Philadelphia Medicine Fall/Winter 2019 - 8

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FEATURE

Stemming the Tide:

The Imperative to Act
Amid the Vaping Epidemic
By: Ryan Coffman, Manager,
Philadelphia Department of Public Health,
Tobacco Policy and Control Program

who now have difficulty getting through a school day without vaping
in the bathroom, or even their classroom, due to their intensifying
nicotine addiction. Many of these youth are not even aware that
these products contain nicotine.

n mid-September, the Centers for Disease Control and Prevention
activated their Emergency Operations Center, a center reserved
for responding to imminent public health emergencies. Since
2001, the center has responded to more than 60 serious public
health emergencies. So, what was the public health emergency that
warranted this significant response? It was not a hurricane, Zika or
even Ebola - but vaping.
The use of electronic nicotine delivery systems, or ENDS, which
are viewed as tobacco products by the Food and Drug Administration,
is also referred to as "vaping." In a matter of roughly 10 years, vaping
has gone from being regarded as a fleeting fad, to an epidemic among
youth as defined by both the FDA and the Wolf administration
here in Pennsylvania.
This epidemic is reversing years of hard-fought progress in reducing
youth tobacco use. It has produced the first increase in all tobacco
product use for middle and high school students since 2017. In
cities and suburbs around the country, vaping has produced kids
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Philadelphia Medicine : Fall/Winter 2019

As we observe rampant use of ENDS by youth, we are learning
about serious health concerns that are being reported and investigated
by both the FDA and CDC. This includes reports of seizures and
serious, sometimes fatal, cases of respiratory illness. Investigations
are underway to pinpoint the constituent or constituents responsible
for these tragic events. What is known at this point is that among
the reported case most patients had a history of using ENDS containing THC and products containing THC and nicotine. There
have been reported cases of ENDS use that just contained nicotine.
A significant number of these cases involve minors and young adults.
What has been the response of the vaping industry in the face of
such troubling information? The vaping industry is sticking to the
same talking points they have used for years. They maintain that
their products are not intended for use by minors, and that they are
a valuable tool to helping existing adult tobacco users transition to
their safer products. Let's take a moment to unpack some of these
statements.
ENDS products have not been approved by the FDA as a
smoking cessation aid. ENDS use is much more common among
youth and young adults, rather than by adults that are trying to
quit. Where studies on the use of ENDS for tobacco cessation
have been done, they have shown mixed results. Research findings
indicate that adults are more likely to develop a pattern of dual use,
where they are vaping and smoking, than to quit use of combustible
tobacco products. Vaping manufacturers claim that they are both

Philadelphia Medicine Fall/Winter 2019

Table of Contents for the Digital Edition of Philadelphia Medicine Fall/Winter 2019