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Time to get serious about teen vaping epidemic

Caroline Tompkins/The New York Times

Massachusetts’ progress in reducing teen smoking during the past two decades is being quickly undermined by the popularity of vaping. The Commonwealth needs to take rapid action to stem the tide of this new wave of nicotine addiction.

Electronic nicotine delivery systems — such as vape pens, e-hookahs, and other forms of e-cigarettes — arrived a few years ago under the guise of providing a less harmful and better smoking experience than traditional cigarettes. E-cigarettes typically have no tobacco and none of the cancerous toxins found in cigarettes. They work by heating a liquid made of nicotine, glycerol, flavorings, and other chemicals. They produce no odor.


According to the manufacturers, like JUUL Labs and others, the new devices were launched to help adult smokers quit their nicotine habit. But they also found a new market and have created a new generation of nicotine addicts. JUUL alone controls roughly 75 percent of the e-cigarette market in the US. It’s no coincidence that teens in high schools all over the state vape in what they refer to as the ‘JUUL lounge’ — the bathroom. They’re not smoking or even vaping — they’re “juuling.”

Nicotine is not safe. It impacts brain development in teens and can cause anxiety, depression, and mood disorders. The ingredient also “makes the individual more susceptible to be addicted to other drugs,” said Dr. Jonathan Winickoff, director of pediatric research at the Tobacco Research and Treatment Center at Massachusetts General Hospital. Some vaping products, he added, can cause lung inflammation.

The youth use data and trends are distressing. It’s why the US Surgeon General issued an advisory late last year about teen vaping, calling it an epidemic. Nationally, adolescents are more likely than adults to use e-cigarettes, according to the Centers for Disease Control and Prevention; one in five high-school students and one in 20 middle-school students were using e-cigarettes. Between 2011 and 2018, the percentage of e-cigarette users among high schoolers jumped from 1.5 percent to 20.8 percent.


Similarly in Massachusetts, 1 in 5 high-school students use e-cigarettes, among the highest youth rates in the nation. Indeed, the huge gains achieved by fighting traditional cigarette use among youth — through public education, raising the legal smoking age to 21, and high taxes — are now being wiped out.

While traditional cigarettes are heavily taxed in Massachusetts, e-cigarettes are not. In their budget proposals, both the governor and the state Senate propose an excise tax on the electronic devices. A tax is a no-brainer. It’s cheaper to vape than to smoke a regular cigarette now. Roughly ten other states have an e-cigarette tax.

Perhaps more controversial is a proposal by state Senator John Keenan to ban sale of all flavoried tobacco products online and at retail shops in Massachusetts. It would make the commonwealth the first in the nation to enact such a ban, although California and Hawaii are considering similar measures.

Already, more than 140 municipalities in Massachusetts ban flavor sales. Studies have shown that flavors that make e-cigarettes taste like mango or cucumber are a huge draw for youth.

In a voluntary action, JUUL announced it’s only selling their fruit-flavored products online, but mint and menthol — still popular among teens — can be found in convenience stores and other retailers.

Last year Attorney General Maura Healey launched an investigation into JUUL and other online vaping retailers on how they market to minors. Healey is among the most vocal elected officials to denounce the teen vaping epidemic and supports an e-cigarette tax and the ban on flavors.


As for JUUL’s claim that its mission is to help adults quit smoking, Healey has an answer. “I laugh when people try to sell this and justify the actions of a [JUUL] or these other companies as doing some sort of good and helping us with smoking cessation,” she said in a public forum last week.

For many youth, it’s proximity and access that is going to determine their risk behavior. The unchecked growth of e-cigarettes could undo progress the Commonwealth has made in curbing nicotine addiction. The state has a chance now to take a strong stance by taxing e-cigarettes and banning flavored tobacco products.