Congress has taken action to put a stop to the soaring popularity of vaping amongst teenagers. Tucked into a spending bill that passed the House and the Senate on Tuesday is a provision that raises the legal age to buy e-cigarette products and tobacco products from 18 to 21, as the New York Times reported.
<p>President Donald Trump, who had said he would ban flavored e-cigarettes and then backtracked from that statement, is expected to sign the bill, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported.</p>
<p>"Raising the tobacco age to 21 is a positive step, but it is not a substitute for prohibiting the flavored e-cigarettes that are luring and addicting our kids," said Campaign For Tobacco-Free Kids media director Dave Lemmon in an emailed statement to <a href="https://www.forbes.com/sites/lisettevoytko/2019/12/19/congress-raises-tobacco-e-cigarette-purchasing-age-to-21/#13ed7530534d" target="_blank">Forbes</a>.</p>
<p>The Senate majority leader, Mitch McConnell, a Republican from Kentucky, <a href="https://twitter.com/senatemajldr/status/1207742536007200768" target="_blank">tweeted</a> yesterday, "The Tobacco-Free Youth Act I introduced with Senator Kaine, is headed to @POTUS' desk and will help address this urgent crisis and keep tobacco products, including e-cigarettes and vaping devices, away from children."</p>
<div id="fec11" class="rm-shortcode" data-rm-shortcode-id="L3D5HC1576874827"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1207742536007200768" data-partner="rebelmouse"><div style="margin:1em 0">🚨The Tobacco-Free Youth Act I introduced with Senator Kaine, is headed to @POTUS' desk and will help address this u… https://t.co/B45OgFcTeV</div> — Leader McConnell (@Leader McConnell)<a href="https://twitter.com/senatemajldr/statuses/1207742536007200768">1576783234.0</a></blockquote></div><p>The legislation has bipartisan support after recent data has shown e-cigarettes growing in popularity amongst teens. As of yesterday, the Centers for Disease Control identified 54 deaths and over 2,500 lung related injuries attributed to vaping. <a href="https://gizmodo.com/congress-passes-law-to-raise-smoking-and-vaping-age-to-1840541553" target="_blank">Gizmodo</a> reported that the 2019 <a href="https://www.fda.gov/tobacco-products/youth-and-tobacco/youth-tobacco-use-results-national-youth-tobacco-survey" target="_blank">National Youth Tobacco Survey</a> found that more than 5 million youth are currently using e-cigarettes, with 1 million using it daily. The report also found that just 5.8 percent of high school students use traditional cigarettes, but 27.5 percent were using vaping products.</p><p>"This is a big win for public health," said Senator Brian Schatz, Democrat of Hawaii, who had proposed the higher national age limit to buy tobacco in 2015 after his state adopted it, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported. "Raising the minimum smoking and vaping age to 21 will protect our kids and save lives." </p><p>Hawaii is far from the only state to raise the legal age limit. So far, 19 states and more than 500 municipalities have already raised the purchasing age to 21, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p><p>Many in the tobacco and e-cigarette industry approved of the measure, seeing it as a way to cushion the criticism the industry faces for marketing to youth. Sen. Dick Durbin is in favor of raising the age limit, but he was disappointed that the provision did not include an outright ban on flavored e-cigarettes. </p><p>"Any serious solution to skyrocketing rates of youth e-cigarette use must include the removal of kid-friendly flavors, not just the tobacco industry's preferred policy," Senator Durbin said in a statement, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p>
<p>The backlash to the marketing to kids recently forced Facebook to change its policies on its site and on Instagram. While Facebook's ad policies have banned vaping and tobacco-products, it does allow influencers to post about smoking and accept sponsorship from advertisers, according to <a href="https://www.cnbc.com/2019/12/18/instagram-to-ban-influencers-from-promoting-vaping-and-guns.html" target="_blank">CNBC</a>.</p><p>The company announced Wednesday that it will no longer allow influencers to post branded content on any of its platforms that promote e-cigarettes or tobacco products, effectively closing the loophole in private posts that advertisers exploited, as <a href="https://www.cnbc.com/2019/12/18/instagram-to-ban-influencers-from-promoting-vaping-and-guns.html" target="_blank">CNBC</a> reported. </p>
<p>The National Academy of Medicine has estimated that 90 percent of smokers developed their addiction before turning 19, when developing brains are most vulnerable to nicotine addiction. That has led some to believe that raising the legal age limit will reduce long-term addiction. </p>
<p>"I think that you would be able to see lots of improvements in reduction of tobacco use among teens, all of which is good because the longer you delay any kind of initiation, the less likelihood there is to develop addiction and the less likely it is that use will escalate," said Robin Mermelstein, professor of psychology at the University of Illinois at Chicago, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported.</p>
<p>Critics, however, contend that the bill makes no mention of how to implement raising the age-limit, and it will be toothless if retailers continue to sell to youth. Furthermore, most public health advocates argue that a ban on flavored e-cigarette products and an excise tax are more effective in reducing youth smoking, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p>
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Vaping360 / Flickr / CC BY-ND 2.0
The Trump administration will ban flavored e-cigarettes. It comes in response to a surge in youth vaping and health concerns following a handful of mysterious deaths and hundreds of lung illnesses linked to the product.
