Adolescent Health Symposium 2/5/16

Tobacco Free Columbia-Dane County Coalition (TFCDC)

Public Health Madison-Dane County

E-Cigarettes

Ryan Sheahan, Coordinator 608-242-6297

rsheahan@publichealthmdc.com

Nina Gregerson, Assistant Coordinator

608-243-0434 ngregerson@publichealthmdc.com

Public Health Madison-Dane County 210 Martin Luther King Jr. Blvd. Rm. 507 Madison, WI 53703

Marissa Thomas, Public Health Associate

608-242-6442 mthomas@publichealthmdc.com

Focus

0

5

10

15

20

25

30

35

2000 2002 2004 2006 2008 2010 2012 2014

Smoking Rate %

Year

Youth Smoking Rate - Statewide Middle School Smoking Rate High School Smoking Rate

SIGNIFICANT PROGRESS

The Rise of the

Electronic Cigarette

ELECTRONIC SMOKING DEVICES

• Metal or plastic tubes that contain a cartridge filled with a liquid that is vaporized by a battery-powered heating element • Heat and vaporize a solution that typically contains nicotine • Aerosol is inhaled by the user when they draw on the device, as they would a regular tobacco cigarette

user exhales the aerosol into the environment

What’s In It? Electronic smoking devices (ESDs) do not just emit “harmless water vapor.” Secondhand

aerosol from ESDs contains nicotine, heavy metals, ultrafine particles, and cancer causing chemicals.

Center for Environmental Health (CEH) review of 97 e-cigarettes study shows the majority of e-cigarette products tested produce high levels of cancer-causing chemicals formaldehyde and acetaldehyde.

Source: Center for Environmental Health (CEH). (2015). A Smoking Gun: Cancer Causing Chemicals in e-cigarettes. Retrieved from ceh.org.

Researchers at Harvard said a very dangerous chemical, diacetyl, is found in the flavoring liquid in more than 75 percent (39 of 51) of flavored e-cigarettes. Diacetyl has been linked to a debilitating respiratory

disease known as "popcorn lung”. The disorder leads to excessive coughing and shortness of breath. Source: Allen J., Flanigan S., LeBlanc M., Vallarino J., MacNaughton P., Stewart J., & Christiani D.. Flavoring chemicals in e-cigarettes: Diacetyl, 2,3-

Pentanedione, and Acetoin in a sample of 51 products, including fruit-, candy-, and cocktail-flavored e-cigarettes. Environmental Health Perspectives. Retrieved from http://ehp.niehs.nih.gov/15-10185/.

Studies

Youth Use of E-cigarettes

• Regular use among U.S. high school students nearly tripled from 2013-2014 – 2013: 4.5% or 660,000 high school students – 2014: 13% or ~2 million high school students

• Regular use among U.S. middle school students more

than tripled from 2013-2014 – 2013: 1.1% or 120,000 middle school students – 2014: 3.9% or 450,000 middle school students

• As of 2014, about 8% of Wisconsin high school students

use e-cigarettes

• Students who report using e-cigarettes are 3 times as likely to smoke conventional cigarettes the following year compared to non e-cig users

• 76.3% youth who use e-cigarettes also smoke

conventional cigarettes

• Youth have reported using e-cigarettes to ingest marijuana, noting that, because of the lack of smell, the vaporized use of marijuana is almost undetectable by others

Youth Use of E-Cigarettes

Calls to Poison Centers have significantly increased in recent years because of accidental ingestion or absorption (through

skin) of the e-cigarette nicotine liquid. 1 teaspoon = fatal for a child

1 Tablespoon = fatal for an adult

Liquid Nicotine is Poisonous

• Cause nicotine addiction • Might lead to sustained tobacco use (not cessation) • Nicotine adversely affects the developing brain

• May re-normalize the act of smoking

Other Potential Harms To Youth

What else are we concerned with?

E-Cigs & the Tobacco Industry

Device Design

Flavoring

Price 18mg/mL bottle of liquid nicotine = 10 packs of cigarettes

18 mg/mL bottle of liquid nicotine = $12

Point of Purchase/Product Placement

Point of Purchase/Product Placement

Point of Sale/Product Placement

Social Media Advertising

E-Cigarette Billboard Advertising

WI Legislature Public Hearing

Billboard in Beloit, WI

Print Advertising

What does this all mean?

Expenditures

In Fact… 18.3 million or 68.9% of middle and high school students

have been exposed to e-cigarette advertising from at least one source.

Proposed FDA Regulations Would Include: -Minimum Purchase Age of 18 (already law in Wisconsin)

- Disclose Ingredients -Halt Distribution of Free Samples

- Health Warning Label Requirement -Vending Machine Restrictions

Proposed FDA Regulations Would NOT Address: -Kid Friendly Flavors

- Advertising Restrictions - Product Placement

-Internet Sales

What Can You Do?

School Policy

• Update School Policy Language to include e-cigarettes

• Focus on the device versus what’s in the device (e.g. nicotine)

• Ensure the policy includes both adults and students

Other Ways You Can Help…

Become AWARE of these products

Educate decision makers about e-cigs / policy work

Educate youth about the dangers of e-cigarettes

Write Letters to the Editor (templates available)

Note advertising / product placement and report to local Tobacco Free Coalition

Memorable Quote:

“Are you smarter than a 6th grader? The 6th graders figured out that e-cigs are better and they’re switching. That’s a

good news story.”

--Don Muehlbauer, owner of DuraSmoke, the largest e-liquid company in the country, during a 2014 public hearing on exempting e-cigarettes

from the state’s smoke-free air law

www.facebook.com/tfcdc1

Twitter: @TF_CDC

Marissa Thomas, Public Health Associate

608-242-6442 mthomas@publichealthmdc.com

Nina Gregerson, Assistant Coordinator

608-243-0434 ngregerson@publichealthmdc.com