Cancer prevention advocates push for state laws to curb youth e-cigarette use

Massachusetts State House. (Photo by Aaron Ye/BU News Service)

By Susannah Sudborough
BU News Service

BOSTON — Activists are mounting pressure on the Legislature to do more to prevent youth tobacco use, advocating for legislative strategies that are likely to reduce the youth market.

Cancer patients, survivors and their families lobbied on Beacon Hill late in March for a bill that would create a 75 percent of wholesale excise tax on e-cigarettes, a $1 per pack increase in the tax on cigarettes and an increase in the cigar tax to 80 percent of wholesale cost.

“There’s decades of evidence that shows increasing the price of tobacco gets people to quit and stops kids from starting,” said Marc Hymovitz, Massachusetts government relations director of the American Cancer Society’s Cancer Action Network, an advocacy group leading the lobbying day.

Indeed, the World Health Organization’s Tobacco Free Initiative cites increasing prices on tobacco through taxes as “the single most effective way to encourage tobacco users to quit and prevent children from starting to smoke.”

The biggest change this legislation would enact is the creation of an excise tax on e-cigarettes, something that does not yet exist in Massachusetts. While Gov. Charlie Baker included one in his budget, it was only 40 percent, matching the current excise tax on cigars.

Hymovitz was clear the intention in raising the price of tobacco is not to penalize users. He said this tax would allow adults trying to quit to use e-cigarettes while stopping youth use.

“Kids are price sensitive,” said Hymovitz. “Kids generally aren’t working or are working low paying jobs.”

In the wake of much concern about youth e-cigarette use, advocates say the pieces of legislation they are focused on are largely meant to prevent and reduce use among teens.

“Parents, teachers, and school administrators are clamoring for a solution to this problem,” said Hymovitz. “They’re seeing it in high schools, middle schools, and even elementary schools now.”

According to the Massachusetts Department of Health, in 2017, 20 percent of all Massachusetts high schoolers were using e-cigarettes or other vaping devices, and 41 percent had tried them at some point. Nearly 10 percent of middle schoolers reported having tried e-cigarettes.

At a recent forum at Newton South High School, Massachusetts Attorney General Maura Healey said that vaping is the most frequent concern she hears about from citizens. She said she had heard horror stories from school officials, such as bathrooms being referred to as “JUUL lounges” (a reference to a popular e-cigarette brand JUUL) and high schools confiscating over 200 vaping devices.

Hymovitz and Healey both emphasized that because the product is newer, children, school officials, and parents are often unaware of how dangerous e-cigarettes are. Healey said that one JUUL pod has as much nicotine as a pack of cigarettes, and called the product “highly addictive.” Advocates are also concerned about the effects nicotine can have on the development of young brains.

“We’ve done a great job at educating kids about the dangers of cigarettes,” said Hymovitz. “The number of kids using tobacco has been steadily decreasing until recently with the growing popularity of e-cigarettes.”

According to the Center for Disease Control, the number of high schoolers and middle schoolers who were using cigarettes in 2018 was approximately half what it was in 2011.

Advocates are also supporting a bill that would ban all flavored tobacco products. They say that e-cigarette companies are purposefully creating child-oriented flavors such as Jolly Rancher, popcorn, Sour Patch Kids, mango, bubble gum, cotton candy, whipped cream, and other sweet flavors.

“It’s clear with the flavors that they [e-cigarette companies] are targeting young people and having success with that,” said Sen. John Keenan, D-Quincy, a sponsor of the bill. “The key to prevention is banning these flavors.”

Lena Pires, principal of New Bedford’s Global Learning Charter Public School, said that when she has talked to her students about the dangers of e-cigarettes, the sweet flavors have a major effect on how they view the product.

“They think it can’t be that bad if it smells like cotton candy,” said Pires.

Pires agreed that banning all flavors would be an effective prevention tactic.

“They don’t really want a tobacco smell on them,” said Pires. “But fruity? They think that’s cool.”

In addition to the flavors, advocates say that the design of e-cigarettes like JUUL make them appealing to young people. Healey said that companies make fun sleeves for these products with images such as superheroes on them.

She also pointed out that the shape of the product itself resembles a USB drive, making it difficult for parents and teachers to identify and easy for children to conceal.

Tobacco companies often choose to target young people as customers because research shows that if someone does not begin smoking by age 21 they are unlikely to start, said Hymovitz. He said that the tactics e-cigarette companies are using to target young people now are a repeat of the strategies they used 50 years ago, except that now they are utilizing social media.

Healey said that e-cigarette companies often use cartoons and bright colors, or picture fun and fashionable young people in their ads to target youths. In addition to social media, she said parents have seen e-cigarette ads appear in homework-help apps on their children’s phones and iPads.

Despite the it being illegal for those under 21 to buy tobacco in Massachusetts, Healey said that young people can get ahold of e-cigarettes by buying them online from retailers who do not have a proper age verification system. She said even if they do not have credit or debit cards, they may use cash to purchase pre-paid debit cards.

Some citizens are concerned that these new laws may prevent adults from using e-cigarettes as smoking cessation products. Hymovitz is quick to point out that e-cigarettes are not an FDA- approved smoking cessation technique.

“You can’t be a smoking cessation product if you’re creating a whole generation of addicted kids,” said Hymovitz.

Keenan added that e-cigarette companies may not want their product viewed as a smoking cessation product because this might be less appealing to young people, and that they often market the product as a “smoking alternative.”

Advocates predict that although tobacco companies and retailers will likely stand against these bills, they are likely to find support within the Legislature.

Rep. Paul Schmid, D-Westport, a member of the Legislature’s Committee on Public Health and vice chair of the Committee on Revenue who will receive the excise tax bill, said that many of his colleagues are concerned about the effect of e-cigarettes on young people. He said that a multi-faceted solution to the problem that addresses packaging, placement, and flavors as well as price will be necessary to stopping youth e-cigarette use.

Young people are also speaking out against e-cigarette use. On April 3, students from across Massachusetts gathered at the Statehouse for Kick Butts Day, which Keenan said was more focused on nicotine prevention than cigarette use than in previous years.

“We are working with students on this,” said Keenan. “They are standing up for themselves. They don’t want to be the next generation addicted to nicotine.”

This article was previously published in SouthCoast Today.

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