Experts, advocates emphasize teen vaping dangers

At the end of a community forum on tobacco use held Tuesday evening at the Oakland Coliseum, a young poet named Latasha Sixfoota stepped to the podium and read a powerful spoken-word piece addressed to tobacco industry CEOs.

“Thank you for taking my mother away from me. Thank you for diminishing her time with me,” she said. “Though you did not physically kill her, you killed my time with her.”

The forum, held at the Coliseum’s East Side Club and hosted by the American Cancer Society Cancer Action Network, an organization that helps fund cancer research and tobacco control legislation, featured a four-person, all-female panel. The event, called “The Tobacco Industry Has a Kids Menu,” included an advocate from Parents Against Vaping E-Cigarettes (PAVe), a founder of an online tobacco prevention resource, and one of the founding members of the African-American Tobacco Control Leadership Council. The event was hosted by Andre Senior, a reporter and anchor at KTVU Fox 2. 

While Sixfoota’s words spoke to the pain of living with a parent’s tobacco addiction (her mother had been a chain smoker for twenty years), the forum’s focus was on arguing that the tobacco industry is enticing younger generations to nicotine addiction through vaping and the use of e-cigarettes.

The main culprit, as far as the forum’s panelists and audience were concerned, was San Francisco-based JUUL, an e-cigarette manufacturer that has come under scrutiny for allegedly marketing its products to young people who would otherwise not be tobacco users. On its website, JUUL states that its products are solely intended to wean adult smokers off of combustible cigarettes.  “As scientists, product designers and engineers, we believe that vaping can have a positive impact when used by smokers, and can have a negative impact when used by nonsmokers,” company officials state on the site.

But Dr. Bonnie Halpern-Felsher, a developmental psychologist at Stanford and one of the panelists, said that e-cigarette manufacturers’ seemingly-innocuous marketing tactics, like the use of playful-sounding names and enticing colors in their products, are contributing to the rapid increase in tobacco use among adolescents.  E-cigarette use increased from 11.7 percent to 20.8 percent among high school students and from 3.3 percent to 4.9 percent among middle school students from 2017 to 2018, according to the Centers for Disease Control and Prevention (CDC).

Referring to the products, Halpern-Flesher said, “They are very similar to candy in their looks, their colors, and in their words. This is also what attracts young people.”

Her research team has found that teenagers and young adults are unlikely to use tobacco without flavors, she said, including traditional flavors like mint and menthol. “There are over 15,500 flavors of e-cigarettes on the market,” said Halpern-Felsher, as some members of the audience gasped in disbelief.  She argued that JUUL’s flavor names—Cool Mint, Mango, and Crème Brûlée—are attractive to young people.

E-cigarettes, which have become increasingly popular in the last decade, are often marketed as a healthier alternative to traditional cigarettes because they neither contain tobacco nor involve combustion. They instead work by inserting flavored e-liquid cartridges into a device shaped like a USB flash drive. Users inhale the vapor. Because they are relatively new, their health effects are still not entirely understood.

A CDC report released last week linked vaping use to a severe and mysterious respiratory disease. The report’s 215 cases, involved otherwise healthy young adults, were connected by the use of vaping products that contained either nicotine or THC, the active ingredient in marijuana.

Panelist Dr. Valerie Yerger, an associate professor of health policy in the Center for Tobacco Control Research & Education at UC San Francisco and a founding member of the African-American Tobacco Control Leadership Council, said she sees the fight against flavored tobacco as a social justice issue. Yerger said that addiction to flavored tobacco can be traced to the normalization of menthol cigarettes among marginalized groups like African-Americans, the LGBTQ community, and low-income people, thanks to aggressive marketing campaigns by the tobacco industry in the 1970s. 

In 2009, the FDA banned the use of flavor additives in cigarettes, except for menthol, which Yerger claims was to appease the tobacco industry and allow it to continue marketing to the African-American community. “Right from the get-go, African-Americans were a bargaining chip,” she said.     

Jasmine Gerraty, a youth tobacco prevention coordinator in Marin County, where, according to a California Healthy Kids Survey, 28 percent of 11^th graders regularly use e-cigarettes, said that students see the signs of vaping culture everywhere.  School bathrooms are referred to as the “JUUL Room,” she said, and in some classrooms, students challenge each other to see who can vape the most without the teacher noticing.  

Gerraty argued that it is crucial that young people take a role as change agents. “They’re angry. They see their friends getting addicted. They’re frustrated. And they want to stop that,” she said. For this reason, students have been instrumental in leading public policy change on vaping and e-cigarettes, she said, although getting school administrators to understand the gravity of youth tobacco addiction can be a challenge. 

Christine Chessen, a spokesperson and advocate with Parents Against Vaping E-Cigarettes (PAVe), and her husband became involved with the organization a little over a year ago after discovering a JUUL device and empty pods in her then-17-year-old son’s backpack. The parents had always talked openly with their kids about alcohol, drugs, cigarette smoking, and making good decisions. But, Chessen said, they were unaware of e-cigarettes until it was too late. “Now we’re paying for him to see a counselor for nicotine addiction,” she said.

Speaking for herself and others within the African-American Tobacco Control Leadership Council, Yerger said she hoped that more young people like Sixfoota will help relay her organization’s message about the dangers of tobacco. “We have the message, but aren’t necessarily the best messengers,” she said.