US Tobacco 21 is Paving the Way for a Tobacco Endgame

The battle against tobacco usage is being fought on all fronts. On December 19, 2019, a measure to raise the minimum age to buy tobacco products to 21 from 18 was passed by the United States Congress and signed by President Donald Trump. This instated banning the sale of all tobacco products and electronic cigarettes to anyone in the US under the age of 21. This follows the raising of the age to buy tobacco in California to 21 in 2016. According to the California Tobacco Control Program: in 2016, roughly 10% of high-school students were smoking cigarettes, but by 2018, only 2%. The percentage of retailers selling tobacco to underaged youth dropped dramatically. These data show that the CA Tobacco 21 law was effective in decreasing the obtainability and usage of tobacco by youth. We expect that US Tobacco 21 will be similarly effective in reducing tobacco use by youth leading to less tobacco addiction in the US.

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Exposure to advertising and perception, interest, and use of e-cigarettes among adolescents: findings from the US National Youth Tobacco Survey

Perspectives in Public Health ◽

10.1177/1757913917703151 ◽

2017 ◽

Vol 137 (6) ◽

pp. 322-325 ◽

Cited By ~ 12

Author(s):

Jia Pu ◽

Xiao Zhang

Keyword(s):

High School Students ◽

Electronic Cigarettes ◽

The Internet ◽

Retail Stores ◽

Cigarette Use ◽

School Students ◽

Cross Sectional ◽

The Us ◽

Advertising Exposure ◽

Different Sources

Objective: US adolescents are exposed to high levels of advertisements for electronic cigarettes (e-cigarettes). This study aimed to examine the associations between exposure to e-cigarette advertisements and perception, interest, and use of e-cigarettes among US middle school and high school students. Methods: Data from the 2014 cross-sectional National Youth Tobacco Survey were used. Logistic regressions were conducted to model four outcomes, including perception of reduced harmfulness compared to regular cigarettes, perception of reduced addictiveness, intention to use, and current use of e-cigarettes. Main predictors were exposure to e-cigarette advertisements via four sources, including Internet, newspaper/magazines, retail stores, and TV. Results: When all the four sources of e-cigarette advertisements exposure were evaluated jointly, exposure via the Internet was associated with elevated likelihood of reporting all four outcomes related to e-cigarettes, while exposure via retail stores was associated with higher likelihood of current e-cigarette use and perception of reduced harmfulness of e-cigarettes compared to regular cigarettes ( p < .05). However, exposure via newspaper/magazines and TV was associated with lower likelihood of perceiving e-cigarettes to be less harmful or addictive ( p < .05). Conclusion: Exposure to e-cigarette advertisements via the Internet and retail stores may play a significant role in adolescents’ use and perception of e-cigarettes. The results call for more research on the influence of different sources of advertising exposure on e-cigarette use to help public health programmes curtail the fast growing use of e-cigarette products among youth.

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Youth Access to Tobacco Products in the United States, 2016-2018

Tobacco Regulatory Science ◽

10.18001/trs.5.6.2 ◽

2019 ◽

Vol 5 (6) ◽

pp. 491-501 ◽

Cited By ~ 5

Author(s):

Sherry T. Liu ◽

Kimberly Snyder ◽

Michael A. Tynan ◽

Teresa W. Wang

Keyword(s):

Public Health ◽

High School Students ◽

The United States ◽

Tobacco Product ◽

Health Concern ◽

Public Health Concern ◽

School Students ◽

Tobacco Products ◽

School Based ◽

Compliance Check

Objectives: In 2018, approximately 4.9 million US middle and high school students reported past 30-day use of any tobacco product. This study describes how and where youth obtained tobacco products and whether refusal of sale occurred during 2016-2018. Methods: Data from 3 annual waves (2016-2018) of the National Youth Tobacco Survey, a school-based survey of US youth in grades 6-12, were analyzed among current (past 30-day) tobacco product users aged 9 to 17 years. Results: During 2016-2018, youth tobacco product users most commonly obtained tobacco products from social sources. Although the percentage of users who reported buying tobacco products significantly decreased from 2016 to 2018 (2016: 15.6%; 2018: 11.4%), no significant differences in the prevalence of being refused sale were observed (2016: 24.7%; 2018: 25.5%). Conclusions: Whereas the number of youth users who report buying tobacco products has declined, sales of tobacco products to youth remain a public health concern, as only one in 4 youth who attempted to buy were refused sale in 2018. Monitoring youth tobacco product purchases, retailer compliance check inspections, and retailer penalties for sales to minors remain important for reducing youth access at retail sources.

