Item 2.1 - Additional Material posted 6-6-191 of 9 June 4, 2019, Item #2.1
1
Ana Alarcon
From:agendadocs resource
Subject:FW: Agenda item#2.1 for the 6/4/19 Council meeting
Attachments:Press release‐surgeon‐generals‐advisory‐on‐e‐cigarette‐use‐among‐youth‐12‐2018.pdf.docx; surgeon‐generals‐
advisory‐on‐e‐cigarette‐use‐among‐youth‐2018.pdf; Table A7.1 Summary of Key CHKS Tobacco Indicators.docx
From: Lorenzo Higley <L.Higley@cox.net>
Sent: Tuesday, June 4, 2019 5:19 PM
To: Steve Vaus <SVaus@poway.org>; Caylin Frank <CFrank@poway.org>; Barry Leonard <BLeonard@poway.org>; John Mullin
<JMullin@poway.org>; Dave Grosch <DGrosch@poway.org>
Cc: Hazell Belvin, Public Health Advocate‐ALA‐CA <SDAdvocacyIntern1@lung.org>; Seilback, Michael
<Michael.seilback@lung.org>
Subject: Agenda item#2.1 for the 6/4/19 Council meeting
Mayor Vaus and Members of the Council,
On behalf of the American Lung Association in California, I am contacting you about the revision of your social host ordinance to
ask why not add tobacco products, as defined by the State of California, to the list of prohibited substances whose
consumption is defined as illegal under your social host ordinance? In 2016, the State of California raised the legal age limit for
purchase of tobacco products to age 21 in order to protect youth from lifetime of addiction and resulting tobacco‐related
disease.
In the United States, tobacco products kill 400,000 smokers annually and an additional 80,000 non‐smokers from secondhand
smoke. Tobacco use is the single largest cause of preventable death in the U.S. As long as you are seeking to protect Poway’s
youth from the hazards at parties provided by social hosts arising from alcohol, marijuana, and other controlled substances;
why would you not include tobacco products as defined by the State in your list of illicit substances and whose use constitutes
the largest current threat to the public’s health today?
Attached please find the most recent self‐reported use of tobacco products and electronic smoking devices from the Poway
Unified School District’s 2016‐17 California Healthy Kids Survey. 22% of Poway’s 11th grade students report that they have “Ever
used electronic cigarettes or other vaping device” and 7% report “current use within the last 30 days”.
I have also attached the Surgeon General’s recent (December, 2018) Advisory on E‐Cigarette Use Among Youth in which he
describes an “E‐cigarette Epidemic Among Youth”. Frankly, these statistics have our hair on fire in the tobacco control
community as use amongst teens has skyrocketed in recent years.
While I am unable to be there tonight at your Council meeting, I urge you to consider adding the “consumption of tobacco
products, as defined by the State of California”, to the list of items prohibited under your social host ordinance.
Respectfully,
Lorenzo
Lorenzo Higley, MSW | Consultant
American Lung Association in California
2020 Camino del Rio North #200| San Diego, CA 92108
O: 619-447-2855 | C: 619-971-6019
Lung HelpLine: 1-800-LUNGUSA
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ADDITIONAL MATERIAL
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FOR IMMEDIATE RELEASE December 18, 2018 Contact: ASH Press Office 202-205-0143 media@hhs.gov
Surgeon General releases advisory on E-cigarette epidemic among youth
U.S. Surgeon General Vice Adm. Jerome M. Adams issued an advisory today stressing the importance of
protecting children from a lifetime of nicotine addiction and associated health risks by immediately
addressing the epidemic of youth e-cigarette use.
E-cigarette use among youth has skyrocketed in the past year at a rate of epidemic proportions.
According to data from the Centers for Disease Control and Prevention and the Food and Drug
Administration’s National Youth Tobacco Survey, the percentage of high school-age children reporting
past 30-day use of e-cigarettes rose by more than 75 percent between 2017 and 2018. Use among
middle school-age children also increased nearly 50 percent.
Data from National Institutes of Health’s Monitoring the Future survey also shows that America’s teens
reported a dramatic increase in their use of e-cigarettes in just a single year, with 37.3 percent of 12th
graders reporting use in the past 12 months, compared to 27.8 percent in 2017.
“We need to protect our kids from all tobacco products, including all shapes and sizes of e-cigarettes,”
said Adams. “Everyone can play an important role in protecting our nation’s young people from the risks
of e-cigarettes.”
