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ADVANCE Perspective: Respiratory Views

Not Just Blowing Smoke

Published May 6, 2016 1:57 PM by ADVANCE for Respiratory Care & Sleep Medicine

By Tamer Abouras


One of the great fallacies we sometimes entertain is the idea that smoking as a tempting boogeyman — particularly for curious adolescents — is largely a thing of the past, thanks to effective PSAs.


The unfortunate truth of the matter, as we’ve covered in this blog recently, is that all smoking (including e-cigarettes) has remained relatively stable over the past five years among adolescents, and the new trend of “safe” smoking alternatives such as e-cigarettes and vaporizers threaten to drive that in an even worse direction.


While the healthcare system is still dealing with the deluge of patients presenting symptoms of lung cancer and COPD as a result of lifelong smoking habits — and hoping to avoid a similar circumstance with current and future generations of Americans — the FDA this week rolled out a rule extending its authority to all tobacco products, which include e-cigarettes, cigars, hookah tobacco and pipe tobacco, as well as others.


"We have more to do to help protect Americans from the dangers of tobacco and nicotine, especially our youth. As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction," said HHS Secretary Sylvia Burwell. "Today's announcement is an important step in the fight for a tobacco-free generation — it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions."


According to an FDA press release, “Tobacco use is a significant public health threat. In fact, smoking is the leading cause of preventable disease and death in the United States and responsible for 480,000 deaths per year. While there has been a significant decline in the use of traditional cigarettes among youth over the past decade, their use of other tobacco products continues to climb.”

SEE ALSO: Tobacco Use in Adolescents

Along with ADVANCE’s coverage of the stall in smoking cessation among adolescents since 2011, the FDA also reported that alternative forms of smoking — including e-cigarettes and hookah — have spiked.


“A recent survey supported by the FDA and the Centers for Disease Control and Prevention shows current e-cigarette use among high school students has skyrocketed from 1.5% in 2011 to 16% in 2015 (an over 900% increase) and hookah use has risen significantly. In 2015, 3 million middle and high school students were current e-cigarette users and data showed high school boys smoked cigars at about the same rate as cigarettes. Additionally, a joint study by the FDA and the National Institutes of Health shows that in 2013-2014, nearly 80% of current youth tobacco users reported using a flavored tobacco product in the past 30 days — with the availability of appealing flavors consistently cited as a reason for use.”


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"This final rule is a foundational step that enables the FDA to regulate products young people were using at alarming rates, like e-cigarettes, cigars and hookah tobacco, that had gone largely unregulated," said Mitch Zeller, JD, director of the FDA's Center for Tobacco Products. "The agency considered a number of factors in developing the rule and believes our approach is reasonable and balanced. Ultimately our job is to assess what's happening at the population level before figuring out how to use all of the regulatory tools Congress gave the FDA."


The full text of the ruling can be found here.

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