Public Health

Why it’s time to pull the plug on e-cigarette ads

What’s the news: The corporations that own CNN, CBS, TNT, TBS and other major broadcasting brands have announced that they will not air advertisements for e-cigarettes amid the ongoing investigation of vaping-related lung illnesses that have sickened hundreds of Americans and killed seven people.

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But that does not go far enough, say the nation’s physicians.

“The use of e-cigarettes by young people is a growing public health epidemic that must be addressed. That’s why 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.

“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 added.

Why it matters for patients and physicians: As of 2016, about 80% of U.S. middle- and high-school students came across advertisements for e-cigarettes, says a March 16, 2018, Morbidity and Mortality Weekly report, “Exposure to Electronic Cigarette Advertising Among Middle and High School Students—United States, 2014–2016.”

About 70% of these students saw e-cigarette advertising in retail stores, roughly 40% saw the ads on the internet or on TV, and about 25% saw e-cigarette ads in newspapers or magazines.

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The ads appear to be having an impact, judging from the results of a national survey of 42,531 eighth–12th graders finding that 40% of 12th-graders have ever vaped nicotine. Additionally, 25.4% of high-school seniors have vaped nicotine in the last month. These figures have grown dramatically, with past-month nicotine vaping skyrocketing 131% among high-school seniors in just two years, says the survey, “Trends in Adolescent Vaping, 2017–2019,” published in The New England Journal of Medicine.

“Current efforts by the vaping industry, government agencies, and schools have thus far proved insufficient to stop the rapid spread of nicotine vaping among adolescents,” wrote the University of Michigan and University of Minnesota researchers behind the survey.

“Of particular concern,” they added, “are the accompanying increases in the proportions of youth who are physically addicted to nicotine, an addiction that is very difficult to overcome once established.”

And vaping-fed nicotine dependence can lead to an even worse habit. “Use of e-cigarettes, hookah, noncigarette combustible tobacco or smokeless tobacco by youth is associated with cigarette smoking one year later,” notes a 2018 AMA Council on Science and Public Health report.

In January, Juul—the San Francisco-based company that has a 75% share of the U.S. e-cigarette market—announced a $10 million TV advertising campaign.

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What’s next: The AMA has long called for e-cigarettes to have the same marketing and sales restrictions that are applied to tobacco cigarettes, including bans on TV advertising. The AMA will continue to support policies and regulations aimed at preventing another generation of Americans from becoming dependent on nicotine.

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.