Surgeon General's Advisory on E cigarette Use Among Youth

Transcript

1 neral Surgeon Ge cigarette Use A mong ’ s Advisory on E - Youth I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance from a lifetime of nicotine addiction and associated health risks children by immediately addressing the of protecting our - cigarette use. The recent epidemic of in e - cigarette use among youth , which has been fueled by new youth e surge of e - cigarettes that have recently entered the market , is a cause for great concern. We must take action now to type s protect the health of our nation’s young people. KNOW THE RISKS. TAKE ACTION. PROTECT OUR KIDS. cigarette Epidemic - A mong Youth E The 1 However, the C onsiderable progress has been made in reducing cigarette smoking among our nation’s youth. , including smoked, tobacco products tobacco product landscape continues to evolve to include a variety of 2 such as smokeless, and electronic products e - cigarettes . , E - cigarettes are designed to deliver nicotine, 2 flavorings, and other additives to the user via an inhaled aerosol. - E they have been the most commonly cigarettes entered the U.S. marketplace around 2007, and s ince 2014, 2 - cigarette use among U.S. middle and high school students increased E used tobacco product among U.S. youth. 3 - 2015 , before declining for the first time during 2015 900% 2017 . during However, c urrent e - cigarette use 2011 - 4 during the past year, from 11.7% in 2017 to 20.8% in 2018 increased 78% among high school students In 2018, . U.S. youth, including 1 in 5 high school students and 1 in 20 middle school students, more than 3.6 million 4 currently use e - cigarettes. 2 the addictive drug in cigarette aerosol is not harmless. Most e E cigarettes contain nicotine – - regular cigarettes, - 2 cigars, and other tobacco products. Nicotine exposure during adolescence can harm the developing brain – 2 impact which continues to develop until about age 25. can N icotine exposure during adolescence learning, 1,2 memory, and attention. Using nicotine in adolescence can also increase risk for future addiction to other 1,2 - cigarettes can potentially expose drugs. In addition to nicotine, the aerosol that users inhale and exhale from e both themselves and bystanders to other harmful substances, including heavy metals, volatile organic 2 be inhaled deep compounds, and ultrafine particles that can into the lungs. ly . I cigarettes also come in kid - friendly flavors - n addition to making e - cigarettes more appealing to young Many e 5 2 some of the chemicals u cigarette E - people, s can also be sed to make certain flavors may also have health risks. 2 I n 2016, one - . U.S. middle and high school students who used to deliver other drugs, including marijuana third of 6 - ever used e cigarettes had used marijuana in e - cigarettes. e cigarettes may For adults, risk - for current smokers if they completely transition from have the potential to reduce 7 cigarettes; however, - who use e a majority of adults - cigarettes also smoke cigarettes. cigarettes to e For youth, 1,2 the use of multiple tobacco products puts youth at even greater risk for addiction and tobacco ms. - related har concluded a Sciences, Engineering, and Medicine report 2018 National Academy of that there was Moreover, 7 evidence that e - cigarette use increases the frequency and intensity moderate of cigarette smoking in the future . 2 e - ut young people is unsafe, even if they do not progress to future cigarette smoking. B any cigarette use among E - cigarettes C ome in Many Shapes and Sizes E - cigs,” “e - - cigarettes are a rapidly changing product class, and are known by many different names, including “e 2 “vape pens.” and R ecently, a new type of e - cigarette has become increasingly popular among hookahs,” “mods,” 8 due to its minimal exhaled aerosol , reduced odor , and small size, making it easy to conceal. our nation’s youth One of the most commonly sold among other shapes. Many of t hese new e - cigarettes look like a USB flash drive , 1

2 flash drive shaped e cigarettes is JUUL, which experienced a 600% surge in sales during 2016 - 2017, giving - USB 9 cigarette in the U.S. by the end of 2017. Other companies are now also - it the greatest market share of any e starting to sell e - cigarettes that look like USB flash drives. - cigarettes have a high level of nicotine . A typical JUUL cartridge, or “ pod All JUUL e contains about as much ,” 10 These products also use nicotine salts , which allow particularly high nicotine as a pack of 20 regular cigarettes. the that has traditionally - base nicotine levels of nicotine to be inhaled more easily and with less irritation than free - been used in tobacco products, including e for young people, because cigarettes it . This is of particular concern could make it easier for them to initiate the use of nicotine through these products and also could make it easier to progress to regular e - cigarette use and nicotine dependence . However, despite these risks, approximately two - 11 JUUL - 24 do not know that of JUUL users aged always contains nicotine. third 15 s You Can Take Action essive steps to protect our children from these highly potent products that risk exposing a new We must take aggr 2,7 The bad news is that e - cigarette use has become an epidemic among generation of young people to nicotine. However, the good news is that we know what works to effectively protect our kids our nation’s young people. 1, 2, 12 use , including e - cigarettes . from all forms of tobacco product We must now apply these strategies to e - cigarettes, including flash drive shaped products such as JUUL. T o achieve success, we must work USB together, aligning and coordinating efforts across both old and new partners at the national, state, and local levels . Everyone can play an important role in protecting our nation’s young people from the risks of e - cigarettes. Parents Information for  You have an important role to play in addressing this public health epidemic. Learn about the different shapes and types of e  - cigarette use for young - cigarettes and the risks of all forms of e cigarettes.surgeongeneral.gov/ . https://e people at - Set a good example by being tob  - free. If you use tobacco products , it’s never too late to quit. Talk to a acco For free help, visit smokefree.gov or healthcare professional about quitting all forms of tobacco product use. 1 - 800 - QUIT - NOW . call  Adopt tobacco - free rules , including e - in your home and vehicle . cigarettes,  Talk to your child or teen about why e - cigarettes are harmful for them. It’s never too late.  Get the Surgeon General’s tip sheet for parents , Talk With Your Teen About E - cigarettes , at https://e - . Start cigarettes.surgeongeneral.gov/ the conversation early with children about why e - cigarettes , including JUUL, are harmful for them. Let your child know that you want them to stay away from all tobacco products, including e cigarettes, because  - involved. they are not safe for them. Seek help and get o Set up an appointment with your child’s health care provider so that they can hear from a medical - cigarettes. professional about the health risks of tobacco products, including e o Speak with your child’s teacher and school administrator about enf orcement of tobacco - free school policies and tobacco prevention curriculum. o Encourage your child to learn the facts and get tips for quitting tobacco products at Teen.smokefree.gov . Information for Teachers  You have an important role to play in addressing this public health epidemic.  - cigarettes and the risks of all forms of e - cigarette use, Learn about the different shapes and types of e including JUUL, for young people at https://e - cigarettes.surgeongeneral.gov/ .  Develop, implement, and enforce tobacco - free school policies and prevention programs that are free from . cigarettes tobacco industry influence , and that address all types of tobacco products, including e - 2