<p>The U.S. federal government plans to ban flavored e-cigarettes amid rising concern over youth vaping and lung illness and deaths linked to the products, President Donald Trump said Wednesday.</p><p>The president and top U.S. officials expressed concern that flavored vaping products ranging from mint to mango were drawing millions of youth into nicotine addiction.</p><p>"We have a problem in our country, it's a new problem ... and it's called vaping, especially vaping as it pertains to innocent children," Trump said in the Oval Office. "There have been deaths and there have been a lot of other problems."</p>
Fda Approval Required
<p>U.S. Health and Human Services Secretary Alex Azar made the announcement at the White House alongside acting Food and Drug Administration Commissioner Ned Sharpless, the president and First Lady Melania Trump.</p><p>Azar said the FDA would create guidelines over the next couple of weeks to remove all flavored e-cigarettes from the market.</p><p>"We simply have to remove these attractive flavored products from the marketplace until they can secure FDA approval, if they can," Azar said, adding that tobacco flavored products would remain on the market for adult consumers.</p><p>But he said that if <a href="https://www.ecowatch.com/tag/childrens-health">children</a> use tobacco flavored products, "we will take enforcement action there also."</p><p>Flavored products may apply for FDA approval, but they would only be granted clearance if they prove to show a net benefit to public health, he said. </p>New Generation of Vaping Addicts
<p>The announcement comes after parents, health officials and politicians have called for federal action to stem a surge in vaping.</p><p>Preliminary federal health data for 2019 shows a quarter of high school students had used e-cigarettes in the past 30 days. The vast majority of underage teens consumed fruit, menthol or mint flavors.</p><p>E-cigarette advocates argue <a href="https://www.ecowatch.com/tag/vaping">vaping</a> is safer than cigarettes and can help users stop smoking, but there is little evidence nicotine-containing e-cigarettes are effective in dropping the habit.</p><p>Critics say companies such as Juul have marketed their products to youths and created a new generation of addicts to feed a multi-billion dollar market. </p><p>"It has taken far too long to stop Juul and other e-cigarettes companies from targeting our nation's kids with sweet-flavored, nicotine-loaded products," said Matthew Myers, of the Campaign for Tobacco-Free Kids, in a statement.</p>Growing Questions Over Safety
<p>Most health experts agree that e-cigarettes are safer than smoking tobacco products that contain thousands of chemicals and lead to the death of nearly a half-million people a year in the United States.</p><p>However, there is scant research on the long-term effects of vaping.</p><p>The administration's announcement comes as e-cigarettes and other vaping devices have been linked to six deaths and nearly 450 cases of possible vaping-related lung illness.</p><p>The exact cause of the deaths and illnesses have not been determined, but most are initially believed to be related to vaping counterfeit <a href="https://www.ecowatch.com/tag/marijuana">marijuana</a> products containing vitamin E oil, which is dangerous if inhaled.</p>From Your Site Articles
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The Orchard Road shopping area in Singapore on Nov. 17, 2018. TkKurikawa / iStock Editorial / Getty Images Plus
By John Bryson
On Jan. 1, Singapore introduced a "no smoking zone" along a three kilometer (approximately 1.9 mile) stretch of Orchard Road—one of the city's busiest shopping districts. It sounds controversial—restricting people's right to smoke in public spaces, as a way of tackling air pollution and improving public health. But smoking is not actually banned down the length of Orchard Road: instead, smokers will be concentrated in 40 designated smoking areas, spaced 100 to 200 meters (approximately 330 to 660 feet) apart.
<p>
Air pollution is a major challenge for cities around the world, as it's a significant cause of death and ill-health. City dwellers have a hard time avoiding the impacts of poor air quality, and children, the elderly and people with preexisting medical conditions are most vulnerable.
</p><p>
Air pollution directly affects business productivity and education, through sickness and loss of working days, and it can discourage inward investment and economic growth. So cities face a substantial penalty for poor air quality, before even accounting for additional public health costs.
