E-cigarettes and vaping: A public health epidemic

The AMA has been a leading force to eliminate public smoking and warn people about the dangers of smoking, including secondhand smoke, since the 1960s. 

The rise of e-cigarettes and vaping has raised concerns that another generation may become dependent on nicotine.

In light of this spike in youth e-cigarette use, along with the recent U.S. outbreak linked to more than 2,000 lung illnesses and over 40 deaths, the AMA has called for a total ban on all e-cigarette and vaping products that do not meet FDA approval as cessation tools.

1. AMA letter to White House: remove flavored e-cigarettes from the market

   1. On Nov. 26, 2019, the AMA and the public health community sent a letter to the White House with the message that we believe it is essential to clear the market of all flavored e-cigarettes, including mint and menthol, if we are going to reverse the youth e-cigarette epidemic.

      Earlier, the AMA and other health and community groups met with President Trump on Nov. 22, 2019, and issued a joint statement that action must be taken to end the unprecedented epidemic of addiction of our youth to e-cigarettes.

   2. The AMA also continues to  supports local, state and federal actions to prohibit the sale of flavored tobacco and e-cigarette products that lure young people into addiction. We applaud states and municipalities that have enacted bans on flavored products and encourage other jurisdictions to follow suit.

2. Total ban on all vaping products not approved by FDA

   “The recent lung illness outbreak has alarmed physicians and the broader public health community and shined a light on the fact that we have very little evidence about the short- and long-term health consequences of e-cigarettes and vaping products,” said AMA President Patrice A. Harris, MD, MA.

   “It’s simple – we must keep nicotine products out of the hands of young people and that’s why we are calling for an immediate ban on all e-cigarette and vaping products from the market. With the number of young people using e-cigarettes spiking it is not only critical that there is research into nicotine addiction treatments for this population, but it is imperative that we continue efforts to prevent youth from ever using nicotine,” Dr. Harris said.

3. Pulling the plug on e-cigarette ads

   1. “We’re calling on media organizations to help us promote public health and reject any advertisements that market e-cigarette products to youth,” said AMA President Patrice A. Harris, MD, MA.
   2. “While we’re pleased to see some media companies denying e-cigarette product ads during the current lung illness outbreak, we also encourage them and others to extend bans on e-cigarette product ads beyond the outbreak to help stem the rising use of these products among youth,” Dr. Harris said.
   3. The AMA supports H.R. 4249, the “Stop Vaping Ads Act of 2019,” and urges Congress to take swift action to adopt legislation to ban e-cigarette product ads.

4. Limiting tobacco sales to adults over 21

   1. We encourage the passage of laws, ordinances and regulations that would set the minimum age for purchasing tobacco products, including e-cigarettes, at 21. The AMA also urges strict enforcement of laws prohibiting the sale of tobacco and e-cigarette products to minors.

5. Taking action on illicit materials fueling the vaping crisis

   1. We are urging e-commerce CEOs to vigorously enforce their existing policies to keep illicit vaping products off their platforms and be vigilant against the sale of empty vaping cartridges and other items used to create counterfeit vaping products.
   2. “It is time for e-commerce companies to take action to ban the sale of materials fueling the counterfeit-vaping crisis,” wrote AMA Executive Vice President and CEO James L. Madara, MD. “Given the pace at which vaping-related lung illness is expanding, there is no time to waste.”

6. More research and education

   1. The AMA encourages further clinical and epidemiological research on e-cigarettes and more education of the public on the health effects, including toxins and carcinogens of e-cigarettes.

   2. As part of this research initiative, the AMA calls for a study of the use of pharmacologic and non-pharmacologic treatment strategies for tobacco use disorder and nicotine dependence resulting from the use of non-combustible and combustible tobacco products in populations under the age of 18.

1. What’s behind the outbreak of vaping-related lung illnesses

   1. Among the patients with lung injuries, 78% reported using tetrahydrocannabinol (THC)-containing products and 37% reported exclusive use of THC-containing products. About 58% reported using nicotine-containing products, and 17% reported exclusive use of nicotine-containing products. The outbreak’s cause is still unknown and the investigation continues, but the CDC recommends that people refrain “from using e-cigarette, or vaping, products, particularly those containing THC.”

2. More key facts from CDC on vaping-related lung illnesses

   1. The CDC is offering regular updates on the vaping-related lung injuries that have struck more than 1,000 of e-cigarette users. The agency offers detailed recommendations for the public as well as physicians and other health professionals.

3. The alarming stats on e-cigarette use among teens

   1. A national survey of 42,531 eighth–12th graders finds that 25.4% of high-school seniors have vaped nicotine in the last month, while 20.2% of 10th graders and 9% of eighth-graders have done so. All of these figures have grown dramatically since 2017, the survey found, with past-month nicotine vaping skyrocketing 131% among 12th-graders in just two years.

4. The FDA wants your e-cigarette reports

   1. The agency has developed a portal to report safety problems with tobacco products. The FDA says it wants reports from patients and health professionals about tobacco products that are damaged, defective, contaminated, smell or taste wrong. The FDA reviews the reports to identify concerning trends.

5. States are taking action

   1. Michigan, Massachusetts, New York, Rhode Island and Utah have taken steps to ban flavored e-cigarette sales or even the sale of all vapes.