Difference Between Skeletal Smooth and Cardiac Muscles
Vapor Devices and Youth
1. Vapor Devices
and Youth
Monroe Community Coalition Briefing
and Discussion
Courtesy of Wendy Burchill, Healthy Communities Specialist
Presented by: Joe Neigel, Monroe Community Coalition
2. Potential health effects from use and/or
exposure, especially to most vulnerable
Rapidly increasing use by teens and
young adults
Vaping other drugs in the devices
High poisoning risk to children
Snohomish Health District 2
Why is Our Coalition Concerned?
8. What
influences
youth to use
tobacco
products?
• Exposure to advertising
• Themes in advertising that
resonate with youth
• Low prices and price-
reducing promotions
• Ease of access to a product
• Candy and fruit-flavored
products
• Health claims
• Allure of technology
• Smoking in movies
Snohomish Health District 8
Tobacco and Youth: the
Surgeon General’s Report
and E-cigarettes, Dec. 2014
9. Advertising Expenditures Across Markets
2011: $6.4 million
2012: $18.3 million
2013: >$80 million
(Majority on TV advertising)
Tobacco and Youth: the
Surgeon General’s Report
and E-cigarettes, Dec. 2014
13. Snohomish Health District 13
Vapor Devices and Non-Smoking Youth,
Snohomish County
• From 2012-2014 the number of
youth who identified as “non-
smokers” but used a vapor device
increased eleven-fold
• On the 2014 Healthy Youth Survey,
1 in 4 MHS Seniors identified as
current users of vapor devices
• Research shows susceptibility to
smoking cigarettes is higher among
those who used vapor devices
Rebecca E. Bunnell, Israel T. Agaku, Rene Arrazola, Benjamin J. Apelberg, Ralph S. Caraballo, Catherine G. Corey, Blair Coleman, Shanta R.
Dube, and Brian A. King. Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users, National
Youth Tobacco Survey, 2011-2013 Nicotine Tob Res ntu166 first published online August 20, 2014 doi:10.1093/ntr/ntu166 .
15. Snohomish Health District 15
Vaping and Other Problem Behaviors
• Scientists have established a clear link between nicotine use and
vulnerability to other substance use.
• An analysis of Snohomish County’s data from the 2014 Healthy
Youth Survey confirms that youth engagement in vaping is
associated with increased rates of engagement in other at-risk
behaviors.
Source: Science Translational Medicine, 2011 & Monroe Community Coalition HYS analysis, 2015
17. Tobacco Products & Smoking Vapor Products & Vaping
FDA Oversight (limited) None
Strict Limits on Advertising & Claims None
Warning Labels Required None
No Sales to Minors / No Free Samples None
DOT: No use on airplanes
Snohomish Health District 17
Vapor Products Are Unregulated
FEDERAL
No Sales to Minors Under 18
Regulated by LCB: Licenses & Taxes None
Vending Machines Restricted None
Sampling & Coupons Restricted None
No Use in Public Places, including
workplaces, schools, transit (SIPP)
None
WASTATE
19. King County Pierce County Grant County Clark County
Year Passed 2011 2011 2014 2015
Exceptions
Where Vaping
in Public
Allowed
None • Adult-only
venues
• Private places
of
employment
• Vapor
product-only
stores
• Vapor
product-only
stores that
prohibit
minors
• Vapor
product-only
stores with
separate
ventilation &
other criteria
ID Checks Required Required Required Required
Vending
Machines
Allowed only
where minors
are prohibited
Allowed only
where minors
are prohibited
Allowed only
where minors
are prohibited
Allowed only
where minors
are prohibited
Sales
Restrictions
No Sampling No Sampling
except in vape
only stores
Vapor
products
behind counter
No Sampling
except in vape
only stores
Signage
Requirements
None None “No Sales to
Minors”
“No Vaping”
and “No Sales
to Minors”
Snohomish Health District 19
Comparison of “No Vaping in Public Places” Laws
21. House Bill 1645 (Governor’s Request)
Targeted at preventing youth access to e-cigarettes and
vaping products
Requires child-proof packaging, warning labels, and
ingredient disclosure
Requires products behind counter and restricts sampling,
coupons, and vending machines
Prohibits possession by minors and use on school property
House Bill 2211 e-cigarette taxation
Neither address vaping in public places
Snohomish Health District 21
Pending State Legislation
22. Marketing: Signage and local advertising that
may increase youth use like those promoting
flavors
Public Use: Treat vaping just like smoking
Retail Licensure: Retail licensure allows for
tracking and regulation of local industry
growth and density.
