After ten years of negligence from the federal government while the e-cigarette and vape trend took off, a local community decided to act. With a 6-1-2 vote, the Dover City Council voted in favor of the Tobacco 21 (T21) ordinance to raise the legal tobacco product purchasing age to 21 on June 27, 2018.
The FDA and legislators were “asleep at the switch on this one,” said Dana Mitchell, Prevention Coordiator at Dover Youth to Youth, a youth advocacy group with a focus on alcohol and drug abuse. As the coordinator of Youth to Youth, Mitchell worked alongside members of the program to push T21 forward and get it passed in Dover.
Dover is one of the many communities nationwide that has been impacted by the rapid growth of a vaping outbreak that has been growing for a decade. Since Dover’s T21 ordinance was passed, there have been 2,290 cases of vaping product use lung injury and 47 deaths in the United States, according to the latest outbreak information from the Center for Disease Control and Prevention (CDC). 53 percent of these cases of sickness or death are of individuals of the ages 24 and under. In October, 2019, the New York Times released an article citing “ten years of federal inaction,” in the vape epidemic and details how the federal government has “repeatedly delayed or weakened efforts that could have protected teenagers.”
The focus of Dover Youth to Youth has always been exactly that - youth, which remained the focus of the T21 ordinance, Mitchell said. It wasn’t all about vaping, but the overarching issue of nicotine and tobacco products abuse, and getting those products out of the hands of the local teens.
Keene, Newmarket, Franklin and Durham have all increased the legal tobacco age to 21. Dover Youth to Youth is continuing this effort by working to bring the ordinance to the state level in New Hampshire and providing advice and support to communities who want to move on the issue.
According to Mitchell, the bill is still alive in New Hampshire Senate, and recently passed through the Commerce Committee. For now, the statewide age has been raised to 19, effective in 2020. Governor Chris Sununu was in support of that change and told the Concord Monitor in October “right now, we are focused on curtailing the surge in youth vaping.” Mitchell said taking T21 statewide and nationwide is critical and predicts that it will happen nationwide eventually. The New Hampshire Senate hearing is in January.
The federal tobacco purchasing age is 18. The Family Smoking Prevention and Control Act, signed by President Barack Obama in 2009, prevents the FDA from using its authority to raise the federal minimum age. This makes it important that T21 passes in every state so that residents can’t just cross a neighboring border and buy the products there, which would undercut the T21 effort to restrict access, Mitchell said.
According to the New Hampshire Youth Risk Behavior Survey, a study conducted by the Department of Health and Human Services (DHHS) that quantify youth use of tobacco and alcohol, the state average of high school students who had used an electronic vapor product in the last 30 days was 24 percent - close to double the national average, which was around 13 percent. The survey is taken every two years, and this data was from the most recent 2017 edition.
Vicky Harris, head of the Dover Coalition for Youth, has analyzed the survey and although the 2019 data is in, it is not yet ready to be disclosed to schools or the public. However, she was able to share what she has seen in the 2019 middle school survey, which shows that 20 percent of seventh and eighth grade students have tried some form of vape product, while nine percent have used one in the last 30 days. Alcohol has always been the most popular substance used among middle schoolers, but vaping is now the most popular for the first time ever, according to Harris.
Vaping statistics were introduced to the survey in 2015, a year in which 25 percent of students reported using a vape product. In an issue brief on youth tobacco use from the DHHS, the data shows a decline in youth cigarette use from 21 percent in 2009 to eight percent in 2017. Dover’s 2017 high school data of 14 percent aligns closer to the 2017 national vaping average. Harris said she predicts the numbers in the latest high school survey will be similar to those in the middle school survey. Although it most likely hasn’t taken over alcohol in high schools, she said she “wouldn’t be surprised if it’s close.”
Principal Peter Driscoll of Dover High School said discipline interventions regarding use of vape products have gone down since last year. He said vaping came onto the scene in 2017-18 when there were 37 suspensions - more than the previous three school years combined (12, nine, and five) - but did drop off in 2018-19 with 22.
While Driscoll said the decrease in enforcement could mean students are just being more subtle rather than vaping less, he also said he believes there is more general awareness surrounding the danger and presence of the products from both students and faculty.
Driscoll said that the emphasis should be on educating students from a young age and informing parents on the dangers of these products. He said Dover High School has been focused on making people aware of the health concerns by sharing CDC information with parents and raising awareness within the school, specifically addiction, and working with Dover Youth to Youth to promote that awareness.
The Family Smoking Prevention and Tobacco Control Act gave the FDA the power to regulate tobacco products. Due to an “intense lobbying effort” from the tobacco and e-cigarette industries, little action has been taken since 2009, according to the Times. Now ten years later, acting FDA commissioner Dr. Ned Sharpless said they should’ve acted sooner in a congressional hearing.
President Donald Trump said he was moving to ban e-cigarette flavors in September. Since then, Trump has retreated from moving forward with the ban and even stalled on a less strict one, according to the Times.
Youth access to vaping products is “creating a generation of nicotine addiction at an early age,” according to Harris, and the implementation of flavors in those products has given e- cigarettes a “crazy outrageous market” towards youth, she said. Despite the risks towards teens, the failure to take action has now extended between two different presidential campaigns, during which both campaigns failed to act due to the pressure from the tobacco and e-cigarette industries.
The issue has not stopped growing either: On November 8, the CDC announced that they found vitamin E acetate in fluid samples tested from vape-sickened patients. The CDC said, “this is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries.”
While the CDC and the FDA continue on the national front, Dover continues its own endeavor against youth nicotine use.
While it’s hard to see the direct impact of the T21 ordinance on the city of Dover, Harris said it accomplished getting the message across “that this behavior is not acceptable to youth in this community.” She said the efforts are still being made to educate the community on the dangers of these products.
For Dover Youth to Youth, January’s statewide hearing is the next step, and their effort to combat the vape outbreak continues - on their own accord.