</p><p>
Clearly, any attempt to develop solutions should be welcomed. But Singapore's no smoking zone is an odd intervention, because it doesn't seem to respond to <a href="https://www.e-elgar.com/shop/a-research-agenda-for-regeneration-economies" target="_blank">the nature of urban growth</a>, which requires an integrated approach across many different systems—from transport, to industry, to healthcare—to avoid its more perverse consequences.
</p><h3>The Root of the Problem</h3><p>
Cities are hubs of creativity and economic activity, but every act of consumption and transportation contributes to environmental pollution. One of the <a href="http://epapers.bham.ac.uk/3069/" target="_blank">basic strategies</a> for dealing with air pollution involves diluting and dispersing pollutants.
</p><p>
The no smoking zone simultaneously displaces smoking and concentrates it within small smoking areas. The level of pollution caused by each of these areas will be influenced by the environment around it, so ideally these environments will help to dilute and disperse smoke. For example, the density and height of buildings affects wind flows, which can help disperse pollution. Street canyons—consisting of similar rows of mid and high-rise buildings—inhibit dispersal.
</p><p>
Structures of different heights create a rough surface, encouraging more air mixing and leading to increased dispersion and dilution. <a href="https://new.devon.gov.uk/greeninfrastructure/" target="_blank">Green infrastructure</a>—that is, the network of natural features and spaces in a given area—can also act as a barrier between sources of pollution, roads and designated smoking areas and people.
</p><p>
But none of this will address the root of the problem. Most air pollution comes from the industrial and domestic burning of fuel for heating and cooling, electricity and transportation. Road transport emissions are the most important sources of urban air pollution, as petrol and diesel engines emit reactive oxides of nitrogen (NOx), and microscopic particulate matter (PM). The wear and tear of brakes and tires, as well as road dust, are also important sources of PM. In strong sunlight, <a href="http://epapers.bham.ac.uk/3069/9/TDAG_FSAQ_2017_BW_v2.pdf" target="_blank">NOx reacts with other compounds</a> to form ozone, a highly toxic pollutant at ground level.
</p><p>
Secondhand cigarette smoke significantly affects air quality in areas frequented by pedestrians, but this is only one ingredient in a very potent cocktail of pollutants. The World Health Organization <a href="https://www.who.int/tobacco/global_report/en/" target="_blank">recommends that</a> a no smoking policy be introduced for areas suffering from secondhand smoke. Long-term exposure to the micro-plumes of smoke which come from people who smoke cigarettes may result in the inhalation of <a href="http://www.ecowatch.com/tag/cancer">cancer</a>-causing chemicals from tobacco, including <a href="https://www.cbc.ca/natureofthings/m_features/background-nitrosamines" target="_blank">nitrosamines</a>.
</p><p>
For Singapore, the challenge is that herding smokers into the 40 designated areas might result in a concentration of micro-plumes. City leaders will urgently need to conduct detailed analysis of the localized impacts on air quality linked with each of these designated areas. This research could then inform any changes to the location and design of the designated areas, including enhancing green infrastructure.
</p><h3>Redesigning the Streetscape</h3><p>
But the no smoking zone can't be the only thing Singapore's authorities do to tackle air pollution. There needs to be an integrated approach, which reconfigures the entire design of each streetscape across the city, to encourage the mixing, dispersion and dilution of pollutants and maximize the quality of the local environment, with an emphasis on green infrastructure and separating people from pollutant sources. Any effective air quality policy must also encourage the use of environmentally friendly public transport, and the shift towards <a href="http://www.ecowatch.com/tag/electric-vehicles">electric vehicles</a>.
</p><p>
The problem with Singapore's no smoking zone will not be enforcement, but in ensuring that this is part of an integrated approach intended to minimize atmospheric pollution. The danger for Orchard Road is that the policy may intensify the problem and the health results through concentration rather than dispersion.
