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Hundreds of Youth Urge Minnesota Lawmakers to Tackle Tobacco Addiction

Nearly 400 youth and adult advocates from across Minnesota rallied on February 27 at the State Capitol to urge lawmakers to address tobacco addiction and “Keep Lungs Loud.” Minnesotans for a Smoke-Free Generation, a coalition of more than 60 organizations that share a common goal of saving Minnesota youth from a lifetime of addiction to tobacco, brought together residents from all across Minnesota during their annual Day at the Capitol. The activists included young students, parents, educators, physicians and other citizens concerned about commercial tobacco use.

Since last year’s Day at the Capitol, 18 Minnesota communities have passed local Tobacco 21 policies. Minnesota now has 23 cities and counties with Tobacco 21 ordinances, covering more than 22 percent of Minnesota’s population. Many locals who advocated for these lifesaving policies were present and honored at this year’s event.

“Today’s Minnesotans for a Smoke-Free Generation Day at the Capitol is a reminder that tobacco addiction affects people all across Minnesota, in every stage of life and every single community,” said Molly Moilanen, Vice President at ClearWay MinnesotaSM and Co-Chair of Minnesotans for a Smoke-Free Generation. “Today also reminds us of the lifesaving progress we can make together through bold state and local policies. Let’s work together to tackle tobacco addiction from all angles, by passing Tobacco 21, funding quit-smoking help and strengthening our clean indoor air law.”

Following the rally, advocates met with legislators and encouraged them to prioritize tobacco prevention this session. The coalition supports three bipartisan bills that will help Minnesota save lives and money. The proposals would strengthen the state’s clean indoor air law, provide quit-smoking help for all residents, and raise the tobacco age to 21. Several lead authors of these bills joined grassroots supporters at the rally.

Grassroots supporters from the Minnesotans for a Smoke-Free Generation coalition urged lawmakers to quickly pass these three bills. Yesterday, the Tobacco 21 bill (SF463/HF331) advanced in both houses, passing out of the House Commerce Committee and Senate Health and Human Services Policy and Finance Committee. The bill to keep indoor air clean (SF462/HF349) also advanced yesterday through the House Commerce Committee, but has not been heard yet in the Senate.

House Committee Hears Two Tobacco Funding Bills

Separately, today the House Health and Human Service Finance Committee heard two bills to fund tobacco prevention and cessation. Committee members held over both bills for potential inclusion in their HHS budget.

The first bill, HF350/SF461, provides funding for Tobacco Cessation Services. QUITPLAN® Services, the state’s free quit-smoking program, is ending in 2020. Lawmakers must fund quit-smoking resources this year so there is no gap in help for Minnesotans who are trying to quit tobacco. If Minnesota does not fund a statewide service, it will become the only state in the nation not providing one.

The second proposal, HF1058/SF1029, states that if Minnesota is successful in recouping tobacco settlement fees from delinquent cigarette brands, a portion must be dedicated to health. Specifically, approximately $12 million a year of those settlement fees would be used for tobacco prevention and control. Since 2015, several cigarette brands have not been paying their required share of settlement fees to the state of Minnesota. Tobacco companies agreed to pay these fees in perpetuity as part of 1998 Minnesota Tobacco Settlement.

“Every year, Big Tobacco causes new addictions, death and disease throughout Minnesota,” Moilanen said. “The tobacco settlement was reached in part to compensate the state for the tremendous harms of tobacco use. These cigarette companies have shirked this responsibility by refusing to pay their fair share of the settlement fees. If that wrong is righted, the best way for Minnesota to use the money is to address tobacco’s harm and help prevent the next generation of tobacco addiction.”

Tobacco use remains Minnesota’s leading cause of preventable death and disease, costing an estimated $7 billion annually and taking the lives of more than 6,300 Minnesotans every year. Smoking rates in Minnesota had been declining for decades, but the adult cigarette smoking rate has stalled out at 14 percent, and for the first time in a generation youth tobacco use has increased. In particular, the surging use of e-cigarettes is threatening the health of Minnesota teens, driving an increase in youth tobacco use that the U.S. Surgeon General has called an epidemic.

Cancer advocates say tobacco bill is flawed, encourage lawmakers to vote no

SALT LAKE CITY — A bill to incrementally raise the age for tobacco products, including electronic cigarettes, to 21 passed through the Utah Legislature Wednesday with a 15-12 vote in the Senate and a 55-16 concurrence vote in the House.

