EPIDEMIC Nina Gregerson, MPH, MCHES | Health Education Coordinator - PDF document

1/30/2020 REVERSING THE E-CIGARETTE EPIDEMIC Nina Gregerson, MPH, MCHES | Health Education Coordinator Public Health Madison & Dane County The Products The Concerns Industry Targeting The State of Legislation What Can You Do 1

1/30/2020 It doesn’t matter what you call them, they are all e-cigarettes E-Pipes | E-Cigars | Mods | Vape Pens | E-Hookahs | Cigalikes | JUULs | Suorin Next Generation of Discreet 2

1/30/2020 Next Generation of Discreet E-Juice 3

1/30/2020 How do they work? Stanford Medicine’s Tobacco Prevention Toolkit 4

1/30/2020 The Concerns It’s an Aerosol, Not a Vapor Stanford Medicine’s Tobacco Prevention Toolkit 5

1/30/2020 What’s in E -Cig Aerosol? • Benzo(ghi)perylene • Chlorobenzene • Propylene glycol • Cadmium • Acetone • Crotonaldehyde • Glycerin • Silicon • Acrolein • Propionaldehyde • Flavorings (many) • Lithium • Silver • Benzaldehyde • Nicotine • Lead • Nickel • Valeric acid • NNN • Magnesium • Tin • Hexanal • NNK • Manganese • Sodium • Fluorine • NAB • Potassium • Strontium • Anthracene • NAT • Titanium • Barium • Pyrene • Ethylbenzene • Zinc • Aluminum • Acenaphthylene • Benzene • Zirconium • Chromium • Acenapthene • Xylene • Calcium • Boron • Fluoranthene • Toluene • Iron • Copper • Benz(a)anthracene • Acetaldehyde • Sulfur • Selenium • Chrysene • Formaldehyde • Vanadium • Arsenic • Retene • Naphthalene • Cobalt • Nitrosamines, • Benzo(a)pyrene • Styrene • Rubidium • Polycyclic aromatic • Indeno(1,2,3- • Benzo(b)fluoranthene hydrocarbons cd)pyrene Stanford Medicine’s Tobacco Prevention Toolkit E-Juice is Super Toxic 6

1/30/2020 Nicotine + Brain Disrupts Proper Brain Development in Young People Nicotine is one of the most ADDICTIVE drugs that exist! Long Term Effects of E-Cigs 7

1/30/2020 3-7 times as likely to switch to regular cigarettes EVALI: E-cigarette, or Vaping, product use Associated Lung Injury 8

1/30/2020 How are e-cig & JUUL manufacturers reaching young people? 9

1/30/2020 JUUL is MORE addictive 59 mg/ml = extremely high! = 1 JUULpod = 1 pack of cigarettes NOTE : EVERY JUULPOD CONTAINS NICOTINE! Price Starter Kit = $49.95 Suorin = ~$28 1 device + 4 pods Not taxed $0.05 per mL Pack of Cigarettes = ~$7-$10 Cigarette Tax = $2.52 ~$8-$30, depending on nicotine level & amount 4 pack JUUL Pods = $15.95 $0.05 per mL $0.05 per mL 10

1/30/2020 Flavors Stanford Medicine’s Tobacco Prevention Toolkit 45% 9 out 10 Would NOT Wisconsin try e-cigs if Teens they didn’t contain flavors! 11

1/30/2020 “Trendy” Accessories Social Media Presence “ They liked my edgy style and that I appealed to the younger market ” – Christina, paid JUUL influencer Stanford Medicine’s Tobacco Prevention Toolkit 12

1/30/2020 Leading to a new generation hooked? 50% are under 18! 13

1/30/2020 JUUL: Big Tobacco Disguised? Deliver as much nicotine in the most non-invasive way to addict their customers Introduce flavors that attract young people and try to downplay the harms of these flavors The makers of Marlboro cigarettes have invested $12.8 billion in JUUL Labs. Use marketing strategies, such as social media, that are known to attract young people Stanford Medicine’s Tobacco Prevention Toolkit $16 BILLION 73 PERCENT 14

1/30/2020 1 in 5 Wisconsin High School Students are CURRENT e-cig users A 154% increase from 2014 to 2018 Source: 2018 WI Youth Tobacco Survey Wisconsin Middle School Students From 2014 to 2018, there was a 272% increase in current e-cig use Source: 2018 WI Youth Tobacco Survey 15

1/30/2020 What’s the State of Legislation? Concerns: • Only applies to cartridge-based products ; NOT e-juice, disposable products, or open-pod systems • Does not address Menthol flavored products (e-cigs, cigarettes) • Does not address flavored other tobacco products (little cigars/cigarillos, hookah, etc.) It’s Not Comprehensive: • Does not address online sales of e-cigarette products • Does not address advertising or marketing of e-cigarette products 16

1/30/2020 SB 364 & AB 422: Current State Tobacco 21 Legislation SB 118: Tobacco & E- Cigarette Placement AB 491: Prohibiting E- Cigarette Use in Workplaces 17

1/30/2020 Governor Ever’s Proposed Bills to Reverse the E-cig Epidemic • License Electronic Smoking Device Retailers • Makes All Wisconsin Schools Tobacco-Free, including Electronic Smoking Devices • Expands Public Health Authority • Enhances Funding for Local Initiatives, Cessation Efforts, and Public Information What You Can Do 18

1/30/2020 Youth Friendly Lesson Plans Addressing the harms of nicotine & e-cigarette use 19

1/30/2020 Review & Strengthen School Policy Ensure it includes strong & comprehensive e-cigarette language 20

1/30/2020 Help Addicted Youth Quit Implement Alternative to Suspension/Citation prgrams & provide cessation resources 21

1/30/2020 INDEPTH: Alternative to Teen Nicotine Suspension or Citation 22

1/30/2020 Provide Resources to Parents So they can know the products and know how to talk to their teens 23

1/30/2020 Engage YOUTH To promote ANY health messaging throughout the school Include Electronic Cigarettes in Municipal Smoke-Free Air Policies 24

1/30/2020 Get Involved Locally 20 Local Tobacco Free Coalitions or Networks located throughout Wisconsin www.tobwis.org 25

1/30/2020 THANK YOU! NINA GREGERSON, MPH, MCHES Public Health Madison & Dane County ngregerson@publichealthmdc.com 608.243.0434 26