Did you know that it’s still a bit like the wild, wild west when it comes to regulating e-cigarettes and other vaping products? Aside from having to be 18 to purchase or use them, there’s basically nothing in place to regulate the products themselves.
In fact, last year, e-cigarette companies were given an extension on a deadline to apply for FDA clearance. The extension pushed the deadline to August of 2022, giving these companies more time to keep their products on the market before they are reviewed by the federal agency.
As troublesome as the lack of regulation may be, it’s especially terrifying given that teens are turning to vaping and e-cigarettes in growing numbers. In Texas, 25% of middle and high school students say they’ve tried some sort of electronic vapor product, even though no long-term studies or scientific research supports the common misperception that they are better for you than smoking traditional cigarettes.
Part of the problem is that once young people start using electronic devices, use of traditional cigarettes could come next – teen e-cigarette users are 23 percent more likely to start smoking traditional cigarettes within six months of use than teens who don’t use e-cigarettes. In fact, one pediatric pulmonologist says electronic smoking devices have become “the new way to get kids addicted to nicotine.”
It’s not just the popularity of Juuls that we should be concerned about though. The CDC has also found that e-cigarette ads target millions of kids using some of the same tactics that the tobacco industry used years ago. Thanks to TV, movies, Internet, magazines, retail stores, sports and music marketing, and celebrity endorsements, young people are seeing e-cigarette ads on a daily basis. This type of exposure – along with the creation of flavored products that are appealing to youth – may also have something to do with the growing number of young e-cigarette users.
Given that a tobacco company once referred to young adult smokers as “replacement smokers,” the current attempt to entice youth with flavored products and “fun” marketing should come as no surprise. The tobacco industry – which has taken over the e-cigarette industry – knows that it needs young people to start smoking so their business doesn’t eventually go away.
There does seem to be some good news: since the FDA extended the deadline for e-cigarette companies to receive agency clearance, the FDA also has begun to crack down on the industry’s intentional and harmful targeting to children. The agency sent warning letters in May of 2018 to companies that “misleadingly labeled or advertised nicotine-containing e-liquids as kid friendly food products such as juice boxes, candies, and cookies.” (How can they not be marketing to youth when products resemble junk food products and have names like “Smurf Sauce” and “V’Nilla Cookies & Milk”?) FDA Commissioner Scott Gottlieb said that these companies have “a responsibility to ensure they aren’t putting children in harm’s way or enticing youth use.”
And yet, this is what we’re seeing…
While the marketing crackdown is a great step forward, there’s still more to do while we wait for the FDA to review these products in 2022. Ninety percent of adult smokers start smoking in their teens or earlier – prevention efforts are critical now.
It’s important for parents and kids to talk about the dangers of vaping and e-cigarette use (from addiction and harmful toxins in e-liquids to future risk of cancer and heart and lung disease) – not to mention the unfortunate reality that youth are being directly and deliberately targeted through advertising.
There’s still so much work to be done to keep our kids safe from these harmful products, but thankfully, there are opportunities for adults and youth alike to get engaged in community prevention efforts.
We also know teens and adults find e-cigarettes appealing because they still believe they are less harmful than other tobacco products. But that doesn’t mean they are safe.
Case in point: one significant new study of nearly 70,000 people revealed that daily e-cigarette use can double the risk of a heart attack. When you consider that e-cigarettes are increasingly becoming a gateway to smoking among youth, these studies should be a concern.
But your average teen isn’t concerned about their chances of a heart attack — or other major health concerns like cancer; they’re drawn to e-cigarettes like JUUL, which “has developed a cult-like following among youth and young adults, fueled by a strong presence on social media sites like YouTube.”
