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As a practicing pediatrician at the University of Vermont Children’s Hospital, I specialize in caring for children with lung and breathing problems. I regularly see children whose health has been compromised by their own tobacco product use or that of their caregivers. We know that the use of tobacco products causes disease and early death in adults, and Vermont pediatricians are increasingly concerned about the rising rate of tobacco use among youth. Pediatricians across Vermont support ending the sale of all flavored tobacco products, including mint and menthol flavoring.
In our clinics, young people tell us they start using e-cigarettes in part because the flavors are appealing, and the flavors make the product seem benign. Soon after trying Bubblegum or Wild Cherry flavored e-cigarettes, they find themselves addicted to nicotine and can’t stop using these products despite how much they want to quit. They are often surprised to find out how dependent they have become. Each day in this country, more than 4,300 children under 18 try an e-cigarette for the first time, and studies show that 89% of these younger tobacco users use a flavored product. Of great concern, more than more than 16% of Vermont’s high schoolers are using e-cigarettes and the cigarette smoking rate is 5.4%, higher than the national smoking rate of 3.8%. Vermont has a tobacco problem.
One 18 year old who began using e-cigarettes at age 13 told me, “I didn’t know what I was doing. Another kid passed me something and told me it tasted like fruit punch, and that sounded good to me. It made me feel really good. I didn’t know it had nicotine in it, I just knew I wanted to do it again.”
This young person has made two attempts to quit during the past year but has not been able to tolerate the emotional swings that come from nicotine withdrawal. They also said, “I feel like I have lost a lot of control over my life because I can’t do anything without having a vape on me.”
Within five minutes of waking each day, this young person uses a flavored nicotine product. They use it throughout the day, and it’s the last thing they do before falling asleep. This young person also has months of coughing when they have a cold and ongoing chest pain that worsens when they vape, and they have not been able to quit even though they want to.
Pediatricians, parents, and schools continue to struggle to support a large number of youth with nicotine dependence. The degree of widespread use we are seeing is not harmless experimentation, nor is it inevitable. Responding to these continued high rates of youth tobacco use takes additional time and resources from schools that are already stretched to their limits.
Young people in Vermont deserve environments that help them to thrive, pursue their passions, develop skills, figure out who they are, and determine what their place is in the world. They deserve a chance to reach adulthood without being targeted for addiction by Big Tobacco. The tobacco industry has purposefully used flavors to entice kids to its products for decades, according to studies (see references for source data). They started with menthol cigarettes, which were insidiously marketed to Black and LGBT communities. Now it’s e-cigarettes. In both cases, tobacco use establishes the brain’s dependence on nicotine at a critical developmental stage — but it’s the flavors that are luring the kids into addiction.
My work helping young people overcome this addiction is, frankly, disheartening. Nicotine is an incredibly powerful substance and it’s a challenging uphill battle for a young person to stop using it once they are dependent on it. This helps explain why a teenager who becomes dependent on nicotine through use of electronic cigarettes is about four times more likely to go on to smoke traditional cigarettes, threatening decades of progress that has been made in reducing youth tobacco use. Our kids are in crisis and it’s time for the Vermont House to follow the lead of the Vermont Senate and pass legislation to end the sale of flavored tobacco products. No matter how much medical professionals would like to help kids and families enjoy healthier lives, we need effective public health policy as our partner in this battle.
Our Vermont Legislature convenes next month and I am urging our state representatives to act immediately on this bill to help prevent addiction and save lives. Nearly 30% of cancer deaths in Vermont are attributable to smoking and it kills more than 1,000 adult Vermonters each year — more than any disease, car crashes, gun violence and suicides combined.
And to parents who are concerned their child may pick up a tobacco product — we need your help, too, in addressing this public health crisis. Please contact your legislator and let them know that they have the power to protect the children and teenagers that my colleagues and I struggle to help every day. Our experience of trying to address this issue in our clinics has made it obvious that effective prevention of nicotine dependence and tobacco use must move upstream – out of my clinic and up to the State House. S.18 is what prevention work looks like – end the sale of all flavored tobacco products in Vermont.
By Dr. L.E. Faricy
