 10 percent. And the U.K. offers us a further important insight: “[D]ata showed that most young people who had never smoked were also not currently vaping (98.3 percent).” This tells us that vaping is highly concentrated in adolescents already open to tobacco use.
Second, so what does cause youth tobacco or nicotine use? Most of the evidence points to characteristics of the individual and their circumstances not tobacco product features. Tobacco use is driven by a complex mix of psychosocial factors, including genetics, parental smoking, poverty, delinquency, rebelliousness, low self-esteem, peer group, etc. A 2016 literature review identified 98 conceptually different potential predictors of smoking onset. A 2019 study looked at stated reasons for e-cigarette use and concluded there were two main drivers: “alternative to cigarettes” and the “larger social environment.” For some young people, tobacco or nicotine use may have functional benefits. It may modulate stress or anxiety, improve concentration or help control conditions such as attention deficit hyperactivity disorder(ADHD). For others, it may be just frivolous and experimental. In 2019, the U.S. Centers for Disease Control and Prevention asked young people why they vaped; the top reason was, “I was curious about them.”
Third, what would teenage vapers do if they were not vaping? Implicit in the activist proposition is the idea that removing flavors will remove the reason to vape and stop the user from vaping. At one level, there is some truth in this. If the products are bland, unpleasant or tasteless, perhaps no one will use them. But here is the problem: What if the demand for tobacco and nicotine has deeper psychosocial causes, such as those discussed above? Removing the flavored products does not make the demand go away. Would the teenage vapers just give up vaping and do more homework and piano practice instead? If the underlying demand remains, that is unlikely. Teenagers interested in nicotine might revert to cigarettes, cigars or other tobacco products. We have some evidence for this: When e-liquid flavors were banned in San Francisco in 2019, there was an increase in teenage smoking compared to other areas where flavors had not been banned. This is hardly a surprise—in one study, young adults were asked what they would do if e-cigarette flavors were banned. About one-third said they were likely to switch to cigarettes.
In 2022, Boston-based public health scientists Mike Siegel and Amanda Katchmar reviewed the body of evidence on youth smoking and vaping, concluding that it “suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking.” Economic analysis also backs this idea—when prices of e-cigarettes increase, youth vaping falls, but youth smoking rises. That tells us that e-cigarettes and cigarettes function as substitutes. If regulators ban e-cigarette flavors, then they should not be surprised if more smoking is the result. For that reason, Siegel and Katchmar concluded “[W]e propose a reevaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.” That is very troubling for the activist proposition—it means policies to address youth vaping cannot be evaluated without concern for their effect on youth smoking. It also means that some youth vaping may be a diversion from smoking and is beneficial. It follows that regulation discouraging vaping could easily be harmful.
Fourth, how would a ban on flavors work? The logic of the activist proposition is that a ban on flavored products would remove flavored products from the market, thus removing the reason for young people to vape. But that is not how prohibitions work in practice. A prohibition does not cause the prohibited product to disappear. But in practice, a prohibition causes the perturbation of a market. It causes changes to the behavior of consumers, legal and illegal suppliers, prices and availability. Foreseeable consequences include switching to cigarettes or other tobacco products; switching to other substances; switching e-cigarettes to the permitted flavors; illicit trade in flavored liquids; home mixing and informal selling; cross-border trade or internet sales; stockpiling and workarounds such as sales of flavors for aromatherapy. Prohibitions change the supply side, and rarely for the better. There should be no mystery about this: Despite longstanding prohibition, the Monitoring the Future survey shows that U.S. 12th-grade past 30-day cannabis use has been around 20 percent and daily use around 5 percent for about the past 25 years. Some of these responses to flavor prohibition will clearly increase harm compared to vaping. Because smoking is so much more harmful, it would only take a slight uptick in smoking to offset any benefit of significantly reduced teenage vaping. But there are also hazards arising from informal manufacturing and workarounds. Illicit supply will bring adolescents into contact with criminal networks as consumers and potentially as low-level participants.
