Originally published in the American Healthcare Journal

By Sen. Dianne Feinstein (D-Calif.)

Even before COVID-19 ravaged our country, e-cigarettes posed a serious health threat to America’s youth. As we emerge from the COVID-19 pandemic, the youth vaping crisis remains an urgency that Congress must address. 

Not only have changes in shopping habits during the pandemic made e-cigarettes easier for underage users to obtain, research published in the Journal of Adolescent Health found that young people who vape are five to seven times more likely to be infected with COVID-19 than those who don’t. 

Vaping leaves young people more susceptible to deadly illness, especially if they haven’t yet received a COVID-19 vaccine. And with one in five high school students reportedly using e-cigarettes, the time to act is now. 

Youth e-cigarette use alarmingly high

Youth e-cigarette use is rampant, and with it comes a higher risk of permanent lung damage or even death. 

The CDC reports that more than 3 million high school students and 550,000 middle school students used e-cigarettes in 2020. More than a third of high school students who use e-cigarettes report using them most days of the month, and 20 percent report daily use. 

In addition to the harmful effects of nicotine on a developing brain, it can also increase stress and anxiety when an addiction is formed. This is especially alarming as we emerge from a pandemic that created severe disruptions in students’ lives and a massive influx in reported mental health issues among adolescents. 

Access to vaping products

COVID-19 has changed the way Americans shop, and the purchase of e-cigarettes is no exception. The pandemic made it easier for underage users to acquire vaping devices by ordering them online and having them delivered, when age checks occurred less frequently. 

According to a national survey published in The Journal of the American Medical Association, online purchasing became the predominant source of purchasing e-cigarettes after the pandemic began. Underage youth found it easier to obtain e-cigarettes through online purchasing and from sellers providing home delivery during the pandemic, highlighting the urgent need to effectively verify age for online sales and for in-person delivery.

A bill I wrote with Sen. John Cornyn (R-Texas), the Preventing Online Sales of E-Cigarettes to Children Act, became law last year and should help reduce this problem. This law mandates that e-cigarettes receive the same strong safeguards already in place for traditional cigarettes and smokeless tobacco. 

These safeguards include mandatory age verification by online e-cigarette sellers before shipment, properly labeled packages showing they contain e-cigarettes and a second round of age verification upon delivery, including an adult’s signature. 

While many provisions of that law took effect on March 27, the U.S. Postal Service was required to put in place new mail regulations by April 26. As of mid-June, that has yet to happen, leading Sen. Cornyn and me to call on Postmaster General Louis DeJoy to publish these new regulations as soon as possible.

Still, more needs to be done, especially given the fact that many young people are already addicted to nicotine and will find new ways to get their hands on e-cigarettes. 

The root of the problem is the attraction these devices have for children in the first place, and that’s where we have to attack the problem.

Flavored vaping products

As was true of traditional cigarettes, flavored products are the gateway for many underage users and a primary reason youth report using e-cigarettes. Of the 3.6 million young Americans who used e-cigarettes in 2020, 85 percent of high school students and 74 percent of middle school students reported using flavored e-cigarettes

It’s not hard to see why children are attracted to these products when flavors like cotton candy, melon and raspberry are offered as options. While most flavors in pre-filled cartridges are banned, disposable e-cigarettes are still sold in a variety of flavors that attract children. Menthol-flavored e-cigarette products also remain on the market, which 37 percent of high school e-cigarette users use

It’s clear that many of these flavored products are being marketed toward young, first-time users. Our efforts to stop the youth vaping epidemic must confront these marketing efforts head-on.

Last year, Gov. Gavin Newsom (D-Calif.) signed into law a statewide ban on the sale of all flavored tobacco products, including those found in e-cigarettes, that is set to take effect next year. Many states, however, lack such a ban. That’s why Congress should act as soon as possible to mandate a nationwide ban on flavored vaping products. 

While we’ve taken a big step forward by requiring online age verification of these products, we need to attack the root of the crisis by outlawing predatory flavors that lure children into vaping. Only then will we be able to curb the rise in youth nicotine addiction.