4 steps we must take to curb the exploitation of Generation Vape

Food and Drug Administration Commissioner Scott Gottlieb announced Wednesday a wave of regulations on the sale of flavored e-cigarettes in an attempt to curb children’s access to these products before he leaves office. These regulations are a start, but we need to go further to prevent Big Vaping from marketing and selling its products to kids.

In recent years, vaping, and particularly juuling (named after the vaping market leader), has turned youth nicotine consumption on its head, making a behavior that used to be uncool suddenly cool again. I have worked for nearly two decades to research how the teen brain experiences addictive behaviors of all kinds, and how to use technology for positive behavior change. I have seen years of gains in tobacco control torn to shreds as Juul combined a more powerful nicotine “hit” with a social media marketing strategy targeting youth.

The combination of addictive substance, flavor and a lens of “technology” makes the e-cigarette one of the best tools invented to exploit and profit from what I call Generation Vape.

There’s no reason, however, anyone should be getting rich off an activity with such an enormous social cost — a lesson we’re starting to enforce in the world of opioids. Just as we are thinking about how to protect developing brains from early exposure to screens, alcohol and other drugs, it’s time we take a fresh look at controlling vaping, too.

Just how common is vaping? In 2018, roughly 3.6 million, or about 20 percent of U.S. teens, reported vaping, making it more common than cigarette smoking. Vaping is an increasingly common way for teens to get high: More than half of teens who vape say they use an e-cigarette for cannabis or THC oils. Mounting research indicates that vaping nicotine is not safe for youth: It’s not just that vaping is a gateway to cigarette smoking; it’s that the e-cigarettes themselves also contain toxins. In 2018, colleagues and I published a study showing that teens who used e-cigarettes had nontrivial amounts of five volatile organic compounds that are carcinogenic in their saliva and urine.

The industry knows this.

But the vaping industry also knows it must reach young, plastic minds if it is going to stay relevant as smoking cigarettes has become less cool. Vaping has given them a new tool. It’s the reason they have been rolling out e-flavors — such as “crème brûlée” or “unicorn poop” — that sound more like something you would find in a candy store than a smoke shop. All of this being said, it is probably safer to vape something than it is to smoke it. But the social cost of more teens being addicted to nicotine or cannabis because they started with vaping is far greater than we may realize.

How do we control vaping? Well, we know a lot from our years of curbing tobacco use. We should:

Destroy the myth that vaping is safe. Across substances, there needs to be a universal message that vaping, even if it is safer than smoking for some adults, is not safe or healthy for teens. For a generation that cares about an “organic” and values-led lifestyle, this should be an easy message to land. Norman Sharpless, Gottlieb’s successor at the FDA, should reinforce this message loud and clear.

Use social media as part of the solution. Partly that means playing offense: Vaping companies should be banned from all advertising on e-platforms, including through “influencers.” But we also need to play defense. If even a small portion of the funding that industry has put into social media was put into counteracting the behavior among teens, it would go a long way. California and other states should move quickly to raise taxes on vaping to fund such efforts.

Enact stricter policies that prevent teens from vaping. The new regulations will limit sale of some flavored e-cigarettes in stores frequented by teens, but restrictions need to go further to restrict access online. Age restrictions on all nicotine products should be raised to 21. In states where cannabis is legal, age restrictions should be strictly enforced. Regulations on the sale of flavors should extend beyond fruit to mint and menthol.

Gut the economics of vaping, which is perhaps the most important element of any plan. All of the venture money that is behind “Big Vaping” should be exposed for backing an industry that promotes use of addictive substances and values profits over the health of our youth.

And Bay Area cities need to stop treating Juul like a technology company worthy of office space and start treating it like the tobacco giant it really is. A new generation of investors is chasing unicorns in the fragile minds of Generation Vape. And, if we don’t move soon, we’ll be the ones left to clean up the unicorn poop they leave behind.

// Originally published on March 17th, 2019 in the San Francisco Chronicle https://www.sfchronicle.com/opinion/openforum/article/4-steps-we-must-take-to-curb-the-exploitation-of-13689178.php