Bishara: Retail licenses limit youth tobacco use
City, county and statewide tobacco retail license ordinances have been proposed as a method to restrict youth access to products containing nicotine.
In 2018, more than 20% of high school students and over 5% of middle school students admitted to using e-cigarettes in the past 30 days, according to the National Youth Tobacco Survey. Currently, 95% of tobacco users begin using products containing nicotine before age 21.
Adolescents are more likely to become addicted to nicotine due to the powerful effect the substance has on developing brains. Adolescent users of e-cigarettes are 3.6 times more likely to use other tobacco products than nonusers.
Strong tobacco retail licensure laws have been effective nationwide in limiting youth access to tobacco and e-cigarettes. These laws work by requiring store owners to pay a license fee that renews annually, which ensures self-financing for enforcement of local regulations on the sale of nicotine products.
They also include meaningful penalties for retail violations such as fines, suspension or revoking a vendor license. These rules can be further strengthened by placing restrictions on where tobacco retailers can exist, such as proximity to schools and other vulnerable communities.
The dangers of tobacco use are well documented and undisputed. Tobacco remains one of the major causes of preventable disease, disability and death in the United States. A community with strong tobacco retail license laws can significantly reduce youth access to tobacco and e-cigarettes, which reduces a lifetime of addiction and disease.
Despite age restrictions on purchasing tobacco and nicotine products, adolescent use of e-cigarettes has reached epidemic levels. After decades of improvement in reducing use of tobacco products, e-cigarettes are addicting a new generation to nicotine.
While e-cigarettes are assumed to be safer than smoking tobacco, the long-term safety of e-cigarettes, their additives and flavorings is unknown. Vaping aerosols can contain known toxicants and cancer-causing chemicals such as aldehydes, nitrosamines and tobacco alkaloids; heavy metals such as lead, nickel and tin; and polycyclic aromatic hydrocarbons.
These chemicals are respiratory irritants that increase the risk of cough, wheeze and asthma exacerbations in users as well as increasing their risk for cancer. The epidemic of vaping associated lung injury — which likely is due to vitamin E found in some e-cigarette/vaping products — demonstrates the unknown dangers associated with e-cigarettes.
The World Health Organization says that tobacco kills up to half of its users, highlighting that safer is far different from safe.
A local community has the right and responsibility to protect its children from the addictive effects of nicotine and the lifelong health hazards and costs associated with this addiction.
The e-cigarette industry has shamelessly targeted youth groups with advertising, flavors appealing to children, and devices that make hiding their habit easy. The current restrictions are clearly ineffective in preventing youth access to tobacco and vaping products.
The Oregon Pediatric Society strongly supports the implementation of tobacco retail licenses in our state because they will decrease nicotine use in children and reduce tobacco-related diseases.
Dr. James Bishara is a pediatric cardiologist at the Oregon Health & Science University Doernbecher Children's Hospital and a member of the Oregon Pediatric Society, the state chapter of the American Academy of Pediatrics.
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