The surge in e-cigarette use among our nation’s youth has been fueled by newer cartridge-based devices
that have become increasingly popular. Many of these e-cigarettes look like a USB flash drive, making
them easy to conceal. One of the most commonly sold versions is JUUL, which now has more than a 70
percent share of the cartridge-based e-cigarette market in the United States. A typical JUUL cartridge, or
“pod,” contains about as much nicotine as a pack of 20 regular cigarettes.
“In the data sets we use, we have never seen use of any substance by America’s young people rise as
rapidly as e-cigarette use is rising,” said HHS Secretary Alex Azar. “Combustible cigarettes remain the
leading cause of preventable death in the United States, and providing an effective off-ramp for
adults who want to quit using them is a public health priority. But we cannot allow e-cigarettes to
become an on-ramp to nicotine addiction for younger Americans. HHS has been and will
continue developing a comprehensive, balanced policy approach to this challenge.”
As noted in the 2016 Surgeon General’s report on E-cigarette Use Among Youth and Young Adults, e-
cigarette use poses a significant – and avoidable – health risk to young people. Besides increasing the
possibility of addiction and long-term harm to brain development and respiratory health, e-cigarette use
may also lead to the use of regular cigarettes that can do even more damage to the body.
“We have evidence-based strategies to prevent tobacco use that can be applied to e-cigarettes.” said
Adams. “We must take action now to protect the health of our nation’s young people.”
For facts about the risk of e-cigarettes, and how to protect our youth, visit: e-
cigarettes.surgeongeneral.gov.
###
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Surgeon General’s Advisory on E-cigarette Use Among
Youth
I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance
of protecting our children from a lifetime of nicotine addiction and associated health risks by immediately addressing the
epidemic of youth e-cigarette use. The recent surge in e-cigarette use among youth, which has been fueled by new
types of e-cigarettes that have recently entered the market, is a cause for great concern. We must take action now to
protect the health of our nation’s young people.
KNOW THE RISKS. TAKE ACTION. PROTECT OUR KIDS.
The E-cigarette Epidemic Among Youth
Considerable progress has been made in reducing cigarette smoking among our nation’s youth.1 However, the
tobacco product landscape continues to evolve to include a variety of tobacco products, including smoked,
smokeless, and electronic products, such as e-cigarettes.2 E-cigarettes are designed to deliver nicotine,
flavorings, and other additives to the user via an inhaled aerosol.2
E-cigarettes entered the U.S. marketplace around 2007, and since 2014, they have been the most commonly
used tobacco product among U.S. youth.2 E-cigarette use among U.S. middle and high school students increased
900% during 2011-2015, before declining for the first time during 2015-2017.3 However, current e-cigarette use
increased 78% among high school students during the past year, from 11.7% in 2017 to 20.8% in 2018.4 In 2018,
more than 3.6 million U.S. youth, including 1 in 5 high school students and 1 in 20 middle school students,
currently use e-cigarettes.4
E-cigarette aerosol is not harmless.2 Most e-cigarettes contain nicotine – the addictive drug in regular cigarettes,
cigars, and other tobacco products.2 Nicotine exposure during adolescence can harm the developing brain –
which continues to develop until about age 25.2 Nicotine exposure during adolescence can impact learning,
memory, and attention.1,2 Using nicotine in adolescence can also increase risk for future addiction to other
drugs.1,2 In addition to nicotine, the aerosol that users inhale and exhale from e-cigarettes can potentially expose
both themselves and bystanders to other harmful substances, including heavy metals, volatile organic
compounds, and ultrafine particles that can be inhaled deeply into the lungs.2
Many e-cigarettes also come in kid-friendly flavors. In addition to making e-cigarettes more appealing to young
people,5 some of the chemicals used to make certain flavors may also have health risks.2 E-cigarettes can also be
used to deliver other drugs, including marijuana.2 In 2016, one-third of U.S. middle and high school students who
ever used e-cigarettes had used marijuana in e-cigarettes.6
For adults, e-cigarettes may have the potential to reduce risk for current smokers if they completely transition from
cigarettes to e-cigarettes; however, a majority of adults who use e-cigarettes also smoke cigarettes.7 For youth,
the use of multiple tobacco products puts youth at even greater risk for addiction and tobacco-related harms.1,2
Moreover, a 2018 National Academy of Sciences, Engineering, and Medicine report concluded that there was
moderate evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.7
But any e-cigarette use among young people is unsafe, even if they do not progress to future cigarette smoking.2
E-cigarettes Come in Many Shapes and Sizes
E-cigarettes are a rapidly changing product class, and are known by many different names, including “e-cigs,” “e-
hookahs,” “mods,” and “vape pens.”2 Recently, a new type of e-cigarette has become increasingly popular among
our nation’s youth due to its minimal exhaled aerosol, reduced odor, and small size, making it easy to conceal.8
Many of these new e-cigarettes look like a USB flash drive, among other shapes. One of the most commonly sold
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USB flash drive shaped e-cigarettes is JUUL, which experienced a 600% surge in sales during 2016-2017, giving
it the greatest market share of any e-cigarette in the U.S. by the end of 2017.9 Other companies are now also
starting to sell e-cigarettes that look like USB flash drives.