As concerned community members, we can advocate for regulation of e-cigarettes by the FDA, which has had the authority to regulate them since 2016 but has delayed implementation of key provisions. We can also share public health materials to build public awareness about potential harms associated with use of JUUL and other e-cigarettes. Several resources are emerging, including educational toolkit materials for teens developed by the Stanford University Department of Medicine, a Truth Initiative fact sheet, and a Campaign for Tobacco-Free Kids fact sheet. Finally, we can get involved with local coalitions like the Galveston/Bay Area and the Wichita County TPCCs (Tobacco Prevention and Control Coalitions) that are working to pass comprehensive smoke-free ordinances and Tobacco21 laws that would prevent anyone under the age of 21 from purchasing tobacco products.
If you have any questions or want more information about what you can do in your community on this issue or other tobacco-related issues, please contact Steve at SRoss@TexansStandingTall.org or 512.442.7501.
When the Hidalgo County TPCC formed in February of 2014, only one smoke-free ordinance had passed within the county. Today, 17 communities are 100% smoke-free.
“Even though there are separate cities in the county, the Valley is like a large community,” said Bowen. “So every time a city passed one, it encouraged another to take it up.”
She credits the combination of grassroots efforts and support from American Heart Association, the American Cancer Society, Texans Standing Tall, and other organizations for their success.
“It took research and planning from the AHA and ACS combined with a lot of one-on-one meetings to convince civic leaders that their communities wanted this,” Bowen added.
The movement built up slowly, with the cities of Edinburg, Pharr and Mission creating smoke-free ordinances from 2014-2016. Then in 2017, momentum took over, with at least one ordinance a month being passed.
Having coalition members committed to creating smoke-free communities was the major factor in making Hidalgo County virtually smoke-free. Every agenda, handout, or email from members included updates on what was happening in cities. So when McAllen had a public hearing, they had over 200 people show up.
The coalition realizes that even with this success, their work is not over.
“There will always be more work, there will always be opportunities,” said Mrs. Bowen. “We hope the community is proud and will take ownership of some projects to continue working on enforcement and implementation.”
Texans Standing Tall understands that passing and enforcing comprehensive smoke-free ordinances is hard work, but we also believe that Texas cities are up to the challenge of implementing changes that help create healthier, safer communities – Gilda Bowen and the Hidalgo County TPCC are living proof of that. If you’re interested in learning more about passing a comprehensive smoke-free ordinance in your community, please contact Steve Ross at sross@TexansStandingTall.org.
School’s out for summer. For many families, spending more time outdoors is a big part of their summertime agenda.
Our Texas parks and beaches are at peak demand for the next several weeks, so it’s a good time to remind everyone about outdoor smoke-free ordinances and why they matter.
Even outdoors, children and adults are affected by secondhand smoke. Asthma attacks, eye irritation, headaches, and ear issues are just some of the effects of secondhand smoke. But it isn’t just an afternoon at the park that is concerning. A 2006 Surgeon General’s Report outlined the dangers of prolonged exposure to secondhand smoke, which include cancer and heart disease in addition to asthma and other respiratory issues. While most studies about secondhand smoke are directly related to indoor exposure, more recent studies have shown that secondhand exposure outdoors can be significant.
Because we know now there is no safe level of secondhand smoke, many communities are looking at expanding their smoke-free policies to include outdoor spaces as well. In addition to protecting people from secondhand smoke, outdoor smoking ordinances can also be helpful to individuals who are trying to quit smoking by eliminating triggers.
They also send an important message to our kids that smoking is not a community norm, which can help prevent later tobacco usage.
While outdoor smoke-free ordinances can be challenging to implement (especially when it comes to defining what is indoor vs. outdoor space), they contribute to a healthier and safer Texas. For more information about pursuing a smoke-free ordinance in your community, please contact Steve Ross, our Statewide Coalition Specialist, at email@example.com or (512) 442-7501.
Our 2017 Statewide Summit was a success – thanks largely to you all for joining us on May 1st and 2nd in Austin, Texas, for the event! With help from a range of national and state experts, participants grew their knowledge on a number of prevention issues, such as fetal alcohol spectrum disorders (FASD), best practices for tobacco prevention and control, addressing binge drinking on college campuses, the relationship between mental health issues and prevention, and more. In case you weren’t able to join us for Summit this year, TST staff members have put together some of the main takeaways from each of the presentations – check it out below!
