When Mary Lou Warn found out her teenager was vaping six years ago, he assured her it was safe. He had done his research, he said, and vaping was just flavored water. It was nothing like smoking.
Warn tried to do his own research but there was little information available at the time on these new e-cigarettes.
“I couldn’t find anything to counter that message,” she said. “I didn’t really have a leg to stand on.”
By the time his son, Jake, went to college, Warn said his addiction to vaping began to have a visible impact on his health. Jake had been an athlete, but now he was pale, had a constant cough, and was restless and depressed.
Jake eventually worked with his doctor to wean off his use over the course of six months. And in the years since, the public has a better understanding of the risks associated with vaping. But Warn says the damage is done.
“I feel like public health is at risk here,” Warn said. “We’re going to see long-term effects and (the response) has to happen faster than it’s happening.”
Before e-cigarettes hit the market, public health advocates in Maine and elsewhere were making progress in their war on tobacco. Smoking was down. It was considered old-fashioned and less accepted in many parts of society.
Vaping manufacturers have bucked this trend with subtle marketing, sleek devices, and tantalizing flavors. Youth vaping rates in Maine nearly doubled between 2017 and 2019, affecting health advocates in a state that already had above-average smoking rates.
But since then, there have been signs that the tide could be turning again. Portland, Bangor and Brunswick have banned the sale of flavored vaping products this year, with South Portland set to consider its own ban.
Maine was to receive about $11 million from a recent deal with Juul, an e-cigarette maker, over its marketing tactics targeting young people. But Maine Attorney General Aaron Frey decided on Friday to walk away from the deal on terms imposed by Juul.
This week, the latest Maine Integrated Youth Health Survey found that vaping rates among high school students in the state have fallen from 45% in 2019 to 32% last year.
The survey numbers are “encouraging,” said Dr. Deborah Hagler, outgoing president of the Maine chapter of the American Academy of Pediatrics. She remains “cautiously optimistic”.
Social distancing and remote learning during the COVID-19 pandemic have likely made it harder for young people to share vaping devices, which is the primary way they are first exposed to e-cigarettes, a she declared. For this reason, it will be important to watch the next set of data that comes out again in two years, when children are back in the classroom, to see if the trend continues.
“We can be happy that the numbers have gone down. We can’t know exactly why they fell,” Hagler said.
The survey also found that 17% of high school students said they had used an electronic vaping product at least once in the past 30 days, compared to 29% in 2019. This means there has been a drop to both the number of new users and the amount of vaping. among current users.
Overall vaping rates for middle schoolers also dropped from 16% to 10%.
“That’s where politics comes in and could be really important,” Hagler said. “Can we maintain the downward trend with good public policy? That means keeping the kids away from the flavors, which we knew was a huge attraction to initiate.
The recent deal over Juul’s marketing tactics amounts to the company admitting, on some level, that it was targeting kids by making vaping cool, Hagler said.
Of people who smoke cigarettes daily, 99% first tried it before age 26, according to the US Centers for Disease Control and Prevention.
Vape makers insist their mission is to keep adult smokers away from cigarettes. Although e-cigarettes contain fewer chemicals than cigarettes, they still contain chemicals associated with serious lung damage, as well as other potentially harmful substances. Additionally, almost all e-cigarettes contain nicotine, which is highly addictive.
There’s a “vigorous discussion” internationally about the effectiveness of these devices as a tool for adult heavy smokers to try to quit, Hagler said. In other countries, they were regulated differently, with limited amounts of nicotine and restrictions on advertising aimed at young people.
But in the United States, they were heavily marketed to young people. And young people who vape are three times more likely to switch to a traditional cigarette, Hagler said.
That’s concerning in Maine, where adult smoking rates are higher than the national average, said Hilary Schneider, Maine government relations director for the American Cancer Society Cancer Action Network. About 17% of adult Mainers smoke. The national average is 12.5%.
Tobacco-related cancer in Maine is higher than the national average, and cancer remains the leading cause of death among Mainers, even during the COVID-19 pandemic. Many of these cancers, such as bladder, throat and neck, have tobacco as a preventable risk factor, Schneider said.
“While it’s great to see a decline in youth smoking, as well as a decline in youth e-cigarette use, usage rates are still too high,” Schneider said. “Ever since rates of youth e-cigarette use exploded, youth smoking rates remain higher than they were more than two decades ago. Cigarette and e-cigarette use among Maine youth remain well above the national average.
Schneider attributed the decline between 2019 and 2021 to policies such as raising the legal age for tobacco products to 21, equalizing the tax on tobacco products other than cigarettes, and increasing government investments in tobacco prevention and treatment.
“The public health response, although late in the game, certainly shows you that evidence-based policies are making a difference,” Schneider said.
Juul settlement talks fail
Earlier this month, Juul Labs agreed to pay nearly $440 million to settle an investigation in 33 states and territories, including Maine, into the e-cigarette maker’s marketing and sales practices. The agreement also requires Juul to comply with strict terms limiting its marketing practices.
Maine was expected to receive between $10.7 million and $11.6 million over the next six to 10 years. But as part of the deal, Juul wanted states to waive the right of school districts to pursue their own lawsuits, according to the Maine AG office. Maine was unwilling to accept this.
“We are disappointed with the outcome of these negotiations, but ultimately we were unwilling to waive the rights of other entities that are also trying to hold Juul accountable for its deception,” Attorney General Aaron Frey said in a statement. a statement to the Maine Monitor.
In a statement, Juul Labs said the terms of the agreement “are aligned with our current business practices that we began implementing following our company-wide reset in the fall of 2019.”
This summer, the US Food and Drug Administration banned Juul from selling e-cigarettes, but the agency quickly decided to suspend the ban for further review. Juul said it filed an administrative appeal against the ban, showing that the denial order was “substantially and procedurally flawed and should be overturned.”
“We remain focused on the future as we strive to fulfill our mission to steer adult smokers away from cigarettes – the number one cause of preventable death – while combating underage consumption,” the company said.
The recent Juul deal serves as “evidence that the marketing tactics used to promote these products are targeting young people,” said Dan Cashman, spokesperson for the Maine chapter of Flavors Hook Kids.
But he said the $11 million probably wouldn’t make much of a difference to youth vaping rates.
“We would like to see flavored products removed from shelves statewide,” Cashman said. “It will have the greatest impact that no amount of money can match.”
Flavors Hook Kids led statewide efforts to ban the sale of flavored tobacco products.
Bangor, Portland and Brunswick passed municipal bans on flavored products after a statewide effort stalled in the Legislature earlier this year. South Portland is gearing up for a vote as early as next month, and at least five other communities are also considering a ban, Cashman said.
Flavors Hook Kids hasn’t given up on its efforts for a statewide ban and hopes to continue pushing it forward in the next session, Cashman said.
But health experts have warned that a ban on vaping products could push people back to traditional cigarettes, The Times Record reported earlier this year.
Cashman said the goal was to keep kids from getting addicted.
“We were winning the war on smoking before vaping became much more common. We’ve backed off since,” Cashman said. “Now is the time to ban the sale of flavored products so we don’t continue to slip.”
Hagler, the pediatrician, said boredom is a big reason kids try vaping. She said many kids have told her they tried vaping for the first time while hanging out with friends and wanting something to do.
“When they engage in vaping, it has a fusion and bonding experience,” Hagler said. “Can we find something as a community that loves our children that is a different way for them to engage? It is a form of primary prevention that is truly undervalued, underfunded, and underutilized.
This story was originally published by The Maine Monitor. The Maine Monitor is a local journalism product published by the Maine Center for Public Interest Reporting, a nonpartisan, nonprofit civic news organization.
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