Tobacco / Vaping Discussion Guide 1. Overview

Tobacco is the leading cause of preventable death and disability in the U.S with over 480,000 deaths a year. Available tobacco products have evolved to include various smoked, smokeless and electronic (vaping) products. Preventing youth tobacco product use is critical, as nearly 9 of 10 adult tobacco users start using before the age of 18. The significant progress in reducing tobacco product use among youth in recent years has been erased due to increases in e-cigarette use among U.S. youths.

Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable are a public health “best buy” and have been shown to reduce the number of people who use tobacco as well as tobacco-related disease and deaths.

Although e-cigarettes may have the potential to reduce harm to adult smokers, they are not harmless. Tobacco use in any form, including e-cigarettes is always unsafe for youth, young adults, pregnant women and their fetuses. E-cigarettes typically contain nicotine; the Surgeon General has concluded that youth exposure to nicotine present in nearly all e-cigarettes can cause addiction and harm the developing adolescent brain. Other components of e-cigarette aerosol, including some flavorings, have been shown to be harmful. 2. Data Points

• According to the 2019 Na�onal Youth Tobacco Survey, E-cigaretes were the most commonly used tobacco product among high school students (27.5%) and middle school students (10.5%).

• More than 5 million American middle and high school students used e-cigarettes in the last 30 days • 11,700 Georgia adults die from smoking-related illness each year. • In 2018 in the U.S. 13.7 % of all adults (34 million), 15.6% of men, 12% of women were current cigarette

smokers.

3. Frequently Asked Questions: What is vaping? Vaping is the act of inhaling a vaporized aerosol from an electronic device. This heated and aerosolized liquid commonly contains nico�ne, flavoring and other addi�ves. It also can contain THC, the chemical in marijuana that makes the user feel “high” or other substances, including fentanyl. Some teens say they just vape flavors, without nicotine or THC. Is that possible? 99% of current vaping products, including 100% of Juul products contain nico�ne. And each JUUL pod contains the same amount of nico�ne as 1-2 packs of cigaretes. Plus, products labeled “nico�ne free” may contain some. THC containing vapes are readily available and widely used, o�en by teens unaware that they contain THC. Other components of vaping liquids, including flavorings alone can be harmful to the lungs How can I tell if or what kids are vaping? That’s part of the problem – it can be very hard to tell if a teen is vaping. And they can discretely vape 24 hours a day, including in class. Not only do manufacturers make discreet devices that resemble flash drives, highlighters and more, but they also do not have the same strong odor that is often a giveaway for parents and teachers. Sources: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2019. Extinguishing the Tobacco Epidemic in Georgia, Georgia Department of Public Health, Health Protection, Epidemiology, Chronic Disease, Health Behaviors and Injury Epidemiology Section, 2018. National Youth Tobacco Survey, 2019.

Tobacco / Vaping Fact Sheet for Legislators

E-cigaretes come in many shapes and sizes. They can be called

“e-cigs,” “e-hookahs,” “mods,” “pod mods” “vape pens,” “vapes,” “tank systems,” and “electronic nico�ne delivery systems (ENDS).”

Most e-cigaretes contain nico�ne, which has known health effects.

o Nico�ne is highly addic�ve, as addic�ve as heroin and cocaine.

o Adolescents are par�cularly suscep�ble to nico�ne addic�on: the majority (90%) of smokers start before the age of 18.

o Nico�ne is a health danger for pregnant women and their developing babies.

o Nico�ne can harm youth brain development, which con�nues into the early to mid-20s, nega�vely affec�ng aten�on, and learning. It also increases the risk of anxiety and depression

o Nico�ne is toxic with thousands of calls to poison control centers each year about children and adults swallowing, breathing, or absorbing e-cigarete liquid through their skin or eyes.

Use of e-cigaretes in Georgia increased with grade level.

*9th grade (20.0%) *10th grade (25.2%) *11th grade (29.8%) *12th grade (32.2%)

Among High School students in Georgia, 26.6% reported that they believed e-cigaretes are

less addic�ve than cigaretes.

Georgia does not have a comprehensive smoke-free law to protect people from secondhand smoke in all indoor areas of workplaces, restaurants, and bars.

116 out of 181 public school districts in the state have adopted tobacco-free policies.