</p><p>
All cities must develop effective solutions to air pollution. For many cities air quality policy enforcement is a major problem. For all cities the primary challenge is to avoid isolated policy interventions intended to address one air quality problem. The critical issue is to develop a much more politically challenging integrated or holistic approach to enhancing the quality of city living.</p>
<p class="shortcode-media shortcode-media-twitter_embed">
</p><div id="919da" class="rm-shortcode" data-rm-shortcode-id="1EUVUS1576661962"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="986361190527000576" data-partner="rebelmouse"><div style="margin:1em 0">95% of World's Population Breathes Unsafe Air https://t.co/0NVplWFhsS @Greenpeace @ScienceNewsOrg</div> — EcoWatch (@EcoWatch)<a href="https://twitter.com/EcoWatch/statuses/986361190527000576">1524001808.0</a></blockquote></div>
<p></p>
<p><em>John Bryson is a professor of enterprise and competitiveness at the University of Birmingham.</em><br></p><p>
<em>Disclosure statement: John Bryson receives funding from DFID and NERC to research air quality in urban areas. First, a project funded by DFID on air quality management in three East African cities: Addis Ababa (Ethiopia), Kampala (Uganda) and Nairobi (Kenya). Second, a project funded by NERC that commenced on Jan. 1, 2019. The West Midlands Air Quality Improvement Programme (WM-Air) is a new initiative to support the improvement of air quality, and associated health, environmental and economic benefits, in the West Midlands.</em>
</p><p>
<em>Reposted with permission from our media associate <a href="https://theconversation.com/singapore-smoking-ban-sounds-radical-but-its-an-odd-way-to-reduce-air-pollution-109074" target="_blank">The Conversation</a>.</em>
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Jon Cartwright / Moment / Getty Images
By Yogi H. Hendlin
The two largest global brands of capsule coffee, Nespresso and Keurig, are regarded by many as environmental nightmares. Billions of the throwaway nonrecyclable plastic products currently clutter waste dumps, waterways and city streets. Both inventor of the "K-cups" John Sylvan and former Nespresso CEO Jean-Paul Gaillard have publicly bemoaned the environmental consequences of the products they once championed. Sylvan has stated that the disposable (but not biodegradable) coffee capsule is "like a cigarette for coffee, a single-serve delivery mechanism for an addictive substance."
<p>
The comparison between cigarette butts and capsule coffee is surprisingly fitting. Both butts and capsules are intentionally designed to be convenient, single-use products. Both are also nonbiodegradable and unrecyclable. As pervasive and polluting as cigarette butts are, however, the e-waste from e-cigarettes presents an even more apt comparison.
</p><p>
As a postdoctoral researcher at the Center for Tobacco Control Research and Education at the University of California, San Francisco with a background in environmental philosophy and public health, I became curious how the waste stream of e-cigarettes has passed <a href="https://doi.org/10.2105/AJPH.2018.304699" target="_blank">completely outside the regulatory radar</a>.
</p><h2>A Smoking Gun?</h2><p>
San Francisco's Pax Labs, maker of the market-leading electronic cigarette (e-cigarette) <a href="https://www.wired.com/2015/04/pax-juul-ecig/" target="_blank">Juul</a>, thinks of its product as a "Nespresso machine, if Nespresso still made great coffee." It also describes its e-cigarette as a "<a href="https://www.wired.com/2015/04/pax-juul-ecig/" target="_blank">gun</a>."
</p><p>The product has soared in popularity, particularly among teenagers. In September Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, called Juul smoking among teens an <a href="https://www.cnbc.com/2018/09/13/fda-chief-targets-juul-for-epidemic-of-teens-using-e-cigarettes.html" target="_blank">epidemic</a>.</p><p><span></span>While the health outcomes for e-cigarette vapor versus an inveterate capsule coffee drinker vary greatly, both "disruptive" products present lingering harms to the environment greater than the products they replace.<br></p><p>
The legacy of cigarette butts imparts a dark story. An estimated <a href="https://link.springer.com/article/10.1007/s40572-014-0016-x" target="_blank">two-thirds of cigarette butts are littered</a>, clogging sewer drains, blighting city parks and contributing to estimated cleanup costs of <a href="http://infohouse.p2ric.org/ref/50/49409.pdf" target="_blank">US$11 billion</a> yearly for U.S. litter alone. Cigarettes are environmentally irresponsible by design, and yet <a href="http://www.who.int/tobacco/publications/environmental-impact-overview/en/" target="_blank">e-cigarettes pose an environmental threat</a> of considerable proportions. Instead of merely being thrown away, these complex devices present simultaneously a <a href="http://linkinghub.elsevier.com/retrieve/pii/S0956053X15000884" target="_blank">biohazard risk</a> with potential high quantities of leftover or residual nicotine and an environmental health threat as littered electronic waste.
</p><p>
Their <a href="https://www.ncbi.nlm.nih.gov/pubmed/29526076" target="_blank">endocrine-disrupting plastics</a>, lithium ion batteries and electronic circuit boards require disassembly, sorting and proper further recycling and disposal. Their instructions do not say anything about disposal. Electronic waste (e-waste) already presents <a href="http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(13)70101-3/abstract" target="_blank">a daunting environmental quandary</a> and is notoriously difficult to recycle. When littered, broken devices can leach metals, battery acid and nicotine into the local environment and urban landscape.