Don’t forget to mark your calendars for our 2018 Statewide Summit, which will take place February 21-22, 2018, at the Austin Marriott South. We hope to see you there!
A Community’s Response to Fetal Alcohol Spectrum Disorder
Nora Boesem | Founder, Roots to Wings
After flight delays, flight cancellations, and an impromptu road trip with a fellow stranded passenger, Nora Boesem finally made it to Summit – and we sure are glad she did! Sharing her story as a foster mother to more than 100 children with FASD, Nora inspired attendees to step into the role of advocates and ACT. In addition to learning about the amazing work Nora does as a mother and in her community, her presentation also taught us:
FASD is a physical disability with behavioral symptoms; it does not go away and it is not outgrown.
Raising and working with individuals who have FASD sometimes means trying differently rather than harder to address some of the behavioral issues encountered.
The effects of FASD are far-reaching and can result in genetic changes that are passed from one generation to the next.
We can see positive changes in our communities when we work together, but it’s important to remember change takes time – patience and perseverance are often required.
Following the Money: How Industry Influences Policy
Jennifer Cofer, MPH, CHES | Director, EndTobacco Program, MD Anderson Cancer Center
Bob Pezzolesi, MPH | Founding Director, New York Alcohol Policy Alliance
Jennifer Cofer and Bob Pezzolesi gave Summit participants insight into the history of how alcohol and tobacco industries influence government policies to promote their own agendas. The presenters brought years of experience in public health, prevention, and the promotion of science-based, public health policies. Participants left with a greater awareness of the major industry contributors to elected officials and policies as well as how the industry impacts national, state and local prevention policies. These takeaways allowed participants to return to their communities empowered with knowledge of industry financial influence and encouraged to advocate for vital public health policies. Additionally, Jennifer and Bob shared some specific resources advocates can use when trying to follow the money:
To learn more about how the tobacco industry influences policy, visit no-smoke.org.
To explore how much money the alcohol industry gives to different politicians and political organizations, check out followthemoney.org
Don’t forget: You have to speak up/advocate so the tobacco and alcohol industries are not the only ones with influence!
Broadcasting Your ACTions
Dave Shaw | President, Arrow
Thanks to Dave Shaw, President of Arrow Media, Summit attendees got an expert crash course on developing messages to gain supporters and move prevention strategies forward. Ultimately, he encouraged us to ask ourselves who our key audiences are, what they care about, and what we want them to know. Dave’s presentation also reminded participants that crafting a strong message relies on:
Considering these factors about your audience:
Where are they from?
What do they know about you?
What keeps them up at night?
How much do they know about the topic?
Why should they care?
What is their number one concern?
Knowing your story really well and understanding what you want people to take away from the conversation.
Remembering that the message and the messenger matter.
A solid process for message development and delivery. This should consider:
The problem, solution, and benefit.
What is the size and scope? Who does it impact?
What difference can we make?
What’s in it for your audience?
The main takeaway, how to connect, and what proof you have.
What do you want people to feel/do?
How do you get people to listen?
How do you make people believe? (Evidence/Data)
Blowing the Whistle on Youth Alcohol Marketing
Youth Leadership Council | Texans Standing Tall
This year, the Youth Leadership Council (YLC) gave two fantastic presentations during Summit, covering topics from alcohol advertisements targeted at youth to effectively engaging youth in prevention activities. During their plenary presentation on alcohol advertising, we learned that:
Alcohol companies spend over 2 billion dollar a year on advertisements.
1 out of every 5 alcohol advertisements appears on programing that youth ages 12 to 20 are more likely to watch.
References to alcohol are very prominent in music, from country to rap.
Alcohol companies use cultural references to entice customers.