Fifth, what is really going on with youth vaping? I believe there are two broad patterns of youth vaping and two distinct behaviors at work, but these are often conflated. The first is frivolous and experimental use, where young people try new things. This has characteristics of a frothy fad: infrequent use, transient and unpredictable. The second is more determined nicotine use: frequent, intense and entrenched. But this group is more likely to be the adolescents who would otherwise be using cigarettes or other tobacco products. The first group contributes to the “youth vaping epidemic” narrative but is not really a cause for great public health concern. The second group represents the migration of nicotine use in society to far safer technologies and is likely beneficial for public health. The activist proposition, however, requires policymakers to believe there is no latent demand for nicotine use and that removing products will eliminate nicotine from society. But it is much more plausible to think of the demand for nicotine in similar terms to alcohol, caffeine, cannabis and other recreational substances. People use nicotine for a reason, and there will be a long-term demand for it. The task for policymakers and regulators is to make that acceptably safe and to resist simplistic activist propositions that are likely to do more harm than good.
In November 2022, the Campaign For Tobacco Free Kids celebrated the success of a mass activist campaign to secure Proposition 31, a ban on flavored products in California. They may have won their political battle, and their aggressive promotion of the activist proposition has again prevailed. But nowhere in its advocacy literature does this powerful coalition level with California’s voters about the underlying drivers of youth nicotine use, the linkages between smoking and vaping, and the risks of unintended consequences. They can deny this real-world complexity, but policies built on bullshit have a nasty tendency to go wrong, to do more harm than good and to call into question the credibility of their advocates.
Clive Bates is the director of Counterfactual Consulting and the former director of Action on Smoking and Health (U.K.).
The smoking rate among young Americans has fallen from 35 percent to 12 percent over the past 20 years, reports The Hill, citing to a new Gallup poll.
Data shows that the decline among those aged 18 to 29 was more than double any other age group measured, meaning young adults are the second least likely group to smoke following those aged 65 and older.
Between 2001 and 2012, the rate of young adult smokers was higher than any other age group.
Between 2019 and 2022, 7 percent of U.S. adults reported smoking e-cigarettes, and 19 percent of young adults reported e-cigarette use.
“Given these differences, young adults are more likely to vape than to smoke cigarettes while among older age groups, cigarette smoking prevails,” the report states.
It is unclear how e-cigarette use has grown in this age group in recent years as Gallup only started polling e-cigarette use in 2019. Data from the U.S. Centers for Disease Control and Prevention shows an increase in youth e-cigarette use between 2011 and 2018, however.
“These data suggest that much of the decline in cigarette smoking among young adults may have been offset by vaping, indicating that young adults are still smoking products containing nicotine but through different means,” the Gallup report states.
An anti-smoking group announced that several studies have found no evidence that the use of e-cigarettes and heated tobacco products (HTPs) are leading non-smokers and youth towards cobustible cigarette smoking in countries such as the U.S., the UK, Australia, Japan, France and Switzerland.
Action on Smoking and Health (ASH)-UK cited the results of five large surveys of 11 to 16-year-olds in the UK between 2015 and 2017 showing that “most young people who experiment with e-cigarettes did not become regular users,” according to media reports.
“Overall, there is no evidence that e-cigarettes have driven up smoking prevalence in this age group. In fact, smoking prevalence among young people has declined since e-cigarettes came onto the market,” ASH-UK stated.
A time-series analysis conducted by researchers led by Emma Beard between 2007 and 2018 in the UK showed that the increase in the prevalence of e-cigarette use in England among the entire sample does not appear to have been associated with an increase in the uptake of smoking among young adults aged 16 to 24.
A 2022 study by University of Bristol researchers found that, based on the “current balance of evidence, using triangulated data from recent population-level cross-contextual comparisons, individual-level genetic analyses and modeling, we do believe, however, that causal claims about a strong gateway effect from e-cigarettes to smoking are unlikely to hold, while it remains too early to preclude other smaller or opposing effects.”
A 2020 study by Dr. Colin Mendelsohn and Wayne Hall concluded that claims of vaping serving as a gateway to smoking are unconvincing. “Smoking more often precedes vaping than vice versa, regular vaping by never-smokers is rare and the association is more plausibly explained by a common liability model,” they stated.
Another comprehensive analysis of whether vaping causes smoking uptake was published by the University of Queensland in Australia. That study concluded also that there was little evidence of a gateway effect. If a gateway effect does exist, it is likely to be small, the study said.
