This post originally appeared as an op- ed in the Northern Kentucky Tribune on February 2, 2020.
By Ben Chandler, Terry Brooks, Ed.D., Ashli Watts and Brent Wright, M.D.
Manufacturers and retailers who sell Juul and other brands of e-cigarettes, or “vapes,” wonder why health advocates won’t just leave them alone. We have at least three reasons:
Kids, kids and kids.
1. Kentucky teens are using e-cigarettes at three times the rate of adults and many of them would never have touched a cigarette.
2. Vaping manufacturers used the same marketing tactics as Big Tobacco to entice today’s kids to try their products. Now many are addicted.
3. E-cigarettes have zero harm-reduction or cessation benefits for kids; in fact, they’re particularly dangerous for youth.
We’ve heard the vaping industry question whether kids are really using e-cigarettes at epidemic levels. Here is the data from the CDC’s 2019 Youth Risk Behavior Survey:
• 53 percent of Kentucky high school students have tried e-cigarettes (compared to 26 percent of adults)
• 26.1 percent of high schoolers used e-cigarettes in the last month (called “current use,” and the rate nearly doubled over 2017)
• 8.6 percent of them used e-cigarettes daily (more than quadrupled since 2017)
• 17.3 percent of middle schoolers used e-cigarettes in the last month (more than quadrupled since 2017)
In contrast, just one in 10 Kentucky adults currently uses e-cigarettes, according to the annual Kentucky Health Issues Poll.
Are E-Cigarettes Safer than Smoking?
Walk into any vaping store in your community and, chances are, you’ll find signs saying that e-cigarettes are safer than smoking. The industry usually points to a single 2013 study from England. That study was actually just a report summarizing the opinions of 12 health professionals who said they believed that e-cigarettes were safer than smoking. But they also said: “A limitation of this study is the lack of hard evidence for the harms of most products on most of the criteria.” The absence of evidence is one reason the vaping industry safety claim falls so far short of truth.
Another reason is that England limits e-cig nicotine levels. The United States has no such limits and a Juul pod contains as much nicotine as an entire pack of cigarettes. Moreover, advancing e-cig technology makes today’s e-cigarettes 10 to 20 times more powerful than 2013 models, and they expose users to much higher levels of nicotine and other toxins.
Back to the question, though: Are e-cigarettes safer than smoking?
For adults, we’re not sure yet, but the bar is pretty low – we know that cigarettes kill 8,900 people in Kentucky every year and help put Kentucky at or near the bottom of health rankings. And a growing body of evidence since 2013 shows that e-cigarettes raise the risk of lung disease, heart disease and stroke. While the industry claims that e-cigarettes were intended to help smokers quit, there are several proven tobacco cessation products that won’t cost smokers a dime out of pocket, and that are much safer than vaping.
Meanwhile, the science is very clear that e-cigarettes are dangerous for youth. The high nicotine levels and flavors in e-cigarettes lead to quick addiction, they’re a gateway to smoking, and they rewire the young brain to make it more susceptible to other addictions.
Most Effective Policy to Reverse the Youth Vaping Epidemic
Tobacco taxes are proven to reduce tobacco use, especially among youth. That’s why we’re asking Kentucky legislators to add a reasonable excise tax on e-cigarettes sold to Kentuckians. Taxing e-cigarettes at the current cigarette tax rate would raise about $34 million in much-needed revenue in Kentucky its first year, while also helping reduce youth vaping. What’s more, three in four Kentucky adults support taxing e-cigarettes on par with traditional cigarettes.
Kentucky has a history of spending far more than it earns from tobacco. Smoking alone costs Kentucky more than $1.92 billion in health care expenditures every year, yet tobacco excise taxes raised only $188.4 million in 2019. And retailers of Juul and other e-cigarettes don’t pay a single penny of that excise tax, yet their products are solely responsible for reversing a decade worth of progress in reducing youth tobacco use. We support House Bill 32, which would tax e-cigarettes at the current cigarette tax rate, to help rectify that.
Kentucky has a youth tobacco problem that threatens our kids’ health, portends massive future health care bills and jeopardizes the readiness of our future workforce. But given that 95 percent of tobacco use starts during youth, it’s a problem we can address if we adopt this reasonable tax during the 2020 General Assembly to help protect kids, before the epidemic is magnified yet again.
Ben Chandler is president and CEO of the Foundation for a Healthy Kentucky; Dr. Terry Brooks is executive director of Kentucky Youth Advocates; Ashli Watts is president and CEO of the Kentucky Chamber of Commerce; and Dr. Brent Wright is president of the Kentucky Medical Association.