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Smoking, Vaping, and the Benefits Cessation in Times of COVID-19: A Public Health Perspective

Frontiers in Dental Medicine ◽

10.3389/fdmed.2020.618364 ◽

2020 ◽

Vol 1 ◽

Author(s):

Rahma Mungia ◽

Danielle Nicole Valdez

Keyword(s):

High School Students ◽

Lung Function ◽

Animal Studies ◽

Electronic Cigarettes ◽

The United States ◽

Tobacco Product ◽

School Students ◽

Public Health Perspective ◽

Susceptibility To Infection ◽

Dental Practitioners

The goal of this article is to inform dental practitioners and specialists of the benefits of smoking and vaping cessation in relation to COVID-19 transmission. COVID-19 caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has affected more than 31.7 million people globally with infection rates continuing to rise rapidly. Smoking dramatically impairs lung function and gives rise to an increase in susceptibility for infection, allowing for a more difficult recovery due, in part, to the damage SARS-CoV-2 does to the lungs. Tobacco smoking is one of the primary causes of death in the United States (US), however, nearly 40 million adults still smoke cigarettes, with 4.7 million middle and high school students using at least one tobacco product, including electronic cigarettes. COVID-19 is transmitted through salivary droplets, causing severe bilateral pneumonia and significantly reduced lung function, putting smokers and vapers at greater risk through cross-contamination and face touching. So far, data from animal studies suggest that vaping leads to an increased susceptibility to infection, which coincides with evidence of increased rates of chronic bronchitis in vapers. There is yet to be data regarding the benefits of smoking and vaping cessation during the COVID-19 pandemic. However, there is evidence suggesting that 4 weeks or more of smoking cessation intervention reduces the risk of contracting COVID-19 and developing severe complications. Because of these probable connections, dental practitioners should advise their patients to stop smoking and/or vaping via the 5 As Cessation Strategy.

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Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco Product Use Among Underage US Students

American Journal of Health Promotion ◽

10.1177/0890117120905231 ◽

2020 ◽

Vol 34 (6) ◽

pp. 648-651

Author(s):

Hunter Marion ◽

William Garner ◽

Alex Estrada ◽

Christopher Moorer ◽

Ixel Acosta-Velazquez

Keyword(s):

High School ◽

High School Students ◽

Electronic Cigarettes ◽

The United States ◽

Online Marketing ◽

Electronic Cigarette ◽

Dual Use ◽

Cross Sectional Survey ◽

School Students ◽

Tobacco Marketing

Purpose: To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age. Design: Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey. Setting: The survey was administered in public and private middle and high schools across the United States. Participants: The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period. Measures: The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade). Analysis: Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure. Results: Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing. Conclusions: Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.

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Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014–2016

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054593 ◽

2018 ◽

Vol 29 (1) ◽

pp. 49-54 ◽

Cited By ~ 9

Author(s):

Saida Sharapova ◽

Carolyn Reyes-Guzman ◽

Tushar Singh ◽

Elyse Phillips ◽

Kristy L Marynak ◽

...

Keyword(s):

High School Students ◽

Nicotine Dependence ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Electronic Cigarettes ◽

Tobacco Prevention ◽

Cross Sectional Survey ◽

School Students ◽

Cigarette Tobacco ◽

Tobacco Products

IntroductionTobacco use mostly begins in adolescence and young adulthood. Earlier age of initiation of cigarette smoking is associated with greater nicotine dependence and sustained tobacco use. However, data are limited on the age of initiation of non-cigarette tobacco products, and the association between using these products and nicotine dependence and progression to established use.MethodsCombined 2014–2016 National Youth Tobacco Survey data, a nationally representative cross-sectional survey of US students in grades 6–12 yielded 19 580 respondents who reported ever using any of five tobacco products: electronic cigarettes, cigarettes, cigars, smokeless tobacco and hookah. Analyses assessed age of reported first use of each product among ever-users, overall and by sex and race/ethnicity. Current daily use, past 30-day use, feelings of craving tobacco and time to first tobacco use after waking were assessed by age of first use.ResultsAmong ever-users, weighted median age for first use was 12.6 years for cigarettes, 13.8 years for cigars, 13.4 years for smokeless tobacco, 14.1 years for hookah and 14.1 years for e-cigarettes. First trying these tobacco products at age ≤13 years was associated with greater current use of the respective product and nicotine dependence compared with initiating use at age >13 years.ConclusionsFirst tobacco use at age ≤13 years is associated with current daily and past 30-day use of non-cigarette tobacco products, and with the development of nicotine dependence among youth ever-users. Proven tobacco prevention interventions that reach early adolescents are important to reduce overall youth tobacco use.

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Youth Access to Tobacco Products in the United States: Findings From Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health Study

Nicotine & Tobacco Research ◽

10.1093/ntr/nty238 ◽

2018 ◽

Vol 21 (12) ◽

pp. 1695-1699 ◽

Cited By ~ 9

Author(s):

Susanne Tanski ◽

Jennifer Emond ◽

Cassandra Stanton ◽

Thomas Kirchner ◽

Kelvin Choi ◽

...

