Texas Legislature to Consider Banning E-Cigarette Sales to Minors

From The Houston Chronicle:

Legislators in Texas, one of just nine states that permit the sale of e-cigarettes to minors, will consider banning such sales amid concerns about growing use of the “safer” alternative to smoking among youth.

Even as the Texas Medical Association and Texas Public Health Coalition plan to lobby the 2015 Legislature to regulate e-cigarettes, three bills have been filed to forbid their sale to anyone under 18, a group now found to favor the battery-powered devices that turn liquid nicotine into a vapor the user inhales. The product isn’t considered harmless, particularly in young people.

“Why should it be OK for minors to buy one nicotine product and not another?” asked state Rep. Carol Alvarado, D-Houston, author of one of the bills. “I don’t know how you justify that. I don’t know how any responsible adult would justify that.”

Alvarado, who as a Houston City Council member spearheaded passage of the ordinance that bans smoking in restaurants and bars, said she’s optimistic the Legislature will pass a bill restricting the sale of e-cigarettes. The idea enjoys bipartisan support, she said, and she is not aware of any likely opposition. The other bills were filed by Sen. Juan Hinojosa, D-McAllen, and Rep. Ryan Guillen, D-Rio Grande City.

Forty-one states have prohibited e-cigarette sales to children, and the U.S. Food and Drug Administration in April proposed a federal prohibition.

$1.7 billion industry

E-cigarettes are considered less dangerous than combustible cigarettes because they deliver less nicotine, the primary addictive ingredient in tobacco, and none of the tars and carbon monoxide known to cause cancer. But the aerosol of ultra-fine particles they produce does include toxins such as formaldehyde and acetaldehyde, both carcinogens, and propylene glycol, which can cause respiratory irritation and affect the nervous system if used over a long period of time. Medical experts call for more study into e-cigarettes’ long-term effects.

Now a $1.7 billion industry, e-cigarettes have surged in popularity since they came from China as a smoking-cessation aid a few years after the turn of the 21st century. Their effectiveness has been questioned, with one review finding that smokers who used e-cigarettes were about a third less likely to quit smoking than those who didn’t use e-cigarettes. Though the matter is debated, critics contend that they are typically used instead of or in addition to conventional cigarettes, not as a transitional tool until the smoker kicks the habit.

Public health experts are most concerned about the increased use among youth. A survey released recently by the National Institute on Drug Abuse found e-cigarette use among teenagers has surpassed the use of conventional cigarettes – 17 percent of 12th-graders reported having an e-cigarette in the previous month, compared to 13.6 percent who said they’d smoked a cigarette; among 10th-graders, 16 percent reported e-cigarette use while 7 percent reported smoking; and among eighth-graders, 8.7 percent reported e-cigarette use while 4 percent reported smoking.

E-cigarettes can be purchased wherever cigarettes are sold. But they’re also sold online and at mall kiosks, where they’re more accessible to young people.

Because they contain nicotine, health officials worry that adolescent use could serve as a gateway to adult smoking.

“Kids are better off if they’re not exposed to e-cigarettes,” said Dr. Lewis Foxhall, a family medicine practitioner and vice president for health policy at the University of Texas M.D. Anderson Cancer Center. “We’re better off if we don’t get another generation of kids addicted to nicotine.”

Child-friendly packaging

Industry association leaders deny that e-cigarettes are intended to addict youth, even though the products come in all manner of seemingly child-friendly flavors, from chocolate chip cookie dough to bubble gum to cotton candy. They say such flavors are effective at curbing adult smokers’ cravings for tobacco.

Industry representatives downplay concerns, citing declining adolescent smoking trends.

“If e-cigarette use really caused kids to start smoking and there really was an alarming use of e-cigarettes by youth, we would see an increase in kids smoking, the opposite of the actual trend,” Dr. Carl Phillips, scientific director of the Smoke-Free Alternative Trade Association, said in a paper. The organization opposes FDA regulation of e-cigarettes.

But Tom Kiklas, founder of the Tobacco Vapor Electronic Cigarette Association, said he’s in favor of state bans on sales to minors. He said e-cigarettes should be considered a tobacco product.

Dr. Donald Lazarus, a Baylor College of Medicine pulmonary critical care specialist, expressed skepticism that FDA regulation would have much effect because of the agency’s “limited power to regulate things purchased over the counter.” He said state regulation may be more effective in keeping e-cigarettes away from children.

“Limiting sales of e-cigarettes to people over a certain age and requiring ID won’t fully keep them out of the hands of kids and teenagers, any more than it has tobacco and alcohol,” said Lazarus. “But those sorts of limits do set up another barrier to access for kids – and if enforcement actions target sellers rather than the kids themselves, they may cause retailers to take age restrictions for e-cigarettes and similar products more seriously.”

The planned lobbying effort by the Texas Medical Association and Texas Public Health Coalition stresses banning e-cigarette sales to minors but also includes extending state regulation of tobacco products to e-cigarettes too. Other provisions would fund research on e-cigarettes’ effects and provide for more school-based education about the effects of e-cigarettes, nicotine, tobacco, and other addictive substances.

But Dr. Eduardo Sanchez, a Texas Medical Association leader and chairman of the Texas Public Health Coalition, said prohibiting sales to minors is the most important goal.

“E-cigarettes are too easy for young people to access,” said Sanchez. “It should be just as difficult for young people to obtain and get hooked on them as combustible cigarettes.”

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