All JUUL e-cigarettes have a high level of nicotine. A typical JUUL cartridge, or “pod,” contains about as much
nicotine as a pack of 20 regular cigarettes.10 These products also use nicotine salts, which allow particularly high
levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine that has traditionally
been used in tobacco products, including e-cigarettes. This is of particular concern for young people, because it
could make it easier for them to initiate the use of nicotine through these products and also could make it easier to
progress to regular e-cigarette use and nicotine dependence. However, despite these risks, approximately two-
thirds of JUUL users aged 15-24 do not know that JUUL always contains nicotine.11
You Can Take Action
We must take aggressive steps to protect our children from these highly potent products that risk exposing a new
generation of young people to nicotine.2,7 The bad news is that e-cigarette use has become an epidemic among
our nation’s young people. However, the good news is that we know what works to effectively protect our kids
from all forms of tobacco product use, including e-cigarettes.1,2,12 We must now apply these strategies to e-
cigarettes, including USB flash drive shaped products such as JUUL. To achieve success, we must work
together, aligning and coordinating efforts across both old and new partners at the national, state, and local
levels. Everyone can play an important role in protecting our nation’s young people from the risks of e-cigarettes.
Information for Parents
You have an important role to play in addressing this public health epidemic.
Learn about the different shapes and types of e-cigarettes and the risks of all forms of e-cigarette use for young
people at https://e-cigarettes.surgeongeneral.gov/.
Set a good example by being tobacco-free. If you use tobacco products, it’s never too late to quit. Talk to a
healthcare professional about quitting all forms of tobacco product use. For free help, visit smokefree.gov or
call 1-800-QUIT-NOW .
Adopt tobacco-free rules, including e-cigarettes, in your home and vehicle.
Talk to your child or teen about why e-cigarettes are harmful for them. It’s never too late.
Get the Surgeon General’s tip sheet for parents, Talk With Your Teen About E-cigarettes, at https://e-
cigarettes.surgeongeneral.gov/. Start the conversation early with children about why e-cigarettes, including
JUUL, are harmful for them.
Let your child know that you want them to stay away from all tobacco products, including e-cigarettes, because
they are not safe for them. Seek help and get involved.
o Set up an appointment with your child’s health care provider so that they can hear from a medical
professional about the health risks of tobacco products, including e-cigarettes.
o Speak with your child’s teacher and school administrator about enf orcement of tobacco-free school
policies and tobacco prevention curriculum.
o Encourage your child to learn the facts and get tips for quitting tobacco products at
Teen.smokefree.gov.
Information for Teachers
You have an important role to play in addressing this public health epidemic.
Learn about the different shapes and types of e-cigarettes and the risks of all forms of e-cigarette use,
including JUUL, for young people at https://e-cigarettes.surgeongeneral.gov/.
Develop, implement, and enforce tobacco-free school policies and prevention programs that are free from
tobacco industry influence, and that address all types of tobacco products, including e-cigarettes.
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Engage your students in discussions about the dangers of e-cigarette use. To help you, the Food and
Drug Administration (FDA), and Scholastic, developed free resources for teachers. These materials can
be found at www.scholastic.com/youthvapingrisks.
Information for Health Professionals
You have an important role to play in addressing this public health epidemic.
Learn about the different shapes and types of e-cigarettes and the risks of all forms of e-cigarette use,
including JUUL, for young people at https://e-cigarettes.surgeongeneral.gov/.
Ask about e-cigarettes, including small, discreet devices such as JUUL, when screening patients for the
use of any tobacco products.
Educate patients about the risks of all forms of tobacco product use, including e-cigarettes, for young
people.