A 2021 study by Wayne Hall and Gary Chan on the “gateway” effect of e-cigarettes found that “e-cigarette use has not been accompanied by increased cigarette smoking among young people in the United States, as would be the case if e-cigarette use were a major gateway to cigarette smoking.”
Under new legislation proposed in New York’s state Assembly, children caught vaping in school may be required to attend a state-created smoking cessation program.
Assemblyman Keith Brown introduced A.10547 to amend the state Public Health Law to require those caught using electronic cigarettes or vapor products in schools to attend an Electronic Cigarette or Vapor Product Prevention, Control or Awareness Program, according to news reports.
Attendance in the program would be part of a bigger state effort to create an educational program used in schools throughout the state to discourage electronic cigarette use.
Children under the age of 21 who are found using or in possession of an electronic cigarette or vapor product will also have their parents or guardians notified, according to the bill text.
“Electronic cigarettes are a relatively recent product and manufacturers had previously geared marketing toward non-smoking youth, with a large assortment of sweet flavors of e-liquid and ad campaigns,” Brown wrote in his legislative justification. “Additionally, certain youth-targeting e-cigarettes were designed to be small and sleek, and refillable with user-friendly pre-filled pods of liquid-making the device easy to conceal from authority figures.”
Current vaping among U.K. children aged 11-17 was up from 4 percent in 2020 to 7 percent in 2022, according to the annual YouGov youth survey for Action on Smoking and Health (ASH) carried out in March and published on July 7. The proportion of children who admit ever having tried vaping has also risen from 14 percent in 2020 to 16 percent in 2022.
Disposable e-cigarettes are now the most used product among current vapers, up more than seven-fold from 7 percent in 2020 and 8 percent in 2021, to 52 percent in 2022. Elf Bar and Geek Bar are overwhelmingly the most popular, with only 30 percent of current users having tried any other brands.
Over the past year there has been growing concern about the increasing popularity of disposable vapes with young people, but this is the first time national figures have been available to show the scale of the change. ASH said the increase in vaping shown by the survey is a cause for concern, and needs close monitoring. However, 92 percent of under 18s who’ve never smoked, have also never vaped, the organization pointed out—and only 2 percent have vaped more frequently than once or twice.
“Just to give it a try” is still the most common reason given by never smokers for using an e-cigarette (65 percent). For young smokers the most common reason for using an e-cigarette was “because I like the flavors” (21 percent) followed by “I enjoy the experience” (18 percent) then “just to give it a try” (15 percent), but they also said, “because I’m trying to quit smoking” (11 percent) or “I use them instead of smoking” (9 percent). Fruit flavors remain the most popular (57 percent).
Vaping behavior is strongly age related, with 10 percent of 11-15 year olds ever having tried vaping, compared to 29 percent of 16 and 17 year olds (the figures for those currently vaping are 4 percent and 14 percent respectively). And while underage vaping has risen, underage smoking is lower than it was in 2020 (14 percent in 2022 compared to 16 percent in 2020).
For the first time this year the survey asked about awareness of promotion of e-cigarettes. Over half (56 percent) of 11-17 year olds reported being aware of e-cigarette promotion, most frequently in shops, or online, with awareness highest amongst those who’d ever vaped (72 percent). Tik Tok was the most frequently cited source of online promotion (45 percent) followed by Instagram (31 percent).
In response to the survey results, the U.K. Vaping Industry Association (UKVIA) called for a range of get-tough measures to crack down on unscrupulous retailers who sell vapes to young people.
“The UKVIA understands the need for the right balance between supporting adult smokers to quit without encouraging take up amongst under-18s and ‘never-smokers,’” said UKVIA’s Director General John Dunne in a statement.
In a letter to the Department for Health and Social Care, the UKVIA proposed a set of recommendations to come down hard on those who sell vapes to minors while maintaining vaping’s critical role for helping smokers to quit, including fines of £10,000 ($11,897) and a national retail licensing scheme.
The U.S. Food and Drug Administration announced the launch of its “Next Legends” youth vaping prevention campaign. The regulatory agency stated that the program is part of the FDA’s ongoing efforts to protect youth from the dangers of tobacco use.