</p><h2>A Preventable Environmental Health Disaster</h2><p>
A main question public health regulators must face is: How are these new devices being disposed of? Are e-cigarettes being thrown away carelessly, like cigarette butts? Or disposed of in special electronic waste facilities, like smartphones? Preliminary results from litter pickups give mixed results. Juul pods are found routinely littered, especially where young people congregate. But because of the double-bind of e-cigarette waste being both electronic waste due to the components and hazardous waste due to the nicotine liquid residue, <a href="http://dx.doi.org/10.1016/j.wasman.2015.02.005" target="_blank">currently there is no legal way to recycle them in the U.S.</a> The Office on Smoking and Health and the EPA need to coordinate their regulations to allow for the safe recycling and waste minimization of these products.
</p><p>
More than <a href="https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.303660" target="_blank">58 million e-cigarette products were sold in the U.S.</a> (not including those sold in vape shops or online) in 2015, 19.2 million of which were disposable e-cigarettes. A <a href="https://tobaccocontrol.bmj.com/content/23/suppl_2/ii54" target="_blank">2014 study</a> found that none of the surveyed e-cigarette packages contained disposal instructions.
</p><p>
The major transnational tobacco companies so far primarily sell throwaway, one-use <a href="http://www.ingentaconnect.com/content/trsg/trs/2017/00000003/00000003/art00008;jsessionid=lfubscfo1k9r.x-ic-live-01" target="_blank">"closed" system products</a>. Vuse and MarkTen, owned by Reynolds American and Altria, respectively, are <a href="https://www.statista.com/statistics/285116/us-e-cigarettes-companies-trend-in-market-share/" target="_blank">two leading U.S. e-cigarettes</a>, and both are closed systems. While these products may prevent nicotine poisoning in small children, their environmental health harms may be significantly larger due to their expendable design.
</p><p>
Most independent vaporizer manufacturers sell open, or reusable, systems, which are more popular with longer-term users and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992632/" target="_blank">possibly more effective to quit than traditional cigarettes</a>. In other markets, however, like the U.K. and Japan, transnational tobacco companies British American Tobacco (BAT) and Japan Tobacco International have begun to heavily market open systems.
</p><p>
BAT's <a href="https://www.govype.com/uk/disposal" target="_blank">website</a> on the disposal of their Vype e-cigarette warns "electrical waste and electronic equipment can contain hazardous substances which, if not treated properly, could lead to damage to the environment and human health." So <a href="http://dx.doi.org/10.5888/pcd13.150502" target="_blank">neither open</a> nor closed systems are environmentally sustainable.
</p><p>
The World Health Organization, in its report <a href="http://www.who.int/tobacco/publications/environmental-impact-overview/en/" target="_blank">Tobacco and Its Environmental Impact: An Overview</a>, recently noted the "quieter but shockingly widespread impacts of tobacco from an environmental perspective." <a href="http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf" target="_blank">Article 18</a> of the WHO Framework Convention on Tobacco Control states that all signatory parties "agree to have due regard to the protection of the environment and the health of persons in relation to the environment in respect of tobacco cultivation and manufacture within their respective territories." It is time to close the loop and pay increased attention to tobacco product disposal as well.
</p><p>
As regulatory agencies continue deciding how to regulate e-cigarettes, not only should the immediate health effects and secondhand effects of the products be taken into account, but I believe the <a href="https://doi.org/10.2105/AJPH.2018.304699" target="_blank">environmental effects</a> of these products should be too.
</p><p>
The <a href="https://www.npr.org/sections/thesalt/2015/01/28/379395819/coffee-horror-parody-pokes-at-environmental-absurdity-of-k-cups" target="_blank">mounting environmental impact</a> of the single-use nonrecyclable coffee fad has left coffee capsule Keurig inventor John Sylvan regretting his invention. Will apocryphal e-cigarette inventor Hon Lik ever have a similar reckoning regarding the mountains of e-cigarette e-waste? Let's hope it never gets to that point.
</p><p><em><a href="https://theconversation.com/profiles/yogi-h-hendlin-563398" target="_blank">Dr. Hendlin</a> is an environmental philosopher and public health policy researcher with over 12 years experience in tobacco control. </em></p><p>
<em>Reposted with permission from our media associate </em><em><a href="https://theconversation.com/e-cigarettes-and-a-new-threat-how-to-dispose-of-them-105096" target="_blank">The Conversation</a></em><em>.</em></p><script async="async" data-counter="https://counter.theconversation.com/content/105096/count?distributor=republish-lightbox-advanced" id="theconversation_tracker_hook" src="https://theconversation.com/javascripts/lib/content_tracker_hook.js" type="text/javascript"></script>
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