Commentary

By Dianne Feinstein

Originally published in the San Francisco Chronicle

According to research published last year in the New England Journal of Medicine, 35% of all high school seniors had vaped over the previous year. That’s nearly double the 18% who were vaping just two years ago, an incredible increase over such a short period.

At the same time, the number of youth who smoke traditional cigarettes continues to decline.

Two reasons for this trend are the easy access to vaping products and the prevalence of flavored vaping products like root beer float, cotton candy and gummy bear that appeal to children.

San Francisco has already moved to ban e-cigarettes, and the state is also contemplating a flavor ban. But to curb youth vaping nationwide, these issues must be addressed by Congress.

Easy access

The rate at which teens are adopting e-cigarettes is dramatic. Despite a 70% decline in the use of cigarettes among high school students since 1997, the use of tobacco products overall has not noticeably declined in recent years because of e-cigarettes.

That’s because a common misconception among teens is that e-cigarettes contain only flavoring and are not harmful to their health. But most e-cigarettes also contain nicotine, which is highly addictive and harmful to developing brains.

The most commonly used brand among minors, Juul, has the same amount of nicotine in one cartridge as 20 cigarettes. And there is scant evidence to suggest that smokers end their nicotine addiction by switching from cigarettes.

Despite the rapid spread of these devices and the recent spike in deaths and illness attributed to their use, there is a shocking lack of regulation on the use and distribution of e-cigarettes. Manufacturers of these devices aren’t subject to the same safety standards as other tobacco products, and that needs to change.

I led a group of senators last year in introducing a bill to require online sales of e-cigarettes to meet the same requirements as traditional cigarettes, including age verification at time of purchase and delivery.

Studies show that one of the easiest ways for underage users to purchase e-cigarettes is online where there is no proactive verification that buyers meet age verification requirements. This bipartisan bill would put in place regulations identical to those faced by online tobacco retailors. A companion to this bill has passed the House, and it should be voted on in the Senate without delay.

Flavored vaping products

Another similarity to regular cigarettes is the effort to market them directly to kids - in this case, through the use of mint, candy, fruit, or chocolate flavored products.

One survey by the Food and Drug Administration and the National Institutes for Health found 80% of youth who vape do so because they like the flavors, and 81% had a flavored e-cigarette the first time they tried it.

The Trump administration recently announced a partial ban on flavors, but it doesn’t go far enough to prevent underage vaping. The administration’s ban applies solely to disposable cartridges, exempting menthol and tobacco flavored cartridges along with vaping “tank” devices that can be refilled. While Juul and other cartridge products are the most popular with children right now, this partial ban will only shift underage users to the exempted flavors and refillable devices not covered by the ban. Scott Gottlieb, President Trump’s own former FDA commissioner, said the proposed ban fell short of the measures necessary to keep children from vaping.

If we’re going to stop underage vaping, we have to get rid of all flavored vaping products, regardless of the method used to inhale it.

Several states have already moved to enact temporary bans on the sale of all flavored e-cigarettes. The city of San Francisco - the home of Juul - has banned the sale of e-cigarettes altogether and a statewide ban on all flavored tobacco products, to include traditional tobacco, has been proposed.

Congress can take further action by enacting a similar ban on all flavored vaping products nationwide.

My colleague Sen. Dick Durbin, D-Ill., has introduced a bill in the Senate that would put in place such a ban. I’m proud to co-sponsor it. It’s time we prohibit these flavors nationally as we did with flavored traditional cigarettes, and we should vote on that bill immediately.

Lung illness

Easy access to vaping products and a lack of regulation has led to a public health crisis.

In addition to a youth vaping epidemic, we’ve now seen a mysterious lung illness leave more than 2,500 people sick and 55 dead. It seems this illness is connected to illicit THC products, but we simply do not know enough to rule out other sources like legally sold e-cigarettes.

That’s because anyone can currently manufacture and sell vaping devices, and put whatever they want in the cartridges or tanks, without having to prove they won’t harm users.

That’s all the more reason to subject these devices to an FDA approval process before they’re sold. We shouldn’t take a trial-and-error approach with the health of so many Americans in the balance.

Clearly, these devices have serious health consequences and we must fully study those consequences so the public can make an informed decision before deciding to use vaping products.

We have faced the menace of addictive, nicotine-based products with serious health risks before, and the decrease in tobacco use, especially by children, is one of the top public health successes of the past half century. We should respond with the same rigorous regulations before more children are addicted and more Americans fall ill or die from vaping.

Dianne Feinstein is California’s senior U.S. senator.