Vaping, E-Cigarettes, and Flavored Tobacco Are Reversing 20 Years of Decreasing Smoking Rates
The public push for a transformation in tobacco policy began with a persistent legislator seeking real change. Opening his historic congressional hearing in 1994, U.S. House of Representatives Energy and Commerce Committee Chair Henry Waxman (D-CA) said (https://senate.ucsf.edu/tobacco-ceo-statement-to-congress), “The truth is that cigarettes are the single most dangerous consumer product ever sold. Nearly a half million Americans die every year as a result of tobacco. This is an astounding, almost incomprehensible statistic. Imagine our nation’s outrage if two fully loaded jumbo jets crashed each day, killing all aboard. Yet that is the same number of Americans that cigarettes kill every 24 hours. Sadly, this deadly habit begins with our kids. Each day 3,000 children will begin smoking. In many cases they become hooked quickly and develop a life-long addiction that is nearly impossible to break.”
The Problem With Vaping
In 2020, with the progression of technology, the tobacco industry has found innovative ways to reach a new generation of smokers with electronic cigarettes and vaping mechanisms. Flavored tobacco, with its enticing names and tastes, has overturned 20 years of decreasing smoking rates, invalidating a societal priority to eliminate tobacco use as a major public health problem.
Despite testifying under oath to Congress during the 1994 tobacco hearing that nicotine was not an addictive substance and that their companies’ products were not harmful, tobacco executives later reversed themselves when clear, scientific documentation proved otherwise. In a similar 1998 House Commerce Committee hearing (https://www.tobaccofreekids.org/press-releases/id_0082), executives admitted that nicotine was an addictive substance.
“Nurses need to educate the public, particularly parents and children, about the adverse effects of e-cigarettes and vaping,” ONS said in its 2019 Use of E-Cigarettes and Vaping position statement (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/e-cigarettes-and-vaping). “Nurses should take action in their communities to address the growing epidemic of underage vaping, advocate for national policies to protect underage users of e-cigarettes, help patients who smoke tobacco products or vape to quit, promote an environment free of aerosols from vaping and tobacco smoke, and support effective e-cigarette, vaping fluid, and tobacco control policies to protect the public from the adverse effects of vaping, e-cigarette use, and nicotine addiction.”
Work on Capitol Hill
Since 2000, an intense, coordinated public health crusade has raised awareness about the effects of smoking, with oncology nurses at the helm of patient-centered care and symptom management education. And it continues today, with U.S. Surgeon General Jerome M. Adams’, MD, MPH, January 2020 report (https://www.hhs.gov/sites/default/files/2020-cessation-sgr-executive-summary.pdf) on smoking.
“One of the most significant public health successes in modern U.S. history has been the reduction in smoking that has occurred during the past half century,” Adams said. “Today, 16 million Americans are living with a smoking-related disease. In addition to the human costs, smoking places a significant financial burden on Americans, as smoking-attributable healthcare spending exceeds $170 billion per year. But healthcare professionals alone cannot solve this public health challenge. Everyone has a role in helping to continue to reduce the burden of tobacco use on our society. As a nation, we can and must spare no effort to reduce the completely preventable health and financial costs that tobacco smoking has on society.”
The Local Approach
More local and state jurisdictions are taking the surgeon general’s advice. Legislative bodies are introducing and passing bills that specifically target electronic forms of smoking, condemning the new devices as public health enablers. Following are a few examples, but many more have been passed:
The commonwealth of Massachusetts filed a lawsuit (https://www.mass.gov/lists/attorney-generals-office-lawsuit-against-juul) against Juul “for creating a youth vaping epidemic by intentionally marketing and selling its e-cigarettes to young people.”
Fort Worth, TX (https://fortworthtexas.gov/news/2018/08/smoking-in-parks/), updated its public smoking ban “in bars and bingo parlors and retail smoke shops within 300 feet of schools, universities and hospitals” to include city parks and other public spaces.
The Nevada Clean Indoor Air Act (https://www.washoecounty.us/health/faq/nevada-clean-indoor-air-act/what-changes-does-the-nciaa-make.php) prohibits “smoking tobacco in any form within indoor places of employment, including, but not limited to: childcare facilities, movie theatres, video arcades; government buildings and public places; malls and retail establishments; all areas of grocery stores; all indoor areas within restaurants; and within school buildings and on school property.”
As local and state elected officials—and public health advocates—gain constituent support for stronger policy initiatives in smoking cessation programs, look for more jurisdictions to follow suit. This is not only a health issue, but an economic one as well.
Learn more about the youth vaping epidemic on the Oncology Nursing Podcast (https://www.ons.org/podcasts/episode-55-youth-vaping-epidemic).