Since 2014 University System of Georgia campuses have been 100% tobacco-free.

In FY20 Georgia allocated $1.8 million in state funds for tobacco preven�on, which is 2.8% of the Centers for Disease Control and Preven�on’s (CDC) Annual Spending Target.

Georgia loses $3.99 billion in produc�vity each year due to smoking.

Health care costs in Georgia, directly caused by smoking, amount to $3.18 billion annually.

Georgia’s Quit Line invests $1.06 per smoker; compared to the na�onal average of $2.21 per line.

Georgia is ranked 49th in the U.S. for its cigarete tax of $0.37 per pack compared to the na�onal average of $1.81. Vapor products are not currently included in the cigarete tax.

Sources are listed on the back.

Sources:

U.S. Department of Health and Human Services Centers for Disease Control and Prevention, 2019.

Extinguishing the Tobacco Epidemic in Georgia. Georgia Department of Public Health, Health Protection, Epidemiology, Chronic Disease, Health behaviors and Injury Epidemiology Section, 2018.

Truth Initiative, 2019. Tobacco in Georgia.

American Lung Association, State of Tobacco Control, 2019

TIPS ON TALKING WITH YOUR SENATOR AND REPRESENTATIVE IN PERSON

Talking to an elected official may seem intimidating at first, but it is important to remember that it is a normal part of their job. Especially if you live in their district they want to know what you think and if they can help. Below are some tips on how you can increase your effectiveness in communicating with your senator and representative with the goal of establishing a long-term relationship.

In Person

Prior to the Meeting • Do Some Homework • Try to know the basics about the topic you are going to address. Be able to articulate what

you are concerned about and why. Practice your “elevator speech” before you meet with your senator and representative or the staff member who works for them. Begin by thanking them for what they do. An “elevator speech” is a 1-2 minute speech that explains what you want and why you want it. It is called this because it needs to be very short. You may have more time to make your points, but you always need to be prepared to make your pitch quickly, especially if you are meeting them “at the ropes”.

• Call your senator’s and representative’s offices and ask to speak to your legislator. Be sure to tell them you live in the legislator’s district. If they are not available than speak with their staff member who schedules the legislator’s time. Ask them to schedule an appointment for you with the legislator on February 20th between 11:15a.m. and 12:45pm.

• Don’t feel slighted if you don’t get to speak to the legislator. Legislative staff members work very closely with the legislator and they are good allies to have.

What to Take with You

• Business Cards • The Fact Sheet for Legislators handout on your topic provided by Voices for Prevention. This

document provides the key information you want them to learn about. Give a copy to your legislator.

How to Address your Legislator: When addressing a member of the state legislature use the following protocols:

• Senator: “Senator (last name)” • Member of the House of Representatives: “Representative (last name)” • Governor: “Governor (last name)” • Lt. Governor: “Lt. Governor (last name)” • Speaker of the House: “Mr. Speaker” • Committee Chairman or Chairwoman “Chairman (last name), or Madam Chair “(last name)”

Be Personal

• Tell them a little about yourself—where you live, what you do for a living, if you are representing yourself or an organization

• Be sure to tell them that you live and/or work in their district

Refer to Fact Sheet for Legislators handout • If possible refer to at least one piece of data that will support your perspective. Select one

key piece of data that helps sell your perspective. Don’t drown them in data; your handout can provide them with additional data.

Be Focused

• Remember they have only a few minutes to spend with you so stay on topic. Also, don’t let the legislator change the subject either. Be polite, but be firm.

Be Positive

• Don’t be argumentative. You may not agree with the stand your legislator is taking on this particular issue, but it is important not to burn any bridges. Little is gained by arguing with your legislator. Mention how this issue affects children and families in their district.

• Don’t be defensive. They may ask tough questions. They are probably asking the questions that will be asked of them. Give them solid information that will help them justify why they should support your issue. Always remember that you have the right to participate in the education of your legislators.

• Remember your goal is to have a long-term relationship. You won’t always agree with your legislator. You are looking for common ground on the issues in which you are interested.