The campaign will educate American Indian/Alaska Native (AI/AN) youth, ages 12-17, about the harms of vaping through unique branding and tailored messaging created to inspire a new generation to live Native strong and vape-free, according to a statement.
There are approximately 400,000 Native teens in the U.S., and more than half of them are at-risk of using tobacco products, including e-cigarettes, according to FDA. Studies show that Native youth are more susceptible to e-cigarette use than their non-Native peers, and they demonstrate disproportionately high experimentation and current use of e-cigarettes.
“The Next Legends campaign is an important and creative way to educate Native youth about the harms of vaping,” said Michele Mital, acting director of the FDA’s Center for Tobacco Products. “E-cigarettes are the most used tobacco product among youth, and they pose serious health risks if used during adolescence, when the brain is still developing. Next Legends builds on the success of previous youth e-cigarette prevention campaigns while also addressing health disparities among Native Americans and Alaska Natives associated with tobacco use. Communicating with Native youth through culturally-aligned messages will help these young people make informed decisions about healthy behavior, including being vape-free.”
More than $1 million worth of illegal e-cigarettes and liquids containing nicotine have been seized in New South Wales (NSW), Australia, this year.
NSW Health has seized more than $3 million of the banned products since July 2020.
Since October 2021, products containing nicotine are only available for people over the age of 18 when prescribed by a medical practitioner for smoking cessation purposes, from an Australian pharmacy or via importation into Australia with a valid prescription, according to 7News.
For all other retailers in NSW, the sale of e-cigarettes or e-liquids containing nicotine is illegal.
The curb on illegal nicotine sales extends to online shops with the maximum penalty of $1650 per offence, six months in prison or both.
Selling to minors also comes with hefty fines. For individuals, up to $11,000 for a first offence, and up to $55,000 for a second or subsequent offence; and for corporations, up to $55,000 for a first offence, and up to $110,000 for a second or subsequent offence.
Chief Health Officer Kerry Chant said retailers were being put on notice, if they were selling the contraband products.
“We are cracking down on the illegal sale of nicotine e-cigarettes and liquids and taking a zero-tolerance approach to those who sell them,” she said.
“NSW Health regularly conducts raids on retailers across the state to protect young people from these harmful devices. You will be caught, illegal items will be seized, and you could face prosecution, resulting in being fined or even jailed.
“The harmful impacts of vaping on young people cannot be underestimated. People think they are simply flavored water but in reality, in many cases, they are ingesting poisonous chemicals that can cause life-threatening injuries.”
The Alcohol and Drug Foundation says around 14 percent of 12 to 17-year-olds nationwide have tried an e-cigarette, with around 32 percent of these students have used one in the past month
Around 12 per cent of students reported buying an e-cigarette themselves.
Juul Labs has reached another settlement in its youth marketing lawsuits. The vaping manufacturer has agreed to pay $22.5 million in a settlement with Washington state over claims that it unlawfully targeted underage consumers with deceptive advertisements.
“Juul put profits before people,” Washington Attorney General Bob Ferguson said Wednesday in a statement. “The company fueled a staggering rise in vaping among teens.”
The settlement comes after North Carolina last year struck a $40 million deal with Juul over how it markets products to underage users. The e-cigarette maker agreed to stop all marketing aimed at young people as part of that deal announced in June.
Juul didn’t clearly state that its products contained nicotine and for more than 20 months, from August 2016 until April 2018, “unlawfully sold hundreds of thousands of vaping products to Washington consumers,” according to Washington’s lawsuit filed in 2020, according to Bloomberg.
The company committed to reforms including stopping all its advertising that appeals to youth and ending most social media promotion in the settlement, according to the statement. Juul must also check Washington stores 25 times a month with secret shoppers to keep its products away from youth.
Juul said the settlement terms are consistent with its present practices and past agreements to help combat underage use.
“This settlement is another step in our ongoing effort to reset our company and resolve issues from the past,” the company said in a statement. “We support the Washington State Attorney General’s plan to deploy resources to address underage use, such as future monitoring and enforcement.”
Juul Labs continues to face similar suits from several states, including New York and California.
