Author: Michelle Villar

08 Jul ACE Project Presents At M-DCPS Summer Training Sessions

In early June, the ACE Project team was invited to present at the Miami-Dade County Public Schools (M-DCPS) Summer Heat, a professional learning program for teachers and counselors that offers multiple sessions over the course of a week. Specific sessions and speakers are chosen to “offer teachers and counselors the tools, learning opportunities, and strategies they need to understand and implement excellent teaching and learning every day.” The ACE Project team, in collaboration once again with curriculum support specialist Gladys Duran and alongside fellow FIU colleague Dr. Nicole Fava, provided multiple professional development training for over 35 teachers, counselors, and administrators at Miami Senior High School. Dr. Elisa Trucco presented on the most recent information regarding e-cigarette use among teens while Dr. Fava presented on trauma-informed care. Congratulations to the ACE Project team for turning up the Heat on their ongoing community outreach and for educating teachers across Miami. 

03 Jul ReACH Lab Graduate Student Accepted To T32 Training Program

A big congratulations is due for ReACH Lab Graduate Student Julie Cristello after getting accepted to the T32 Training Program, where she will receive training in three tracks specific to Substance Use Disorders and Co-Occurring Disorders: “Developmental psychopathology/neurobiology and child/adolescent risk factors for substance use, prevention and intervention for adolescent substance use disorders, and dissemination, implementation, and health services practice.” Ms. Cristello was one of only three graduate students chosen from the FIU clinical program for this training fellowship. This program, funded by the National Institute on Drug Abuse, is supported by three FIU institutions: the Center for Children and Families (CCF), the Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), and the Department of Epidemiology. The program places an emphasis on ensuring that the training is “translational (e.g., moving from controlled studies to community-based participatory research), transdisciplinary (e.g., applying research strategies with different models and paradigms), and relevant for diverse populations (e.g., comorbid conditions across populations, including ethnically/racially disadvantaged groups).”

The ReACH Lab is proud of you as always Julie, congratulations on this amazing opportunity!

26 Jun Out With The Old, In With The New: Cigarette Sales Decrease, ENDS Sales Continue To Rise

A recent report by Nielsen using convenience-store data on tobacco products confirmed trends that have been developing in the last few years. As of April 20th, “traditional cigarette industry volume dropped by 8.5%” in a one-month period. For all of 2019, Wells Fargo Securities analyst Bonnie Herzog projects that there will be an almost 5% decline in traditional cigarette sales. In contrast, despite public health efforts encouraged by the Food and Drug Administration (FDA), such as banning some flavors favored by adolescents, e-cigarette sales continue to rise, with the e-cigarette industry showing a volume increase of 72.7% year over year. Juul continues to be a giant in the ENDS (Electronic Nicotine Delivery System) industry, holding a whopping 74.6% of the market share, even after removing their popular fruity flavors from convenience stores following federal agency concern of adolescent vaping rates. 

Juul’s overpowering hold on the e-cigarette industry, however, does not mean that ENDS are the biggest players in the nicotine market; e-cigarettes currently account for only 5% of all nicotine products on the market (following traditional cigarettes at 82% and chewing/smokeless tobacco at 8%), but this percentage could increase in upcoming years. Other companies besides Juul, such as NJOY and Vuse, are also catching up. “Vuse, the No. 2-selling e-cig by R.J. Reynolds Vapor Co., rose from 13.4% to 13.7%”, and unlike Juul, this company has not imposed any flavor restrictions. Competition is stiff for the ENDS giant.

If you would like to know more, click here.

05 Jun Hawaii Weighs Statewide Ban on Flavored E-Cigarette Products

Hawaii lawmakers are considering a bill that would ban flavored vape products, after a hearing earlier this year. If this bill passed, Hawaii would become the first state in the nation to ban flavored tobacco, although numerous US cities have passed similar measures. Hawaii’s legislature tried putting through a similar bill in 2014 against flavored products, but it did not pass. As with most arguments regarding vaping restrictions, advocates claim that the flavors are crucial in helping adults looking to switch from traditional cigarettes to e-cigarettes while critics fight against the claim, saying that the current boom of teenage vaping is a more important focus. The state’s health department claims that their youth are vaping at unprecedented levels, with a sixfold increase among middle and high school students. If these rates are accurate, this would put vaping rates of Hawaii youth at double the national average. 

