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E-cigarette warnings to arrive in high school bathrooms nationwide

The US Food and Drug Administration will stage a massive education campaign aimed at the nearly 10.7 million...

Posted: Sep 19, 2018 10:04 AM
Updated: Sep 19, 2018 10:04 AM

The US Food and Drug Administration will stage a massive education campaign aimed at the nearly 10.7 million teens at risk for e-cigarette use and potential addiction, the agency said Tuesday.

For the first time, the agency will take the message that vaping is dangerous into high school bathrooms and social media feeds of those at-risk youth to stop what the FDA calls an epidemic of e-cigarette use by minors.

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The trend was flagged in a 2016 report from the US surgeon general, which cited a 900% increase in e-cigarette use by high school students between 2011 to 2015.

More than 2 million middle and high school students used e-cigarettes in 2017, the FDA said.

"We're in possession of data that shows a disturbingly sharp rise in the number of teens using e-cigarettes in just the last year," FDA Commissioner Dr. Scott Gottlieb said. "In short, there's no good news."

While applauding the FDA's move, Linda Richter, director of policy research and analysis for the nonprofit Center on Addiction, said that if the agency had taken action when the trend was first identified, "we probably could have avoided the surge in the use of child-friendly, high-dose nicotine products that we're now seeing among kids as young as 12 years old."

"Today's teens were on the cusp of being the first generation to broadly reject cigarette smoking but instead have become hooked on nicotine due to a decade of lax oversight over e-cigarette products," she added.

The dangers of e-cigarettes

E-cigarettes work by heating a pure liquid called e-juice -- composed of flavorings, propylene glycol, glycerin and often nicotine -- until it vaporizes. Popular flavors like tutti frutti, cotton candy and sour gummy worms have attracted younger users to e-cigarettes, which now often look like USB devices that are easy to hide and use without detection.

Recent studies have shown that e-cigarettes are a direct gateway to traditional cigarettes and have a number of health issues beside the addictive properties of nicotine. A study in the journal Pediatrics, for example, found five cancer-causing toxins in the urine of 16-year-olds who inhaled e-cigarette vapor.

"No youth should ever use e-cigs," Surgeon General Dr. Jerome Adams said in a video during Tuesday's announcement. "We must make it crystal clear that e-cigarette use can expose them to dangerous chemicals that can cause lung damage when inhaled."

Bathrooms are a first for FDA

The new campaign is an extension of the The Real Cost Youth E-Cigarette Prevention Campaign, which the FDA says is a nearly $60 million effort funded by fees from the tobacco industry.

The campaign will launch on digital sites and social media platforms popular with young people, such as YouTube, Facebook and Spotify, with videos that show disturbing pictures of damaged lungs and zombie-like students with vaping products glued to their mouths.

In addition, the campaign will place posters in the bathrooms of at least 10,000 high schools across the country, the first time the FDA has placed ads in bathrooms.

"For the first time ever, we are bringing the campaign into high schools to the point of contact where they are doing the behavior," said Kathy Crosby, who directs the Office of Health Communication and Education at the FDA's Center for Tobacco Products.

In addition, she said, the ads will be on school education platforms such as where teens check their grades or sports scores.

"Flavored vape juice may not be as sweet as it sounds," one video says as the strawberries on the screen rot into dry fungus.

"Strangely enough, some students come in here to put crap into their bodies," one bathroom poster reads.

The need for this aggressive approach, Center for Tobacco Products Director Mitch Zeller said, is due to the fact that while young people may never consider smoking a cigarette, "about 80% of youth see no problem in the use of e-cigarettes."

More startling, Crosby added, is that use is growing because teens are encouraging their friends to use e-cigarettes, a behavior officials have not seen for years with tobacco products.

The campaign used focus-group testing with young people to maximize the impact of the ads, Zeller said. The testing found that highlighting specific health messages such as chemicals and dangers was more effective than a general message that vaping is bad.

"Vaping can put dangerous chemicals, like diacetyl, into your lungs," one poster says.

"Vaping can deliver nicotine to your brain, reprogramming you to crave more and more," another reads.

