With as many as 80% of teens 1 not perceiving cigarettes dropped to - PDF document

TACKLING A THREAT TO TEENS PREVENTING TEENS FROM USING E-CIGARETTES Kathy Crosby Director, Office of Health Communication & Education FDA Center for Tobacco Products May 15, 2019 This information is not a formal dissemination of information by FDA/CTP and does not represent Agency position or policy. CENTER FOR TOBACCO PRODUCTS 1 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products A NEW THREAT HAS EMERGED MORE TEENS ARE AT RISK NOW THE UNIVERSE OF AT-RISK TEENS TODAY • There are approximately 25 million teens in the U.S. 2 25M Teens • In 2017, teens at risk for or already smoking (aged 12-17 years) With as many as 80% of teens 1 not perceiving cigarettes dropped to 8.7 million teens 3 10.7M • However, FDA estimates nearly 10.7 million great risk of harm from regular e-cigarette use, youth 3 are at risk for or already experimenting with e-cigarettes we are likely looking at a larger target than • Even if there’s 100% overlap, there are millions more youth at risk for e-cigarettes than for with combustibles alone cigarettes alone 8.7 ??? • Science indicates that teens who vape are more likely to start smoking cigarettes 4 – will formerly non- susceptible teens transition to a deadly product? 1 MTF 2017; average of responses of 8 th , 10 th , 12 th graders 2 U.S. Census Bureau 2016; 3 NYTS 2017; 4 NASEM 2018 2 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 3 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products TEENS UNDERSTAND RISKY BEHAVIORS, BUT DON’T SEE USING LEARNING FROM HUNDREDS OF TEENS AT RISK FOR E-CIGARETTES E-CIGARETTES AS RISKY They have limited knowledge about e ve limited knowledge about e c e-cigarettes e- They are They are and need more information Academically Aspirational Driven They believe they are smart enough to make They believe they are smart enough to make good decisions based on a spectrum of risk They are They are They compare e They compare e e-cigarettes to other substances e- ci c igarettes to other substances Popular Athletic with vaping seen as being among the lowest risk k 1 and Social 1 MTF 2017; average of responses of 8 th , 10 th , 12 th graders 4 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 5 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products

“THE REAL COST” YOUTH E -CIGARETTE PREVENTION RESEARCH FINDINGS • Six creative concepts were tested quantitatively and one was produced for launch Snap teens out • “Epidemic” was then copy tested with 300 youth of their “cost - free” – “Epidemic” had a Perceived Effectiveness (PE) score of 4.17 out of 5.0 17 – Youth clearly understood the main message of the ad and the ad performed well on other mentality by sharing performance measures information about the – Findings indicate a significant opportunity to increase teen’s knowledge about health effects potential impact that e-cigarette use can have on their health 17 FDA 2018, unpublished data 6 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 7 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products FDA LAUNCHED “EPIDEMIC” ON SEPTEMBER 17, 2018 CREATIVE EXTENSIONS: WEB, SOCIAL, DIGITAL ADS & POSTERS 8 M May 15, 2019 | Youth Tobacco Cessation Workshop 15 2019 | Y th T b C ti W k h C Center for Tobacco Products t f T b P 9 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products MESSAGING ON THE POTENTIAL RISKS OF “VAPING” MESSAGING ON THE POTENTIAL RISKS OF “VAPING” E-cigarettes can be very addictive Nicotine negatively effects the developing brain • Nicotine is the highly addictive drug found in cigarettes and other tobacco products 6 • Nicotine can rewire the brain to crave more nicotine, particularly because adolescent brains are still developing 6 • One JUUL pod contains as much nicotine as a pack of 20 regular cigarettes 7-9 • Nicotine exposure during adolescence may have long-lasting effects such as increased • Ten puffs of JUUL can deliver the same amount of nicotine as smoking a cigarette 9 impulsivity and mood disorders 11,12 • Teens who vape may end up addicted to nicotine faster than teens who smoke because • Nicotine exposure during adolescence may have long-term effects on parts of the brain vapes may be used more frequently 7-10 responsible for addiction, learning, and memory 13-19 • Nicotine exposure during adolescence affects brain functions important for reward processing, which makes it easier for youth to become addicted to nicotine 20,21 6 USDHHS 2010; 11 USDHHS 2016; 12 England et al. 2017; 13 Ehlinger et al. 2016; 14 McDonald et al. 2007; 15 Smith et al. 2015; 16 Xu et al. 2003; 17 Bergstrom et al. 2010; 6 USDHHS 2010; 7 Wynn et al 2018; 8 PAX Labs, Inc. 2015; 9 Jackler & Ramamurthi 2019; 10 Ramamurthi et al. 2018 18 Adermark et al. 2015; 19 Lee et al. 2015; 20 Trauth et al. 2001; 21 Placzek et al. 2016 10 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 11 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products

MESSAGING ON THE POTENTIAL RISKS OF “VAPING” PAID MEDIA PLAN Chemicals in e-cigarette aerosol can harm the body • ‘The Real Cost’ Youth E -Cigarette Prevention Campaign is currently hyper-targeting the media to reach 12- to 17-year-olds on digital and social channels • Vaping can expose your lungs to acrolein , which can cause irreversible damage 22-25 • Nearly 700 Million teen impressions (eyes on messaging) in the first 8 months • Vaping can expose your lungs to diacetyl , a chemical that has been linked to irreversible lung disease 26 • New ads will start running on TV this summer • Vaping can expose your lungs to toxic metal particles like chromium, nickel and lead 27,28 • Vaping can release dangerous chemicals into your bloodstream, like formaldehyde , which is known to cause cancer 23,29 22 Goniewicz et al. 2014; 23 Cheng 2014; 24 OSHA 2018; 25 Bein & Leikauf 2011; 26 Allen et al. 2016; 27 Williams et al. 2013; 28 Olmedo et al. 2018; 29 Goniewicz et al. 2014 12 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 13 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 13 YOUTH E-CIGARETTE PREVENTION IN SCHOOLS TEENS ENGAGEMENT SINCE LAUNCH • Posters mailed to all 37,000 U.S. high schools Total Likes: Total Shares: Total Comments: • Partnership with Students Against Destructive 391,717 41,393 23,531 Decisions (SADD) to increase reach and impact • Collaboration with Scholastic to bring lesson plans, infographics, and scientific facts to more than 700,000 teachers and administrators nationally Teens think that Teens think Teens ask Teens don’t • http://www.scholastic.com/youthvapingrisks/ believe that vapes non-nicotine vaping is safer for help with are harmful vapes are safe than smoking quitting 50% 20% 20% 10% May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 15 May 15, 2019 | Youth Tobacco Cessation Workshop Center for Tobacco Products 14 TEENS NOW UNDERSTAND THEY ARE ADDICTED THEMES SURROUNDING QUITTING E-CIGARETTES October 25, 2018 | FDLI Center for Tobacco Products 17 17 7 May 15, 2019 | May 15 May 15, 2019 | Youth Tobacco Cessation Workshop 2019 | Youth To Youth Tobacco Ce bacco Cessation ssation Workshop Workshop Center for Tobacco Products Center Center Center f C C t t for T for T b for T f T T obacco obacco obacco Prod Prod Prod d d 16