Snohomish Health District 22
MCC Policy Considerations
We all understand the serious dangers of smoking, and the toll it continues to take on the health of our society. That’s why we have laws like no smoking in public places and workplaces.
And these new vapor devices seems to offer a substitute for cigarettes that may be a less harmful way to receive a dose of nicotine.
But public health professionals are very concerned about the increasing use of vapor products for a number of reasons.
We are concerned about and don’t fully understand the Potential health effects from use and/or exposure to the vapor.
There is Rapidly increasing use of vapor products by teens and young adults, including among never smokers, that suggests we’re going to have a new generation of nicotine addicted people.
High poisoning risk from the e-juices that contain highly concentrated nicotine to children, and calls to poison centers are increasing. Currently no regulation on child-proof packaging or warning labels. The amount of nicotine in the cartridges is potentially deadly to a child.
The refillable tanks mean that it’s easy to Vape other drugs in the devices. We have a state and county laws that prohibit smoking tobacco or marijuana in public and a state law that prohibits any consumption or use of marijuana in public places. Yet we don’t know what drug is being vaped in public in these devices.
Agreed that this table might be better for their binders…for the meeting, maybe we show an actual example of each kind?
E-cigarettes have some type of battery and heating element that heats a chemical mixture into a vapor that is inhaled, rather than burning tobacco or other substances. The technology of vapor devices is rapidly changing and includes microprocessors to control the heating element and sensors to detect air flow and inhalation.
Some are prefilled with a nicotine solution and disposal.
Others have a rechargeable battery and a refillable cartridge or tank for e-liquids containing nicotine or other drugs and a variety of other chemicals including flavorings.
All of us want to understand the potential health impacts of e-cigarettes, and whether they are safer than cigarettes.
Because there are no federal FDA regulation, there is no requirement that ingredients are disclosed as they are for tobacco products; and no certainty of consistency of ingredients or quality control.
So we cannot say vaping is safe because we don’t know exactly what mix of chemicals is in the vapor.
Lack of regulation = no safety testing & inconsistent quality control
The cartridge holds concentrated nicotine, as much as in a full pack of cigarettes.
The User controls nicotine dose by how deeply inhaled, and how long the vapor is held in the lungs, and how many puffs taken.
The nicotine is dissolved in solvents like propylene glycol, and glycerin that form byproducts when heated including:
formaldehyde, a known carcinogen and respiratory irritant
acrolein, irritant that has not been sufficiently studies for health effects
acetaldehyde, a possible carcinogen
Studies of vapor have detected other harmful volatile organic chemicals like benzene and xylene.
Metals have been found in the vapor including tin, chromium, aluminum that come from the device casing or electronics. Some tests have found lead and cadmium which are highly toxic metals.
The rest of what’s in the vapor depends on what’s in the chemical mix, including flavorings.
Manufacturers of vapor products say they’re using flavoring chemicals that are “Generally Recognized As Safe” by the FDA.
The Flavor & Extract Manufacturers Association (FEMA) has stated that such safety claims by e-cigarette manufacturers are “false and misleading” because the Generally Recognized as Safe status is only for food additives, and does not imply safety if the same chemical is inhaled.