3 Engage your students in discussions about the dangers of e cigarette use . To help you, the Food and  - ), and Scholastic , developed free resources for teachers. These materials can FDA Drug Administration ( www.scholastic.com/youthvapingrisks . be found at Health Professionals Information for  You have an important role to play in addressing this public health epidemic . Learn about the different shapes and types of  - cigarettes and the risks of all forms of e - cigarette use, e including JUUL, for young people at - cigarettes.surgeongeneral.gov/ . https://e such as JUUL - cigarettes, including small, discreet devices  , when screening patients for the Ask about e use of any tobacco products . Educate patients about the risks of all forms of tobacco product use, including e  cigarettes, for young - people .  Encourage patients to quit. For free help, patients can visit smokefree.gov or call 1 - 800 - QUIT - NOW . Information for States , , Tribes, and Territories Communities epidemic.  You have an important role to play in addressing this public health Implement evidence -  population - level strategies to reduce e - cigarette use among you ng people , based such as including e - cigarettes in smoke - free indoor air policies, restricting young peoples’ access to e - educatio cigarettes in retail implementing price policies, and developing settings, licensing retailers, nal initiatives targeting young people .  Implement strategies to curb e - cigarette advertising and marketing that are appealing to young people.  Implement strategies to reduce access to flavored tobacco products by you ng people . . KNOW THE RISKS. TAKE ACTION. PROTECT OUR KIDS References The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon 1. Office of the Surgeon General. General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. https://www.surgeongeneral.gov/library/reports/50 - years - of - progress/full - report.pdf . 2. Office of the Surgeon General. E - cigarette Use among Youth and Young Adults: A Rep ort of the Surgeon General. Washington, DC: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2016. htt ps://www.cdc.gov/tobacco/data_statistics/sgr/e - cigarettes/pdfs/2016_sgr_entire_report_508.pdf . 3. Wang TW, Gentzke A, Sharapova S , et al. Tobacco Use Among Middle and High School Students - United States, 2011 - 3 201 7 . MMWR Morbidity and M ortality W eekly R epo rt. 201 8 ;6 7 (2 2 ): 629 - 6 3. 4. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the Field: Increase in use of electronic – - 2018. MMWR cigarettes and any tobacco product among middle and high school students United States, 2011 2018 - 1277 . Morbidity & Mortality Weekly Report ; 67(45):1276 5. - 17 Years, 2013 - 2014. Ambrose BK, Day HR, Rostron B, et al. Flavored Tobacco Product Use Among US Youth Aged 12 Jama. 2015;314(17):1871 - 1873. 6. Trivers KF, Phillips E, Gentzke AS, Tynan MA , Neff LJ. Prevalence of Cannabis Use in Electronic Cigarettes Among US Youth. JAMA pediatrics. 2018 ;172(11):1097 - 1099. 7. - Cigarettes. National Academies of Sciences, Engineering, and Medicine. 2018. Public Health Consequences of E onal Academies Press. https://doi.org/10.17226/24952 Washington, DC: The Nati . 8. Ramamurthi D, Chau C, Jackler RK. JUUL and other stealth vaporisers: hiding the habit from parents and teachers. Tob Control. 2018. Epub ahead of print. doi: 10.1136/tobaccocontrol - 2018 - 054455. 9. Ki ng BA, Gammon DG, Marynak KL, Rogers T. Electronic Cigarette Sales in the United States, 2013 - 2017. Jama. - 1380. 2018;320(13):1379 3

4 Tob 10. Willett JG, Bennett M, Hair EC, et al. Recognition, use and perceptions of JUUL among youth and young adults. 2018. Epub ahead of print. doi: 10.1136/tobaccocontrol - Control. - 054273. 2018 11. Truth Initiative. JUUL e - cigarettes gain popularity among youth, but awareness of nicotine presence remains low. . youth https://truthinitiative.org/news/juul - e - cigarettes - gain - popularity - among - Preventing tobacco use among youth and young adults. 12. US Department of Health and Human Services. Atlanta, GA: US Department of Health and Human Services, CDC;2012. . https://www.cdc.gov/tobacco/data_statistics/sgr/2012/index.htm 4

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