Youth are especially vulnerable to these types of advertisements because they are new and inexperienced customers.
Community prevention advocates can monitor advertisements in their community, especially around schools and in places youth are more likely to see them.
The YLC also presented during an interactive breakout session on day two of the Summit. They discussed important practices organizations can employ for effective youth engagement:
Involve youth in recruitment efforts to increase the size of a youth group.
Have an application process, letter of agreement, and clear guidelines for communicating roles and expectations to help retain youth members over a longer period of time.
Let youth work with adult members to make decisions about which projects they will be involved in and what their roles will be.
Allow youth to learn and grow leadership skills.
Practice positive group characteristics, such as setting clear responsibilities and expectations, learning how to work together as a team, and establishing clear lines of communication.
Use the “Ladder of Participation” to assess progress and examine how youth and adults can work together more effectively.
On a related note, in the Fall, Texans Standing Tall and will be providing a new Community engagement guide (with accompanying trainings) that provides more in-depth information on youth and adults working together to achieve effective partnerships. Please contact Georgia Marks at firstname.lastname@example.org or 512.442.7501 for further information.
Best Practices Make Perfect
Karla S. Sneegas, MPH | Program Service Branch Chief, Office on Smoking and Health – Centers for Disease Control and Prevention
We were excited to welcome Karla Sneegas to talk about the CDC’s recommendations for best practices in tobacco prevention and control. From Ms. Sneegas, we learned:
Tobacco use remains a considerable public health problem nationally and in Texas, where it costs almost $9 Billion a year in medical care and loss of productivity. Every year, over 28,000 Texans lose their life prematurely due to smoking.
The CDC recommends that Texas spend $10.13 per person per year on tobacco control. However, the state currently spends only $0.47 per person.
By following the CDC’s Best Practices for Comprehensive Tobacco Control Programs, states can effectively and comprehensively attack the problem.
There are five main components to a comprehensive tobacco control program:
State and community interventions
Mass-reach health communications interventions
Surveillance and evaluation
Infrastructure, administration and management
Bottom line: we know how to implement better interventions, more efficiently, with a stronger evidence base and a greater reach. Now we just need to reach the recommended funding level for a sustained tobacco control program to most effectively reduce tobacco use.
Promoting Community Standards to Address College Binge Drinking
Toben Nelson, ScD | Assoc. Prof., Epidemiology & Community Health, Univ. of Minnesota School of Public Health
This year, we were so excited to have Dr. Toben Nelson join us at Summit! It was incredibly helpful to have him share strategies for building partnerships between colleges and communities to implement effective prevention strategies. He opened a dialogue between our current campus partners and prevention coalitions in their communities, which was also a huge advantage of having him with us. Dr. Nelson also encouraged those of us in the prevention field to:
Reframe how communities and colleges think and talk about environmental strategies.
View policies as community standards and enforcement as what makes everyone accountable to those standards.
Use existing tools in our collaboration efforts.
Up in Smoke! Tobacco Prevention Funding
Joel Dunnington, MD, FACR | Retired Professor of Diagnostic Radiology at UT, MD Anderson Cancer Center
Dr. Joel Dunnington brought his wealth of knowledge to Summit and provided an overview of the Tobacco Settlement Funding, its intended purpose, and how it’s actually been used. Participants also learned how much could be accomplished if funding levels were closer to the CDC’s recommendations so they can take action and help move Texas closer to the recommended levels. Participants also learned:
In Texas, the Tobacco Settlement Funds established the Permanent Fund for Health Tobacco Education and Enforcement
In 2011, the 82nd Legislature expanded the use of the three Permanent Funds, including the Permanent Fund for Health Tobacco Education and Enforcement, to pay the principal or interest on a bond for the Cancer Prevention and Research Institute of Texas. As a result, the Permanent Fund for Health Tobacco Education and Enforcement will be zeroed out at the end of FY2018.