Pinterest pages
Instagram
Web ads
Sponsorships
Re-normalization of smoking
(Grew from 1.6% to 14.4%)
The Vaportini transfers alcohol directly from the lungs to the bloodstream - increasing the levels of intoxication The Vaportini was created by Julie Palmer back in 2009, but it went on sale on her website for $34.50 each in December Read more: http://www.dailymail.co.uk/news/article-2262311/Parents-horror-new-35-device-lets-INHALE-alcohol-goes-sale-U-S.html#ixzz3ZI95HLBa
Re-normalization of smoking
(Grew from 1.6% to 14.4%)
FDA regulates tobacco products under Tobacco Control Act, but this law does NOT currently apply to e-cigarettes and vaping products that heat rather than burn.
FDA regulates smoking cessation products like nicotine patches and gum; but there are no vapor products or e-cigarettes currently approved as smoking cessation products.
Thus far, four Boards of Health in WA state have taken local actions to regulate vaping similarly to smoking by restricting use in public places and adding other regulations for vapor products that are similar to tobacco products.
All four laws apply to vaping of nicotine or other substances. All four laws do NOT apply to any tobacco use cessation product as regulated by FDA.
The provisions of the laws mirror restrictions for tobacco products under state and federal law.
Thus far, four Boards of Health in WA state have taken local actions to regulate vaping similarly to smoking by restricting use in public places and adding other regulations for vapor products that are similar to tobacco products.
(these bill summaries as of May 30,2015)
Governor Request, House Bill 1645 (Rep. Pollet) – Summary of 2nd Substitute
Vapor products = devices for any substance, including nicotine
Liquor Control Board regulation similar tobacco products, incl. Retailer and Distributor Licenses.
Child-proof packaging required (subject to federal preemption)
Requires warning labels and ingredient disclosure
Possible rules on flavorings and harmful additives
Retailers must keep vapor products behind the counter
No free samples to public. Coupons restricted to in-person transactions.
Sampling only in licensed stores that restrict access by minors
No vending machines, except where minors prohibited
No sales to minors or possession by minors
Vapor products not allowed on school property
Adds violations to civil penalty structure for tobacco, and increases amounts of penalties under RCW 70.155.100.
Key concern with 1645 is whether it will include local preemption, especially any preemption on use of vapor products. 2SHB 1645 does NOT preempt stronger local laws.
If 2SHB 1645 passes in 2015 session:
Takes effect: Oct 1, 2015
LCB rule-making needed for licensing, product labelling and ingredient disclosure (no deadline for rules in bill – typically takes 1-2 years)
HB 2211 – separate bill on taxing e-cigarettes and vapor products at 60%. Of tax collected, 40% would be deposited to Essential Public Health Services Account.
This is lower tax rate than cigarettes, and slightly lower than 65% rate for cigars.
Taxation of Tobacco Products (from HB 221 Summary).
The Other Tobacco Products (OTP) tax is due from a distributor for the sale, use, consumption,
handling and distribution of cigars, pipe tobacco, chewing tobacco and other forms of tobacco,
except cigarettes. The OTP tax is due when the product is brought into or manufactured in
Washington for sale in the state. The OTP tax is distinct from the cigarette tax, which is imposed
at a rate of $3.025 per pack of 20 cigarettes. The OTP tax rate is 95 percent of the taxable sales
price of most tobacco products. For cigars, the tax is capped at 65 cents per cigar. Dipping
tobacco is taxed based on the net weight listed by the manufacturer at the rate of $2.526 per
single unit of 1.2 ounces or less and at a proportionate rate for larger single units. The OTP tax
revenue is deposited into the state general fund.
Also AG request bill to raise smoking/vaping age – HB 1458/SB 5494.
Originally would have raised legal smoking/vaping age from 18 to 21, but 2nd substitute bill now sets legal age at 19.
Applies to tobacco products and vapor products.
HB1645
Cities, counties, schools, businesses can amend their existing policies to add vapor devices to their no-smoking/tobacco policies
Mention ESD and how they are assisting
