THE UNITED States Food and Drug Administration (US FDA) has proposed new steps to protect the American youth by preventing access to flavored tobacco products and banning menthol in cigarettes.
We mention the initiative because, according to the Oral Cancer Foundation, 50 people will die in the next hour because of tobacco. It cites a 2007 report of the Institute of Medicine that says tobacco kills more Americans annually than AIDS, alcohol, cocaine, heroin, homicides, suicides, car accidents and fires combined. Tobacco is a risk factor for some 25 diseases, including lung, bladder, mouth, pharyngeal, pancreatic, kidney, stomach, laryngeal and esophageal cancer.
In a statement, released November 15, Dr. Scott Gottlieb, Commissioner of the U.S. Food and Drug Administration, said that tobacco use remains the leading cause of preventable death and disease in America. Combustible cigarettes cause the overwhelming majority of tobacco-related disease. When used as intended, they are responsible for the death of half of all long-term users.
Dr. Gottlieb pointed to the “disturbing trend of youth nicotine use.” He added that “historic declines” have been achieved in recent years in the rates of combustible cigarette use among American children.
As a cancer survivor and a physician who cared for hospitalized cancer patients, Dr. Gottlieb said the new policy thrusts “are grounded in hard evidence…they also are deeply personal.”
He said “any policy accommodation to advance the innovations that could present an alternative to smoking – particularly as it relates to e-cigarettes – cannot, and will not, come at the expense of addicting a generation of children to nicotine through these same delivery vehicles. This simply will not happen.”
He said “the data show that kids using e-cigarettes are going to be more likely to try combustible cigarettes later. This is a large pool of future risk.”
The policies he outlined strives to strike a careful public health balance between the opportunities to transition to non-combustible products to be available for adults and to make nicotine products less accessible and less appealing to children.
“The data make unmistakably clear that, if we’re to break the cycle of addiction to nicotine, preventing youth initiation on nicotine is a paramount imperative,” he pointed out.
In the US, almost all adult smokers started smoking when they were children. Nearly 90 percent started smoking before the age of 18, and 95 percent by age 21. Only about 1 percent of cigarette smokers begin at age 26 or older.
Reported e-cigarette use among high school students, which peaked at 16.0 percent in 2015, had decreased to 11.3 percent in 2016 and held steady in 2017.
The US FDA and the US Centers for Disease Control and Prevention has just released data from the 2018 National Youth Tobacco Survey. The nationally representative survey that covers middle and high school students show, Dr. Gottlieb said, “astonishing increases” in kids’ use of e-cigarettes reversing years of favorable trends in America’s fight to prevent youth addiction to tobacco products.
“These data shock my conscience,” he said, pointing out that from 2017 to 2018, there was a 78 percent increase in current e-cigarette use among high school students and a 48 percent increase among middle school students.
The total number of middle and high school students currently using e-cigarettes rose to 3.6 million — that’s 1.5 million more students using these products than the previous year.
Additionally, more than a quarter (27.7 percent) of high school current e-cigarette users are using the product regularly (on 20 or more days in the past month). More than two-thirds (67.8 percent) are using flavored e-cigarettes. Both these numbers have risen significantly since 2017.
“These increases must stop,” Dr. Gottlieb said. “And the bottom line is this: I will not allow a generation of children to become addicted to nicotine through e-cigarettes. We won’t let this pool of kids, a pool of future potential smokers, of future disease and death, to continue to build.”/PN
Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