And the Survey Says? Results from TST’s Alcohol Excise Tax Survey
Matt Gamble | Vice President of Operations, Baselice & Associates
Matt Gamble, Vice President of Operations at Baselice and Associates, gave a presentation sharing the results of the Texans Standing Tall’s recent statewide survey. The survey measured voters’ overall attitudes towards an increase in the alcohol excise tax, what programs they think should receive the estimated $708 million in additional revenue, and what messages respondents found most persuasive. Many were surprised to learn:
A majority of Texans across all demographics and regions support the initiative.
Despite conventional wisdom saying otherwise, most Texas voters do not shrink at the term “tax” when it comes to raising alcohol excise taxes.
Women and regular churchgoers are most supportive of an increase in alcohol excise taxes.
Texas voters responded most favorably to economic and public health messages that discussed how:
The alcohol excise tax has not been raised in Texas since 1984.
Excessive drinking costs the state $19 billion/year and each Texan $695/year.
A dime a drink increase in alcohol excise taxes could improve public safety by decreasing impaired driving and motor vehicle crashes/fatalities by 112/year.
Increasing the alcohol excise tax benefits public education by providing additional $177 million/year for schools.
Ending the Stigma of Co-Occurring Conditions
Noah Abdenour, Certified Peer Specialist | Director of Peer Support Services, Austin State Hospital
Noah Abdenour presented on the intersection between prevention and mental health, taking a special look at the relationship between prevention and recovery. By sharing his personal story, Noah was able to reinforce the theme of deciding to A.C.T (Accomplishing Change Together). His journey included examples of how peers played an integral role in helping him transform his life. During his presentation, we also learned that:
Co-occurring disorders are when somebody has a mental health condition and substance use issue at the same time. He emphasized how co-occurring disorders can be difficult to diagnose due to the complexity of symptoms. He also mentioned that one can often times mask the other, and vice versa.
Prevention can play a role in behavioral health by helping people maintain self-care and wellness.
Current issues with the behavioral health landscape in Texas include lack of access to care, workforce shortage, inadequate training for some behavioral health professionals.
Communities in ACTion (Panel)
Tom Marino | Social Host Workgroup Chair, Circles of San Antonio Coalition
Tracy Talavera | Coalition Coordinator, Circles of San Antonio Coalition
Gilda Bowen | Coordinator, Uniting Neighbors in Drug Abuse Defense Tobacco Prevention & Control Coalition
Rosalie Tristan | Communities Against Substance Abuse Coordinator, Behavioral Health Solutions of South Texas
Ed Swedberg | Deputy Executive Director, Texas Alcoholic Beverage Commission
Michael Sparks, Moderator | President, Sparks Initiatives
The Communities in ACTion focused on how local communities are acting to create change through ordinances, story-telling, and enforcement efforts. Michael Sparks, national alcohol policy expert, moderated the discussion, which included Circles of San Antonio staff and coalition members, UNIDAD Tobacco Prevention and Control Coalition staff and volunteers, and the TABC Deputy Executive Director. This highly accomplished and motivated panel discussed different factors essential for community change:
Relationship building within the community is critical. Without these relationships in place, the strategy, no matter how effective, will inevitably fail.
A strategy requires an additional emotional catalyst to draw the community in. Relevant personal stories drive the strategy forward by placing a human face on an emotionally inaccessible, typically data driven issue.
Upon implementation, a policy is only effective when thoroughly enforced.
Compliance checks are way to address underage drinking in communities.
Coalitions can work with TABC and the local police by reporting stores and bars that repeatedly violate the law by selling to minors.
In addition to the plenary sessions highlighted above, Summit attendees also had the opportunity to participate in breakout sessions on both days of the event. During the breakouts, participants were able to work more closely with our expert speakers to further explore the presentation topics and how they can apply the information to their prevention work at home.
If you have any questions or would like additional information about the Texans Standing Tall’s Statewide Summit, please contact us at 512.442.7501 or email@example.com.