HB324, sponsored by Rep. Steve Eliason, R-Sandy, changes the age from 19 to 20 on July 1, 2020, and to 21 one year later. The bill raises the age for “obtaining, possessing, using, providing, or furnishing of tobacco products, paraphernalia, and under certain circumstances, electronic cigarettes.”

Arguments around this bill has centered on the debate of preemption, with cancer advocates speaking against an early version of the bill. The bill that passed made only one amendment to preemption language in current code, adding the minimum age of sale to what cannot be modified by cities and counties.

Sen. Curt Bramble, R-Provo, the Senate sponsor of the bill, said this compromise would allow cities that have already raised the age for sale of tobacco, including Lehi and Cedar Hills, to keep the age at 21 instead of following the incremental age increase in the state.

She said addiction should not be shamed or criminalized, especially for youth. If youth get in trouble while they are building who they are as a person, they could define themselves as thugs or criminals.

“This is not about smokers, this is about protecting youth from having access to these addictive materials that the tobacco industry is pushing,” Tischler said.

According to Tischler, 800 youth in Utah each year become daily smokers, and vaping is especially a problem for youth because they have more access to it and it’s easier to hide from parents.

Jordan Osborne was part of an anti-tobacco youth group in Utah County and helped change laws to make parks tobacco free. But when he was 18, a friend a few years older bought him a vape pen and he became a smoker. He still vapes and occasionally smokes cigarettes. He said he doesn’t feel like he is addicted, but he gets aggravated when he hasn’t smoked.

“If they had the smoking age at 21 back then it would have made it even harder for me to even get (tobacco),” Osborne said.

He said if he had never started using tobacco he would be a lot healthier and wouldn’t have to have something to help him relax.

Cedar Hills and Lehi both passed ordinances in the last few weeks raising the age to buy tobacco to 21. But opponents to HB324 say language in the bill could stop other cities from making changes to local tobacco laws.

Vaping isn’t working at cessation; it is working at hooking our teens

When electronic cigarettes first came on the market, we hoped they might help reduce the tremendous harm caused by tobacco cigarettes. If smokers inhaled a vapor containing nicotine, flavorings and other additives rather than the multitude of cancer-causing chemicals in tobacco smoke, there might be some benefit.

While some adults have used e-cigarettes to wean themselves from tobacco, research indicates that e-cigarettes are really just another nicotine delivery device with its own unique hazards that addict users to nicotine. This is especially concerning for teens and young adults who are using e-cigarettes with alarming frequency.

One recent study did suggest that e-cigarettes helped adults stop smoking. However, those who quit tobacco continued to consume e-cigarettes and nicotine a year later. More common appears to be the experience of smokers studied by Dr. Russell Bowler, a professor of medicine at National Jewish Health. He found that most of the tobacco smokers who started using e-cigarettes in hopes of quitting tobacco continued to smoke tobacco at similar or higher levels five years later. Former smokers who began using e-cigarettes were more than 16 times as likely to resume tobacco smoking.

Additional research at National Jewish Health has shown that, while less harmful than tobacco smoke, e-cigarette vapor itself is harmful. It injures cells lining the airways and blood vessels in the lungs, and increases susceptibility to respiratory viruses.

E-cigarette use, or vaping, by teens and young adults is especially worrisome. After decades of decline, the consumption of tobacco products has taken a U-turn and begun a precipitous climb. Vaping among middle and high school students increased 900 percent from 2011 to 2015 and nearly doubled in just the last year.

Today, one in 20 middle schoolers and one in five high school students use e-cigarettes. College students and young adults vape at similar or even greater rates.

Research has shown that youth who try an e-cigarette are more likely to begin smoking tobacco. The Surgeon General and the Food and Drug Administration have both called e-cigarette use by teens and young adults a serious public health threat.

Nicotine in e-cigarettes poses unique threats to young users’ health. Adolescence is an important period of brain development when learning capacity, decision making, working memory, reward processing and emotional regulation all grow and mature. Nicotine use during adolescence profoundly alters this process, priming the brain for future addictions and increasing the risk of mood disorders, intellectual problems and impulsiveness.

