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The Latest on Vaping: New Stanford Study on Covid-19 Risks and What's Still on the Market

RECENT STUDIES


According to a new study led by researchers at Stanford University School of Medicine, vaping is linked to a substantially increased risk of COVID-19 among teenagers and young adults. Published online in the Journal of Adolescent Health on August 11, 2020, the study

found that youth who vaped are five to seven times more likely to be infected with the virus causing COVID-19 than those who did not vape. E-cigarette users were five times more likely to get a COVID-19 diagnosis and dual users of e-cigarettes and cigarettes were seven times more likely. Data was collected via online surveys in May 2020 of 4,351 individuals ages 13-24 years old who lived in all 50 states of the U.S., the District of Columbia and three U.S. territories.  As the study's senior author stated, "Young people may believe their age protects them from contracting the virus or that they will not experience symptoms of COVID-19 but data shows this isn't true among those who vape". The study's numbers surprised the researchers who hope these findings will prompt the FDA to further tighten regulations governing how vaping products are sold to youth. Although the Stanford study did not get to examine the severity of COVID-19 symptoms or hospitalization rates of those who vaped and contracted the virus, there is growing

evidence that suggests aerosol from vaping devices can harm lungs at the cellular and organ levels and worsen the body's ability to fight respiratory infections. With respect to smoking, a review of five studies published to date show that it is most likely associated with getting sicker from COVID-19.  The largest study of 1,099 people with COVID-19 revealed that those who smoke are 2.4 times more likely to get very sick (e.g., requiring admission into an intensive care unit). Smoking is known to weaken the immune system and the body's ability to fight infections. THE LATEST ON FLAVORED BANS AND VAPING PRODUCTS STILL ON THE MARKET Vaping Tobacco. With San Francisco-based JUUL blamed for the explosion of teen vaping rates in recent years, federal, state and local regulators have been scrambling to regulate e-cigarettes and enact flavored tobacco vaping product and outright e-cigarette bans. While JUUL has been under siege and its U.S. sales curtailed, a big game of Wack-A-Mole has ensued. What's the latest?  Though JUUL was hit hard and the FDA in January 2020 banned fruit and mint flavored vaping products, the ban had been weakened after heavy lobbying of the Trump Administration by the vaping industry. The FDA excluded menthol products and a loophole for disposable vapes opened up through which companies such as Puff Bar drove a Mack

truck.  Puff Bars deliver a hit of nicotine that is even stronger than JUUL and its flavors are just as enticing.  In July 2020, the FDA sent Puff Bar's CEO a warning letter ordering them to remove all flavored e-cigarettes and youth appealing flavors from the market. Puff Bar's CEO and CFO reportedly denied they owned the company, claiming they only managed the Puff Bar website. And although the Puff Bar website now says it has ceased online sales, Puff Bars and an array of products such as Suorin, Hype Ultra, and Puff Plus can still be found on another e-commerce site - Eliquidstop - which is owned by none other than Puff Bar's CEO and CFO.  Other copycat brands of disposable e-cigarettes that look like JUULS can easily be found

on a multitude of online sites. One of the more popular these days is the STIG, which comes in flavors such as Tropical Mango, Mighty Mint and Lush Ice. According to its website, one STIG pod "packs enough juice and power" for a three pack to be the equivalent of 60 cigarettes - and just for under $20.  On the local level, in 2019 San Francisco passed an e-cigarette ban that is the most comprehensive in the country. Voters resoundingly defeated a ballot initiative (supported by JUUL) to overturn the ban. Cities and towns throughout Marin also have enacted to varying degrees their own flavored vaping bans. And on August 28th, 2020, California became the second state in the nation (after Massachusetts) to prohibit the sale of flavored tobacco products, including flavored vapes, menthol cigarettes, flavored little cigars and cigarillos, loose leaf "roll your own" tobacco, and smokeless tobacco. Exempt from California's ban, however, are hookah and shisha (the molasses-based tobacco product heated in a hookah). The California ban takes effect on January 1, 2021, after which retailers will be prohibited from selling these flavored tobacco products. And so the rush to stock up has begun with online sales still happening until further FDA action is taken. Vaping Cannabis. At the same time, sales through legal cannabis dispensaries throughout the Bay Area of a dizzying array of cannabis products, including candies, baked goods and concentrates that are vaped or dabbed show no signs of slowing down. (Read about the

difference between vaping and dabbing here). Teens often swap out nicotine pods for cannabis-oil pods and thus vaping in all forms continues. So while retail sales of tobacco vaping products is being curtailed, quite the opposite is occurring with respect to cannabis.


Last year's EVALI (E-Cigarette or Vaping Product Use-Associated Lung Injury) crisis was largely due to cannabis vaping and one in six cases was traced back to commercially purchased THC in legal states. And in Marin, Big Cannabis industry proponents are engaged in constant efforts to open up retail shops in our towns, affording easy access by youth, and decreasing the perception of harm by normalization and false product claims on health. WHAT'S A PARENT TO DO?


Continue to get educated on the latest products, monitor your child and look for signs of vaping and smoking. An excellent recent webcast from Operation Parent entitled "How Vaping is Effecting Teens Especially During COVID" can be viewed here. It identifies risk and protective factors and signs of use and withdrawal. In addition, BTI has covered vaping exhaustively over the past several years. Read our previous blogs on:

HOW TO GET HELP

If you discover that your child is vaping, immediately seek help. A free mobile program, The Truth Initiative's "This is Quitting" is the first of its kind program to help youth quit vaping and one of the only vaping interventions out there for youth.


As always, please do not hesitate to reach out to BTI in confidence if you need any additional resources by emailing us.

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