Editor’s note: This commentary is by Prospero Gogo Jr., MD, who is an associate professor of medicine and director of the Cardiac Catheterization Laboratory at the University of Vermont Medical Center/Larner College of Medicine.
[T]his session, the Vermont Legislature is considering several bills which will make it more difficult for teens to access tobacco products as well as tobacco substitutes such as e-cigarettes and vaping products.
These include:
• the restriction of internet sales of vaping products
• a new tax on e cigarettes and vaping products
• a bill to raise the age to purchase tobacco and tobacco substitutes including vaping and e-cigarette products to 21
All of these should help address the vaping epidemic among Vermont middle and high school students. A recent survey demonstrated that almost one in three Vermont high school students tried a vaping product.
I’m an adult cardiologist. My patients are usually not in high school and fewer use vaping products, so why am I such an avid supporter of this legislation? For one, I have a 12-year-old son who may soon have to fend off the offers and the pressures of trying these products if the current environment is not changed. And second, and this I say tongue in cheek, I want to put myself out of business! How?
Last year, the cath lab at the University of Vermont Medical Center performed 1,300 procedures to open blocked heart arteries. The smoking rate in those who receive a stent for a blocked artery at UVMMC was 24%. Compare this to the current smoking rate in Vermont of 16%. Of these 1,300, 300 patients presented with a large heart attack, and most of these procedures occur “after hours” prompting us to run into the hospital at all hours to treat these patients with life-sparing procedures. Most strikingly, the smoking rate among those in this group at UVMMC was 48%. Despite a lower smoking rate (which has plateaued over the last three years) smoking is still the number one preventable cause of disease in Vermont and in the United States.
But what does this have to do with teen vaping?
A recent study in JAMA: Pediatrics demonstrated that teens who tried vaping/e-cigarettes were possibly up to eight times more likely to start smoking cigarettes than those who did not vape.
And vaping itself is unlikely to be harmless. My colleagues who study respiratory diseases have already demonstrated the potential risks to lung health, but what about cardiovascular health?
I attended the most recent international cardiology research meeting in New Orleans last month, and sat in on a session going over recent data from the Centers for Disease Control. In the study, they associated at least a 30% increased risk of heart attack and a 50% increased risk of depression amongst those who vape and who have never smoked cigarettes.
We need to keep teens from accessing these products, and making them more expensive and making it more difficult to obtain (most 15- to 17-year-olds who vape obtain the product from their 18-year-old classmates who can currently legally purchase vaping products at convenience stores) will contribute substantially to realizing that goal.
There is discussion to exempt members of the military from some of these restrictions. However, the U.S. military and the Vermont National Guard have given their full support to tobacco 21. Cigarette smoking is a leading impediment to readiness for battle. This was confirmed by studies by the U.S. military in the 1980s and reconfirmed by a recent British military study. In both of these studies, troops who smoke on average performed significantly worse on most fitness tests compared to non-smokers. Furthermore, military bases in jurisdictions with tobacco 21 laws enforce it on the base. If we want the strongest, healthiest soldiers for the defense of our state and our nation, there should not be an amendment to weaken provisions for military personnel.
If you feel as strongly about this as I do, make sure you contact your state legislator and the governor this week and tell them you support these measures.