"The stalls may have #1 and #2," another bathroom poster says, "but vapes may have #24, #28, and #82." The small print beneath explains, "Vapers can inhale toxic metals into their lungs -- like these from the periodic table: chromium, nickel, and lead."

Richter said it might be more effective "if the target audience included kids younger than 12, since many 12-year-olds already are vaping," adding that the message should also be presented by trusted teachers and other peer and adult role models.

Matthew Myers, president of the nonprofit Campaign for Tobacco-Free Kids, said, "I think the ad campaign is extraordinarily positive and courageous for the federal government, and it will make some difference. But the vaping industry has used a deadly marketing campaign combining kid-enticing flavors and marketing on social media that has also been very effective.

"Voluntary action by companies has never been a solution," he added, "and the FDA must prohibit their social media marketing and crack down on the use of flavors."

Gottlieb pledged Tuesday to do more, referencing warning letters sent last week to more than 1,300 retailers that illegally sold Juul and other e-cigarettes to minors.

At that time, the FDA also gave e-cigarette manufacturers 60 days to show how they'll keep the devices out of the hands of young people or face regulatory action.

"I am meeting with largest manufacturers myself, and I won't stop until this problem is solved," Gottlieb said. "It may be the most important thing I do in my time as commissioner."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 292811

Reported Deaths: 6613
CountyCasesDeaths
DeSoto19515228
Hinds18611385
Harrison16431275
Rankin12543261
Jackson12419216
Lee9641160
Madison9378194
Jones7857145
Forrest7094136
Lauderdale6760225
Lowndes5998137
Lamar581180
Lafayette5698113
Washington5135128
Bolivar4580120
Oktibbeha438691
Panola424992
Warren4101113
Pearl River4083128
Pontotoc406668
Marshall398392
Monroe3977126
Union392173
Neshoba3758166
Lincoln3447100
Hancock338673
Leflore3349118
Sunflower316685
Tate299874
Pike298293
Scott291867
Alcorn289660
Itawamba288571
Yazoo283262
Tippah275465
Copiah273957
Coahoma272666
Simpson270778
Prentiss267658
Leake251370
Wayne250540
Marion249878
Covington247178
Grenada244676
Adams232877
George229845
Newton223151
Winston220274
Tishomingo211465
Jasper211244
Attala205969
Chickasaw200550
Holmes181470
Clay177848
Stone171129
Tallahatchie169239
Clarke168271
Calhoun155527
Smith151531
Yalobusha142236
Greene126533
Walthall123340
Noxubee122629
Perry120934
Montgomery120537
Lawrence119021
Carroll117223
Amite110732
Webster109229
Jefferson Davis99931
Tunica98023
Claiborne97329
Benton92524
Humphreys91326
Kemper89422
Quitman76614
Franklin75419
Choctaw69416
Wilkinson62226
Jefferson61027
Sharkey48817
Issaquena1676
Unassigned00

Alabama Coronavirus Cases

Cases: 490220

Reported Deaths: 9744
CountyCasesDeaths
Jefferson704661342
Mobile35810721
Madison32203443
Tuscaloosa23961409
Montgomery22417489
Shelby21773211
Baldwin19635272
Lee14883147
Morgan13571248
Etowah13118312
Calhoun13090283
Marshall11212203
Houston10036257
Limestone9321133
Elmore9313179
Cullman8864177
St. Clair8771220
Lauderdale8570210
DeKalb8419173
Talladega7450162
Walker6492249
Jackson6466102
Autauga617285
Blount6072125
Colbert5978118
Coffee5229100
Dale4614106
Russell401431
Franklin397675
Covington3948105
Chilton383196
Escambia376670
Tallapoosa3559139
Clarke342749
Dallas3396140
Chambers3393103
Pike292771
Lawrence281284
Marion280793
Winston245665
Bibb243759
Marengo238554
Geneva238468
Pickens223554
Barbour209550
Hale208464
Fayette199356
Butler195165
Henry182341
Cherokee176338
Monroe165638
Randolph162740
Washington156233
Crenshaw143353
Clay143254
Macon140543
Cleburne136539
Lamar131632
Lowndes130148
Wilcox120825
Bullock116534
Conecuh106523
Perry105327
Sumter98231
Coosa86823
Greene86732
Choctaw54723
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