Encourage patients to quit. For free help, patients can visit smokefree.gov or call 1-800-QUIT-NOW.
Information for States , Communities, Tribes, and Territories
You have an important role to play in addressing this public health epidemic.
Implement evidence-based population-level strategies to reduce e-cigarette use among young people,
such as including e-cigarettes in smoke-free indoor air policies, restricting young peoples’ access to e-
cigarettes in retail settings, licensing retailers, implementing price policies, and developing educational
initiatives targeting young people.
Implement strategies to curb e-cigarette advertising and marketing that are appealing to young people.
Implement strategies to reduce access to flavored tobacco products by young people.
KNOW THE RISKS. TAKE ACTION. PROTECT OUR KIDS.
References
1. Office of the Surgeon General. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon
General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention (US),
National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
https://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.
2. Office of the Surgeon General. E-cigarette Use among Youth and Young Adults: A Report of the Surgeon General.
Washington, DC: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2016.
https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf.
3. Wang TW, Gentzke A, Sharapova S, et al. Tobacco Use Among Middle and High School Students - United States, 2011-
2017. MMWR Morbidity and Mortality Weekly Report. 2018;67(22):629-633.
4. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the Field: Increase in use of electronic
cigarettes and any tobacco product among middle and high school students – United States, 2011-2018. MMWR
Morbidity & Mortality Weekly Report 2018; 67(45):1276-1277.
5. Ambrose BK, Day HR, Rostron B, et al. Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014.
Jama. 2015;314(17):1871-1873.
6. Trivers KF, Phillips E, Gentzke AS, Tynan MA, Neff LJ. Prevalence of Cannabis Use in Electronic Cigarettes Among US
Youth. JAMA pediatrics. 2018;172(11):1097-1099.
7. National Academies of Sciences, Engineering, and Medicine. 2018. Public Health Consequences of E-Cigarettes.
Washington, DC: The National Academies Press. https://doi.org/10.17226/24952.
8. Ramamurthi D, Chau C, Jackler RK. JUUL and other stealth vaporisers: hiding the habit from parents and teachers. Tob
Control. 2018. Epub ahead of print. doi: 10.1136/tobaccocontrol-2018-054455.
9. King BA, Gammon DG, Marynak KL, Rogers T. Electronic Cigarette Sales in the United States, 2013-2017. Jama.
2018;320(13):1379-1380.
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10. Willett JG, Bennett M, Hair EC, et al. Recognition, use and perceptions of JUUL among youth and young adults. Tob
Control. 2018. Epub ahead of print. doi: 10.1136/tobaccocontrol-2018-054273.
11. Truth Initiative. JUUL e-cigarettes gain popularity among youth, but awareness of nicotine presence remains low.
https://truthinitiative.org/news/juul-e-cigarettes-gain-popularity-among-youth.
12. US Department of Health and Human Services. Preventing tobacco use among youth and young adults. Atlanta, GA: US
Department of Health and Human Services, CDC;2012.
https://www.cdc.gov/tobacco/data_statistics/sgr/2012/index.htm.
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Poway Unified Page 37
2016-17 Main Report – Module A: Core
Table A7.1
Summary of Key CHKS Tobacco Indicators
Table
Grade 7
%
Grade 9
%
Grade 11
%
NT
%
Use Prevalence and Patterns
Ever smoked a whole cigarette 1 3 7 44 A7.2
Current cigarette smoking‡ 0 1 3 23 A7.3
Current cigarette smoking at school‡ 0 0 1 7 A7.4
Ever tried smokeless tobacco 1 1 3 15 A7.2
Current smokeless tobacco use‡ 0 1 1 10 A7.3
Current smokeless tobacco use at school‡ 0 0 1 4 A7.4
Ever used electronic cigarettes or other vaping
device 3 9 22 61 A7.2
Current use of electronic cigarettes or other vaping
device‡ 1 3 7 31 A7.3
Current use of electronic cigarettes or other vaping
device at school‡ 0 1 1 8 A7.4
Cessation Attempts
Tried to quit or stop using cigarettes na 1 2 19 A7.5
Attitudes and Correlates
Occasional smoking great harm 42 38 41 28 A7.6
Smoking 1-2 packs per day great harm 80 84 87 74 A7.6
Very easy to obtain cigarettes 6 14 25 47 A7.6
Notes: Cells are empty if there are less than 10 respondents.
‡Past 30 days; na—Not asked of middle school students.
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