Hawaii is no stranger to progressive lawmaking; “it was the first state to raise the legal smoking age to 21.” In fact, a far more radical bill was proposed earlier this year that would raise the age to buy cigarettes in the state to 100; predictably, this ambitious bill was not passed. However, this example of Hawaii’s earnest beliefs about nicotine products are a hopeful indication of this bill passing.

If you’d like more information from the article, click here. 

29 May Increased Number Of Americans Perceive E-Cigarettes To Be Harmful

According to a recent analysis, an increasing number of American adults perceive e-cigarettes to be as harmful or more harmful than traditional combustible cigarettes. Researchers combined data from the Tobacco Products and Risk Perceptions Survey, administered by the Georgia State University Tobacco Center of Regulatory Science, and the Health Information National Trends Survey, administered by the National Cancer Institute, both of which are nation-wide surveys administered to U.S. adults yearly. According to the combined results, “the percentage of people who believed that e-cigarettes were less harmful than regular cigarettes decreased from 45% in 2012 to 35% in 2017. The number of people who thought e-cigarettes were as harmful as cigarettes increased to 45% in that time, and the percentage who believed that e-cigarettes were more harmful remained low, at less than 10%.”

The authors of the report seem worried by these results, noting that the findings “underscore the urgent need to accurately communicate the risks of e-cigarettes to the public.” Although both combustible cigarettes and e-cigarettes each pose their own health risks, it is generally agreed that e-cigarettes are the lesser of two evils, with less chemicals and additives than traditional combustible cigarettes. This of course does not mean that e-cigarettes are healthy or safe to use without risks, but for adults with a choice between the two, who are usually trying to quit cigarette smoking, it is typically believed that vaping is safer than smoking cigarettes. This belief, however, is not held by Stanton A. Glantz, a professor at the University of California, San Francisco Center for Tobacco Control Research and Education, who calls people that believe you can switch from cigarettes to vaping “e-cigarette optimists”. Glantz has the facts behind him, mentioning that about two thirds of adult e-cigarette users jointly smoke cigarettes (i.e. use both simultaneously), therefore negating any potential benefits from switching solely to e-cigarettes. He does, however, hope this negative perception of e-cigarettes reaches adolescents to help curb the recent and dramatic rise in vaping among youth, saying that “in terms of overall public health effects, this explosion of youth use swamps any potential harm reduction that may accompany adults switching from cigarettes to e-cigarettes.”

For more information from the article, click here.

22 May “Make the Switch”: Juul’s Newest Marketing Campaign

Juul has recently come out with their newest marketing campaign “Make the Switch” aimed at adults to switch from combustible cigarettes to e-cigarettes, which is currently running on TV, on the web, and on the radio. Juul seems to be shying away from their older advertisements with this new campaign; the vaping giant previously received huge backlash concerning their”cool” advertisements, featuring young models and bright colors, due to the worry of the influence their marketing campaign had on adolescent vaping.

However, Juul never seems to stray far from controversy, as the company was publicly criticized by anti-smoking advocates and experts who say that Juul’s claims in their “Make the Switch” campaign are not backed by science, and that there is no research to indicate that their products definitively help smokers switch from combustible cigarettes to electronic cigarettes. This group called for action from the FDA, which has not approved e-cigarettes as a cessation product, to investigate the advertisements. FDA spokesman Michael Felberbaum had little to say on the subject, saying that the FDA “continues to closely scrutinize potentially false, misleading or unsubstantiated claims ‘to make sure the public is’ not misled into mistakenly using inherently dangerous tobacco products for medical uses.” Tobacco control researcher Stan Glantz had heavier words to say on the matter, saying “I think Juul is skirting the edge of the law, and I think that the FDA is letting them get away with it.” Glantz and other advocates are fighting for FDA enforcement specifically because “e-cigarettes are not subject to the decades-old laws that ban advertising of traditional cigarettes on TV, radio and billboards.” Currently, the only restriction the FDA has on e-cigarette advertisement is the mandatory inclusion of a one-line warning: “This product contains nicotine. Nicotine is an addictive chemical.”

If you’d like to read more from the article while waiting on more details from the FDA or Juul, click here.