E-cigarettes have become immensely popular, fueled by flavors and marketing targeted at young people. Peer pressure to vape is bearing down on those who don’t. Many don’t even realize they are vaping nicotine and mistakenly believe they are inhaling simple water vapor. Teenage brains are especially susceptible to nicotine’s addictive and rewarding effects, yet many fail to recognize the threat e-cigarettes pose to long-term mental and physical health.

After decades of fighting to reduce harm from tobacco, it is astounding that a new generation faces a renewed threat from tobacco. We must help young people avoid nicotine and quit e-cigarettes. Teens can call the Colorado QuitLine (1-800-QUIT-NOW), which recently lowered the age of eligibility for services to 12.

As the operator of the Colorado and many other state quitlines for 17 years, National Jewish Health has extensive experience treating nicotine addiction with personalized plans to avoid nicotine, navigate peer pressure and manage nicotine withdrawal. At the same time, the FDA must tighten regulation of e-cigarettes and follow through on promises to close down manufacturers who don’t meaningfully limit youth access to e-cigarettes.

JUUL, the dominant company in the market, must follow through on its action plan to cease marketing to youth and limit their access to its products.

We urge Colorado legislators to pass the recently introduced bill to raise the age for legal purchase of e-cigarettes.

Together, we can protect our youth from the dangers of e-cigarettes and vaping.

Dr. Michael Salem is president and CEO of National Jewish Health. Thomas Ylioja, PhD, is an assistant professor of medicine and clinical director of health initiatives at National Jewish Health.

Lehi becomes first Utah city to raise legal tobacco age to 21. It may not be the last.

The Salt Lake Tribune:

Lehi • The City Council here approved raising the legal age for tobacco to 21 in what is a first in Utah, where state law allows 19-year-olds to purchase and possess tobacco products.

The new ordinance, approved unanimously Tuesday night, also applies to e-cigarettes. It will take effect 20 days after it is signed and posted.

Ryan Bartlett, spokesman for the state Health Department’s Tobacco Prevention and Control Program, said he would love to see other Utah cities follow suit. “I know there are a few looking at it right now.”

Bartlett said there are 425 cities and counties in 23 states that have adopted 21 as the minimum age for tobacco.

In neighboring Colorado, the towns of Aspen, Basalt and Avon passed their own Tobacco 21 policies, one after another, starting in 2017.

Bartlett said he has noticed that when a city passes a Tobacco 21 policy, other grass-roots movements tend to pop up in other localities and municipalities soon after.

Tobacco 21 laws can legally trump Utah law because there is no pre-emptive language blocking political subdivisions from passing more restrictive rules, Bartlett said. Cities, however, can’t set the legal age below 19.

Hawaii is one of six states that have implemented Tobacco 21 policies and was the first to do so in 2016. Bartlett said Oregon, California, Massachusetts, New Jersey and Maine adopted similar statutes in subsequent years.

Just last week, Richard Creagan, a Hawaii representative, introduced a bill proposing to raise the minimum age for tobacco in his state to 100 by 2024.

Utah’s law has set the minimum age at 19 since 1963. But for a half-century before that, tobacco buyers had to be 21 or older, according to Bartlett. Before 1911, the legal age was 18.

Localities and states that pass Tobacco 21 measures do ultimately restrict young people’s access to cigarettes and other tobacco products — an important feat, Bartlett said, as research shows the younger someone starts tobacco use, the more likely he or she is to become hooked.

How pervasive is teen vaping? Students at this local high school formed an addiction support group

“ORANGE, Ohio — Ahmed Abouelsoud “hit a Juul” last year when a friend offered it to him. He was hooked from the start.

You may not be familiar with the lingo here. “Hitting a Juul” meansinhaling nicotine-laced, flavored vapor from a vaping device made by a company called Juul Labs. The device looks like a computer thumb drive. It’s easy to conceal. And it’s the vaping device of choice for many teens, available at the corner gas station, for sale to 18-year-olds who then sell them to younger friends.

Ahmed is hardly alone. Vaping, according to Dr. Scott Gottleib, commissioner of the U.S. Food and Drug Administration, is now epidemic among teens.

“I’ve seen it everywhere,” said Edie Ungar-Shafron, the psychologist at Orange High School, where Ahmed is a senior. “It’s pervasive.”

It is everywhere, said Ahmed: “All of my friends and everyone I see and everyone at any social event all have jewels. Everyone our age.”

Ahmed would never consider lighting up a cigarette. They’re nasty, he said. But he loved the feeling when he hit the Juul. The soothing vapor, the mint flavor, the high.