Make the Ask

• Don’t leave without asking them to support your topic. • Let them know you are always willing to help them with information any time. Ask them if they

have any questions for you. End the Meeting

• Don’t stay too long • Thank them for their time and attention

Follow-up

• Send a thank you note and anything else you promised them. • Consider inviting them to your facility or to gather with children and/or parents and/or

families you serve to let them see and hear first-hand what is needed for the community.

E-CIGARETTES SHAPED LIKE USB FLASH DRIVES:

INFORMATION FOR PARENTS, EDUCATORS,AND HEALTH CARE PROVIDERS

Electronic cigarettes (e-cigarettes) are battery-powered devices that can deliver nicotine and flavorings to the user in the form of an aerosol.

E-cigarettes come in many shapes and sizes.

WHAT’S THE BOTTOM LINE?

A new e-cigarette shaped like a USBflash drive is being used by students

in schools.

Nicotine is highly addictive and can

harm brain development,which continues until about age 25.

The use of any tobacco product

— including e-cigarettes—is

unsafe for young people.

Parents, educators, & health care providers can

help prevent and reduce the use of all

tobacco products, including e-cigarettes,

by young people.

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>> Learn HOW in this fact sheet.

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AN INCREASINGLY POPULAR E-CIGARETTE DEVICE, CALLED JUUL, IS SHAPED LIKE A USB FLASH DRIVE.

MarkTen Elite PAX EraJUUL

Use of JUUL is sometimes called “JUULing.”

JUUL’s nicotine liquid refills are called “pods.” JUUL is available in several flavors such as Cool Cucumber, Fruit Medley, Mango, and Mint.

All JUUL e-cigarettes have a high level of nicotine. According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes.

JUUL became available for sale in the United States in 2015. As of December 2017, JUUL is the top-selling e-cigarette brand in the United States.

News outlets and social media sites report widespread use of JUUL by students in schools, including in class-rooms and bathrooms.

Other devices are becoming available that look like USB flash drives. Examples include the MarkTen Elite, a nicotine delivery device, and the PAX Era, a marijuana delivery device that looks like JUUL.

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E-CIGARETTE USE IS NOT SAFE FOR YOUNG PEOPLE.

E-cigarette aerosol is not harmless. It can contain harmful ingredients. However, e-cigaretteaerosol generally contains fewer harmful chemicals than smoke from burned tobacco products,like regular cigarettes.

NICOTINE

ULTRAFINE PARTICLES

FLAVORING SUCH AS DIACETYL, A CHEMICAL LINKED TO

A SERIOUS LUNG DISEASE

CHEMICALSVOLATILE ORGANIC

COMPOUNDSHEAVY METALS SUCH AS NICKEL, TIN, AND LEAD

Most e-cigarettes contain nicotine,

which is highly addictive and can

harm brain development,

which continues until about age 25.

YOUNG PEOPLE WHO USE E-CIGARETTESMAY BE MORELIKELY TO GOON TO USEREGULARCIGARETTES.

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PARENTS, EDUCATORS, AND HEALTH CARE PROVIDERS CAN HELP PREVENT AND REDUCE THE USE OF E-CIGARETTES BY YOUNG PEOPLE.

PARENTS CAN:» Learn about the different shapes and types of

e-cigarettes and the risks of all forms ofe-cigarette use for young people.

» Talk to their children about the risks ofe-cigarette use among young people. Expressfirm expectations that their children remaintobacco-free.

» Set a positive example by being tobacco-free.

EDUCATORS CAN:» Learn about the different shapes and types

of e-cigarettes and the risks of all forms ofe-cigarette use for young people.

» Develop, implement, and enforce tobacco-freeschool policies.

» Reject youth tobacco prevention programssponsored by the tobacco industry. Theseprograms have been found to be ineffectivefor preventing youth tobacco use.

PEDIATRIC HEALTH CARE PROVIDERS CAN:

» Ask about e-cigarettes, including devicesshaped like USB flash drives, when screeningpatients for the use of any tobacco products.

» Warn patients about the risks of all forms oftobacco product use, including e-cigarettes,for young people.

PARENTS, EDUCATORS, AND

HEALTH CARE PROVIDERS CAN HELP

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THE PROBLEM Cigarette smoking remains the leading cause of preventable death and disability in the United States, despite a significant decline in the number of people who smoke. Over 16 million Americans have at least one disease caused by smoking. This amounts to $170 billion in direct medical costs that could be saved every year if we could prevent youth from starting to smoke and help every person who smokes to quit.