15 May Why Vaping Is So Dangerous For Teens

Traditional cigarette use has been highly researched, with thousands of studies detailing health risks and pathways to nicotine dependence. As a society, there is nothing unknown to fear in regards to cigarettes. We know that smoking cigarettes is associated with increased risks of cancer, lung and heart health deficiencies, and nicotine dependence. We know how cigarette use affects the developing brain, and we know how difficult it can be for cigarette smokers to achieve smoking cessation. When you compare the wealth of information we have on cigarette smoking to the almost barren amount of data we have on e-cigarettes, it seems appropriate to feel perplexed and almost fearful of the potential effects that e-cigarettes might have, specifically in adolescents. Dr. Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital, says that ” it turns out that e-cigarette use by kids doesn’t look the same at all…How you’re delivering [nicotine] and how much you’re delivering … everything you change really matters.” As the article states,“Levy said she’s seen vape-addicted kids in her program showing what appear to be psychiatric symptoms rarely seen with traditional cigarettes or among adults. Some have anxiety and cannot focus, for example.” Researchers are racing to find more information about e-cigarettes, especially after the alarming and dramatic increase in adolescent vaping rates that the FDA recently called an “epidemic.”

So what do we currently know about e-cigarettes? 

E-cigarettes were designed mainly to assist traditional cigarette smokers in the cessation process, and current research seems to show that e-cigarette use is in fact safer than cigarette use. This does not mean that e-cigarettes are safe to use; e-cigarettes have fewer chemicals and irritants than traditional cigarettes, but many known dangerous chemicals including lead and diacetyl (a chemical linked to lung disease) still exist in e-cigarette vapor and aerosol. The fact remains that e-cigarettes were meant mainly for adults who had spent years developing a nicotine dependence, not for teens who had never had experience with nicotine before using e-cigarettes. As the article states, “despite early fanfare that e-cigarettes might offer a less harmful alternative to adult smokers, experts say youth are being hit hard by a combination of how vapes deliver nicotine, how kids’ brains are wired and developing, and the gadgets’ unique appeal to kids.”

Levy also spoke about the nicotine content in a Juul pod (one Juul pod has the same amount of nicotine as roughly one pack of cigarettes), saying: “[It’s unclear] how high those [nicotine] peaks go and how quickly it gets into the bloodstream and into the brain.” Levy continued, saying that teens tend to report symptoms that “sound a lot like nicotine toxicity,” such as headaches and stomach aches.  Maciej Goniewicz, an associate professor of oncology and pharmacology at Roswell Park Comprehensive Cancer Center, “found higher levels of cotinine — a breakdown product of nicotine — in the urine of adolescent vapers than had been reported in prior research of teenage cigarette smokers.” According to Goniewicz, “vape manufacturers may be able to pack more nicotine into their products by creating “nicotine salts,” which may mask nicotine’s naturally unpleasant taste and lead the drug to be absorbed by the body quicker.”

A big fear researchers also have is nicotine consumption in relation to brain development in adolescents. The brain does not finish developing until your mid-twenties, and nicotine can harm the developing adolescent brain in the parts controlling attention, memory, learning, mood, and inhibition. Using nicotine in adolescence has also been shown to increase the risk for future addiction to other drugs, like cocaine. This is due to nicotine changing the way synapses, the connections in the
brain, are formed. Adam Leventhal, director of the Health, Emotion, and Addiction Laboratory at the University of Southern California, says that “the circuits underlying pleasure and the pursuit of novel, enjoyable experiences develop much faster than the circuits that promote decision making, impulse control and rational thinking.”

Levy is also concerned with treatment for these nicotine dependent teens, suggesting that while medications may be helpful, counseling is also necessary. “We end up needing to teach kids how they can deal with cravings, how they can identify high-risk situations, how they can actually deal with being surrounded by people who are using these things,” Levy said. “Because the reality is that, for most kids, we treat them and put them back in school, and then they go to the bathroom, and everybody’s Juuling.” She also stresses correcting the misinformation the public has concerning the safety of e-cigarettes, saying that “Even to this day, I have kids saying, ‘well, I thought it was safe’ or ‘I know it’s safer than cigarettes,’…and ‘safer than cigarettes’ is a really low bar”

For more information from the article, click here. 

09 May Bill Proposed To Raise Minimum Vaping Age To Twenty-One

Senate Majority Leader Mitch McConnell proposed a bill this week that would raise the legal age to buy tobacco products, including vapes, in the United States to 21 years old. This bill comes following a national public outcry due to the health risks that ENDS products pose. A generation of teens is becoming nicotine dependent, which McConnell expressed saying: “For some time, I’ve been hearing from the parents who are seeing an unprecedented spike in vaping among their teenage children. In addition, we all know people who started smoking at a young age and who struggled to quit as adults. Unfortunately it’s reaching epidemic levels around the country.”