“When I actually started being able to breathe in the smoke and get a buzz, I, like, loved it. It was something unlike I’ve ever done before because I’ve never smoked or done anything,” he said.

And like many teens, he found himself addicted, blowing money on the replacement “pods” and sneaking off to vape in secret at school. When he resolved to quite, he threw his Juul from the balcony of his high-rise apartment. A short time later, having turned 18 and of legal age to purchase, he simply bought another one.

I’ve been trying to quit for I don’t even know how long but I’ve never been able to set my mind to it ‘til recently,” he said. “I’ve been trying to do it, but I always end up, like, setting myself back and hitting it again.”

What changed recently was that Ahmed joined a weekly vaping addiction support group at Orange High School and began sharing his successes and setbacks with fellow students trying to kick the vaping habit.

It’s a surreal experience seeing high school students as young as 15 gather in a small conference room to share addiction stories as if they’re at a 12-step meeting. Vaping has become that pervasive.

Juul says it targets smokers, that vaping is a healthier alternative and perhaps a way to quit. Young people provide evidence that there’s another market, the kind who go for mango and mint flavors. The kind who, like smokers of their parents’ generation, just can’t quit.

And it turns out the path to recovery may lie with the teens themselves.

The Orange High School program, called ABC, (For About Change), was the brainchild of Senior Mark Pristash, 18, who was the first to open up to school Ungar-Shafron about his addiction.

“After multiple times of trying to quit by myself, I just didn’t know what to do. I didn’t think it was possible. I just thought I was way too addicted,” he said.

He and the school psychologist walked the school track and talked about coping strategies, about how the first three days are the hardest, about the dangers to Pristash’s brain posed by Juuling. “Their brains are under construction and they can’t handle it. It’s such a horrible chemical,” she said.

The sessions motivated him. Months ago, he quit. And then he looked to help the legions of other kids attached to their Juuls.

“Once I got through it, I knew it was possible, and I just wanted to give other students the opportunity to learn how to quit something if they’re going through the same thing that I was going through,” he said.

So he brought a friend, and then another, and then he and Ungar-Shafron, along with Jessica Venditti, a social worker assigned to the school from the Bellfaire JCB social service agency, created the ABC support group. Students meet on Thursdays — no administration or other teachers allowed.

Venditti said students tell her that being suspended doesn’t help. It just gives them more time at home to vape.

The administration of the school is on board. Students caught vaping at school still face punishment, but the hope is they’d get help before they get in trouble. And those caught with devices are referred to Venditti.

“It’s a way that we can get the problem addressed without hammering the students with being out of school and, obviously, the more you’re out of school, the more your academics are affected,” said Assistant Principal Steve Hardaway.

The ABC group wrote a grant proposal and got $500 from the PTA for treats and gadgets to occupy fidgety hands. In their sessions, they learn facts about addiction, eat Ungar-Shafron’s homemade brownies, plates of assorted cheeses and plenty of fresh fruit. And they share what they’re going through.

Abouelsoud laid it bare during one session, after several students talked about how well their recovery was going.. He’d had a good stretch of avoiding the Juul, then got tempted (“because everyone is doing it and it’s all around you”) and was back at it again. He said he hoped to get another new vape-free streak going.

“Peer to peer is so much more impactful than them hearing it from us,” said Venditti, who noted that Ahmed’s situation is one all of the vaping students will face.

“They’re going to have to commit themselves over and over and over again to their goal, even if they’ve been successful or for a period of time. They’re going to walk into a social setting and be faced with a choice. And so they have to keep working at it,” she said.

It’s amazing to see these young people working at it, and daunting when you consider the small size of the group — maybe two dozen kids — relative to the size of the student body, north of 700.

Parents, there’s a good chance your child is Juuling, or has close friends — tempting friends — who do. It would be great if every school started a peer-to-peer group like Orange did. But even without it, an honest conversation with your child and some old-fashioned parental snooping is in order. This isn’t about imposing authority, this is about protecting the health of our kids.

“We had been talking about it and for years he said. ‘It’s stupid. Anybody that does that is stupid. I don’t know why anyone would do that.’,” said Laura Kochis, whose son, Jared, a 17-year-old junior is in the group. “And then I found it in his room.”

Jared said he hasn’t vaped since November after struggling to quit, and blowing his savings, over the summer. He told his mom he’d quit long before he really had.