Keyword(s):

United States ◽

Electronic Cigarettes ◽

The United States ◽

Tobacco Product ◽

Tobacco Products ◽

Population Assessment ◽

Gas Stations ◽

Usual Source ◽

Convenience Stores ◽

The Us

Abstract Objectives Tobacco products in the US market are growing in diversity. Little is known about how youth access tobacco products given this current landscape. Methods Data were drawn from 15- to 17-year-olds from the Wave 1 youth sample of the US nationally representative Population Assessment of Tobacco and Health (PATH) Study. Past 30-day tobacco users were asked about usual sources of access to 12 different tobacco products, and if they had been refused sale because of their age. Results Among 15- to 17-year-olds, social sources (“someone offered” or “asked someone”) were the predominant usual source of access for each tobacco product. “Bought by self” was the usual source of access for users of smokeless (excluding snus, 23.2%), cigarillos (21.0%), cigarettes (13.8%), hookah (12.0%), and electronic cigarettes (10.5%). Convenience stores and/or gas stations were the most often selected retail source for all products except hookah. Among youth who attempted purchase, 24.3% were refused sale of cigarettes, 23.9% cigarillos, and 13.8% smokeless tobacco. Conclusions Most 15- to 17-year-old tobacco users obtain tobacco products through social sources; however, among those who purchased tobacco, the majority report not being refused sale because of age. At the time of survey, cigarette and cigar sales to under 18 years were prohibited in all 50 states, and electronic cigarettes sales in 47 states and two territories. 2014 Annual Synar Reports signaled increasing trends in retail violations of state and/or district laws prohibiting tobacco product sales to under 18 years. Monitoring illicit youth sales, conducting compliance check inspections, and penalizing violations remain important to reduce youth tobacco access at retail venues. Implications Access to the spectrum of tobacco products by youth in the United States remains predominantly through social sources. However, of the minority of youth tobacco users in 2014 who purchased tobacco themselves, a few reported being refused sale: Convenience stores and/or gas stations were the most common retail source for tobacco products. The strategies of monitoring illicit youth sales, conducting compliance checks, and penalizing violations remain important to reduce youth tobacco access at retail venues. Limiting sources of youth tobacco access remains an important focus to reduce the burden of tobacco on the public health.

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US vaping regulations are likely to tighten

Emerald Expert Briefings ◽

10.1108/oxan-db244021 ◽

2019 ◽

Keyword(s):

United States ◽

High School Students ◽

Federal Court ◽

The United States ◽

Think Tanks ◽

School Students ◽

Tobacco Products ◽

Content Type ◽

Federal Level ◽

The Eu

Significance McConnell explained that his move is to crack down on middle and high school students increasingly using “tobacco products” and becoming “hooked”. This comes as a federal court on May 15 ordered the Food and Drug Administration (FDA) to expedite issuing regulations for e-cigarettes, in a suit brought over concerns about a spike in ‘vaping’ (smoking using e-cigarettes) among young people in the United States. Impacts Opioid-related court rulings could set relevant precedents for firms manufacturing other addictive substances. Tobacco firms are likely to encounter difficulty when trying to fund credible policy think tanks. E-cigarette regulations will likely draw on global examples and research; the EU has e-cigarette regulations, for instance. Tobacco firms would support raising the tobacco age, which is more likely to pass at federal level than not.

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E-Cigarette Use Is Associated With Intentions to Lose Weight Among High School Students

Nicotine & Tobacco Research ◽

10.1093/ntr/nty245 ◽

2018 ◽

Vol 22 (5) ◽

pp. 838-842 ◽

Cited By ~ 1

Author(s):

Dale S Mantey ◽

Onyinye Omega-Njemnobi ◽

Steven H Kelder

Keyword(s):

High School ◽

Weight Loss ◽

High School Students ◽

Electronic Cigarettes ◽

Multinomial Logistic Regression ◽

The United States ◽

Cigarette Use ◽

School Students ◽

Full Sample ◽

Or Management

Abstract Introduction Recent literature has demonstrated individuals may be using electronic cigarettes (e-cigarettes) as a method of weight loss and/or management. Furthermore, e-cigarette companies are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students. Methods Data were obtained from the 2015 Youth Risk Behavior Surveillance survey. Participants were 12 847 students in grades 9–12 in the United States. Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9–12 grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use. Results Overall, 23.7% of the sample used e-cigarettes in the past 30 days. E-cigarette use was associated with 1.38 (95% CI = 1.07% to 1.78%) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (95% CI = 1.05% to 1.97%) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (95% CI = 1.04% to 1.88%) greater odds of intentions to gain weight, controlling for covariates. Conclusion Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship. Implications and Contribution This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents, both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss and/or management.

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