Surprisingly, vaping giant Juul seems to support the initiative. This is likely due to Juul’s public image recently suffering a dramatic drop after the company was accused of marketing towards underage teens. Supporting a bill that would raise the legal age to consume ENDS products but that would not outright ban the sale of them could potentially be a good strategy for the company. Others are skeptical that the bill will truly be enforced and that retailers will stop selling to those under 21. For now, it is too early to tell.

To read more from Senator McConnell’s statement, click here. 

01 May Juul Continues To Lobby Against E-Cigarette Legislation… After Vowing To Help Stop Adolescents From Vaping

After their recent efforts to help curb adolescent vaping by announcing plans to stop selling vape flavor pods and restricting their own e-cigarette sales to those 21 and over, Juul seems to be contradicting themselves in recent news. More than 80 Juul lobbyists across the nation are pushing back against state-wide bans on flavored e-cigarette pods, endorsing legislation that would deny local governments the right to enact strict vaping measures, and working to ensure that bills to discourage adolescent vaping are difficult to enforce. Although it seems the company is still in favor of raising the legal age for buying e-cigarette and tobacco products to 21, some of the bills and measures Juul supports offer minimal violation fees and sanctions for those found selling to anyone under 21. “Juul is attempting to rehabilitate its public image by posing as a public health advocate while working behind the scenes to weaken or defeat tobacco control proposals and prevent communities from even considering policies to curb tobacco use,” said Nancy Brown, chief executive of the American Heart Association.

Lindsay Andres, a Juul spokeswoman, said that their lobbyists were only focused on raising the minimum age for buying e-cigarette and tobacco products. However, in numerous states, proposals that Juul publicly supports, known as Tobacco 21 (T21), “contain measures that public health experts consider poison pills.” For example, a recently passed T21 law in Arkansas that Juul helped to pass blocks local governments from “enacting new rules regarding the manufacture, sale, storage or distribution of tobacco and vaping products — including restrictions on flavored products.” As a result, health advocates in numerous states have opposed T21 bills backed by Juul…bills that were also supported by the tobacco industry. Steve Hansen, a councilman from Sacramento, met with two Juul lobbyists who wanted to intercept Hansen’s bill proposal to ban the sale of all flavored e-cigarettes and tobacco products in his city. The two lobbyists pushed a plan to only ban flavors that are “knowingly attractive to minors.” After the city council rejected Juul’s plan and passed his bill, Mr. Hansen recounted how shocked he was by the lobbying efforts of the vaping giant, saying “in my six years on the City Council I’ve never seen the number of money, lobbyists and Astroturfing we’ve seen here on anything else.” It seems the fight against Juul and adolescent vaping will continue for the indefinite future 

For more information from the article, click here. 

25 Apr New FDA Policy Could Get Some Flavored E-Cigarette Products Pulled Off The Market

The United States Food and Drug Administration (FDA) is attempting to take action against the sale of e-cigarette products in stores accessible to minors, outlined in a policy draft they released mid-March. This policy would also take action against websites that sell e-cigarette products and do not confirm legal age or limit the amount of products sold to one person. FDA Commissioner Dr. Scott Gottlieb believes this policy will lead to certain flavored e-cigarette products to stop being sold completely; this excludes, however, mint, tobacco, and menthol flavored e-cigarette products as Gottlieb wants to leave these options for adults switching from traditional tobacco products to e-cigarettes. Matthew Myers, president of the Campaign for Tobacco-Free Kids, does not believe this policy is sufficient damage control for the current explosion of teenage e-cigarette use, saying that “a public health crisis of this magnitude demands faster and more forceful action than the steps announced by the FDA.” Mentioning data from the Center for Disease Control (CDC), Myers also points out that more than half of adolescent e-cigarette users use menthol and mint flavored products, suggesting that leaving these flavors on the market is not an option if the goal is to stop teens from using e-cigarettes. On top of proposing a ban on flavored cigars and menthol cigarettes, Myers also proposed that the FDA “should prohibit all flavored e-cigarettes that have not been subject to public health review by the agency, halt online sales of e-cigarettes until stronger safeguards are in place to prevent sales to kids, restrict marketing that attracts kids, and enforce rules prohibiting the sale of new products without FDA authorization.”Myers continues, saying that “the restrictions on flavored e-cigarettes announced today by the FDA are a step forward, but they are inadequate to reverse the youth e-cigarette epidemic and fall short of prohibiting the flavors that have made e-cigarettes so popular with kids.”

To read the FDA policy draft, click here. To read more from the article, click here.