There is no safe level of exposure to secondhand smoke. It causes stroke, lung cancer, and coronary heart disease in adults. Georgia does not have a comprehensive smoke-free law to protect people from secondhand smoke in all indoor areas of workplaces, restaurants, and bars. However, the state has continued to identify opportunities to protect people from secondhand smoke in other locations. Upon request, the state provides research, data and analysis, and scientific consultation to communities, multiunit housing operators, hospitals, businesses, and colleges and universities that want to protect residents from secondhand smoke. Currently, five cities and one county have adopted a comprehensive smoke-free ordinance, and 33 University of Georgia campuses have adopted tobacco-free campus policies. Further, the state has partnered with the Georgia Hospital Association and now 132 hospitals are tobacco-free and 31 are smoke-free. Furthermore, these policies prohibit tobacco use at school-sponsored or school-related events both on and off campus. Currently, 116 out of 181 public school districts in the state have adopted tobacco-free school policies.

PAGE LAST UPDATED: 4/5/2019

PUBLIC HEALTH RESPONSE TO TOBACCO USE IN GEORGIA

Of adults smoked cigarettes in 2017

17.5% Adults die from smoking-related

illnesses each year

11,700 Was spent on

healthcare costs due to smoking in

2009

$3.2B

In 2017, 19.5% of US high school youth reported currently using any tobacco product, including e-cigarettes. Among US high school youth, 8.8% reportedcurrently smoking cigarettes.$1.6M

Was received from CDC for

tobacco prevention and control activities

in FY 2018

GEORGIA KEY FACTS

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CDC’s ROLE IN ADVANCING STATE TOBACCO CONTROL PROGRAMS Georgia is one of 50 states plus DC that receives funding and technical support from the Centers for Disease Control and Prevention to support comprehensive tobacco control efforts and quitlines. The Office on Smoking and Health (OSH) is the lead federal agency for comprehensive tobacco prevention and control. For decades, OSH has led public health efforts to prevent young people from using tobacco and to help all tobacco users to quit.

Incoming calls to the Georgia state quitline increased by an average 177% during the 2018 Tips® campaign. The Georgia state quitline received a total of 12,563 calls from April 23rd – October 8th

during the 2018 Tips® campaign.

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RGIA

PAGE LAST UPDATED: 4/5/2019

Tobacco prevention and control activities are a public health “best buy.” Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable have been shown to reduce the number of people who smoke, as well as tobacco-related diseases and deaths. For every dollar spent on tobacco prevention, states can reduce tobacco-related health care expenditures and hospitalizations by up to $55. The longer and more states invest, the larger the reductions in youth and adult smoking. A comprehensive statewide tobacco control program includes efforts to:

CDC’s TIPS FROM FORMER SMOKERS® (Tips®) CAMPAIGN HELPS GEORGIA SMOKERS QUIT SMOKING Despite significant progress, tobacco use remains the leading preventable cause of death and disease in the US. The good news is that 7 out of 10 smokers want to quit smoking. That is why since 2012 CDC has been educating the public about the consequences of smoking and exposure to secondhand smoke and encouraging smokers to quit through a federally funded, national tobacco education campaign, Tips From Former Smokers®. The campaign features former smokers suffering from the real consequences of smoking.

The Tips® campaign connects smokers with resources to help them quit, including a quitline number (1-800-QUIT-NOW) which routes callers to their state quitline. The Georgia quitline provides free cessation services, including counseling and medication. These services are effective in improving health outcomes and reducing healthcare costs.

GEORGIA TOBACCO PREVENTION & CONTROL PROGRAMS REDUCE HEALTHCARE COSTS

“I was thinking about relapsing today and the new commercials came on. It changed my mind real fast. You don't understand the power of these commercials until you have made the decision to quit. Terrie Hall makes me cry every time . . . that could easily be me.” – Justin: January 2016

For more information on tobacco prevention and control, visit cdc.gov/tobacco.

Protect people from secondhand smoke 1 2 3 Prevent initiation of tobacco

use especially among youth and young adults

Promote cessation and assist tobacco users to

quit

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